Cathy Cress

Expert in Aging Life and Geriatric Care Management

Who Should Attend a Sibling Family Meeting About End of Life Issues?

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Who Should Attend a Family Meeting About End of Life Issues?

Ø A professional mediator if you are a dysfunctional family.See below for the red flags of the dysfunctional family:

§ You actively compound already difficult decisions with intractable, interpersonal conflict

§ You create additional problems independent of the decision that brought you together in the first place

§ You pit themselves against one another

§ Family members assume they are right (and the others are wrong)

§ You assume the roles of adversaries in their individual quests to solve the problem

 

Ø A facilitator if you are a nearly normal family. See below for the red flags of the nearly normal family:

§ You Communicate well enough

§ You accept differences of opinion as inevitable and an opportunity for more effective decision-making

§ You lock arms to address the problems they encounter.

 

Ø The older parent, if they are  mentally competent and can sit through the meeting. If he or she cannot attend, due to health probelms,let him or her know who has been invited and  what you plan to discuss. If he or she cannot attend, report back to him or her right away about the meeting. This keeps the control with the patient where it belongs. It is after all their life being discussed. If the elderly parent can’t attend, then the person most familiar with the needs of dying person should attend

Ø The power of attorney for health care, (if there is one) who is the health care agent and who carries out the advanced directive parent’s wishes and makes health care decisions if they are incapacitated

Ø All adult siblings

Ø A representative from( a case manager or medical social worker) Hospice if Hospice is involved

Ø A geriatric care manager if one is involved

 

Do You Compare Siblings in Your Young Family?

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Don’t make comparisons between two siblings. It can set up sibling rivalry in the future and cause parents unnecessarily worry in the present. My daughter Kali has twin boys and they are developing at different rates. They both crawled and walked around the same age but one twin talks a mile a minute and the other does not talk. This has caused parental anxiety that is not necessary, as a speech therapist told Kali. The talking twin is talking for the non-talking twin. He just needs more one to one time and some exercises that the therapist showed Kali and her husband.

 

But in the future, as siblings age, these comparisons of this can leaded to sibling wars 40 years in the future. Parent’s recall and say out loud, who got the first tooth, who walked first, who rode a bike first or who did better in school -subconsciously pitting siblings against each other.

 

As siblings grow up and reach midlife, after they have raised their own families, baby boomer siblings’ come back together. Midlife siblings celebrate family rituals, socialize together and critically care for aging parents. Deep-rooted sibling rivalry from early comparisons between siblings can cause estrangement begun in early childhood. Deep down in the sibling psyche, these feelings of sibling rivalry have sprung from comparisons the parents made decades ago.

For anyone who has read East of Eden, or seen the iconic James Dean film you say see the brutal battles that play out later in life from early sibling comparisons. This unintended consequence of early parenting creates alienated siblings who can’t form that sibling team to socialize together or work as a team to manage aging parental care.

So calm your parental present and give your young siblings a future without sibling’s rivalry- don’t make comparisons.

 

 

Why have a sibling family meeting about end of life issues?

 

 

Life-threatening illness ratchets up stress on midlife siblings caring for an aging parent. Sibling family meetings about end of life issues are a great tool to discuss the eventual or imminent death of aging parents. They can be used to establish a safe environment where plans, decisions, conflicts, and grief issues can be discussed honestly and openly. Family-centered care, which is what midlife siblings want to offer an aging parent, is an integral part sibling family care at end of life. The overall goal of a sibling family meeting about end-of-life care is to coalesce or enhance supportive communication, and family functioning and carry out a parent’s wishes about death

Family dynamics and functions can be improved by a siblings family meeting about end of life through:

· Promotion of cohesiveness

· Reduction of midlife sibling conflict

· Encouragement to share thoughts and feelings with each other

· Promotion of “cooperation and communication among family members in decision making”

Integral to this process is the sharing together of family grief if the parent is at the end of life or fear of end of life .If the family meeting is preemptive it also a way to make a preventative plan about family roles and responsibilities at end of life for a parent.

It’s important to realize that discussions involving end of life decisions can take be quite lengthy, can involve numerous family members, including midlife siblings in a series of meetings spaced over time.

 

In future blogs I will cover who should attend these type of family meeting and how to do an agenda.
For more information check out by book Care Manager’s Working With the Aging Family, Jones and Bartlett 2009 Gwendolyn Lazo Harris MA, CT and Diane Le Van, MA, Gerontologist, wrote an excellent chapter entitles Dying Grief and Burial in the Aging Family

 

Are Midlife Step or Half Siblings Coming To Labor Day Barbecue- Here’s a Plan

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Are your midlife  stepsiblings or half siblings going to be at the coming Labor Day barbecue? Maybe you expect acid reflux from the hot sauce that parental  divorce dribbles on family celebrations.

 

Rituals like Labor Day events are the glue that bond family life. They patch up family and sibling disputes and give us the architecture of a year full of celebrations marking family history. Rituals are the touchstones for rites and family passages and keep us gathering over and over again to celebrate and observe those landmarks. Rituals also give form to every day we spend and are the counterpoints of the turning clock when the family can gather and talk, share and gossip.

 

But the tidal wave of divorce among baby boomers and Generation X brought step siblings with old grudges, half siblings who lost family love, ½ their rooms, and gained a shredded family nest. Now the family does not know who it’s members really are and rituals like labor day – can turn into a nightmare.

 

This is true especially for aging parents, who may be at the labor day event, don’t need the drama and will need all of you to be a family team when they need care as they decline.

Here are some tips to include everyone including step siblings and half siblings

 

Call everyone ahead of time . Invite them and ask everyone to bring a dish. That is the beginning of building a family team- sharing

Don’t make this a family meeting where old sibling grudges get hashed out. Celebrations are just that. If someone pushes you button, keep that angry response to yourself and maybe arrange a future family meeting.

Family meetings can be planned post labor day with a geriatric care manager or a mediator’s help.

Reinvent your labor day get-together through a new twist that really makes an effort to includes step and half siblings and glue that jagged bond. Create activities that everyone can join -– blood, step, or half siblings.

 

Check ahead and find out what everyone likes to do. If they are step kids or stepsiblings make sure you have fun things to do ahead of time that they enjoy. Make sure everyone is an included, especially new member of the family like young stepsiblings who may feel like third wheels in your clan. If they have a difficult time blending (most do) – reach out to make them part of the group. Understand their reluctance to join an existing blood family where they have bloody history or a nasty Cinderella nightmare tale. Bring them up to the top floor of the castle.

Gathering for ritual occasions like labor day or any holidays, allows you to spend time together as a family and gives kids their siblings the tools to solve problems, negotiate and compromise and learn the skills of working together as a group.

 

Ritual gatherings with step half and blood siblings can build those bonds, so future sibling, ” I Hate You stories”, are not created in the here and now whether siblings are is half, blood, or step.

 

Parenting Twins- You Need Father’s More

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Young families today need to involve Dad’s more my daughter Kali and husband Dan have 14-month-old twin boys , born here in Redondo Beach (LA), Ca. . So I would like to dedicate this blog to Dad’s of twins and offer a few important things that Dad’s need to do to support twin siblings.

To say the least –if you are the father of twins, you need to give to extra support to your wife- much   more than you do with the birth of a single baby. Raising twins is grueling all along the way to maybe ages two or three – 24/ 7 with two babies, two feedings, two diaperings huge loads of laundry and two exhausted parents. After three I suspect there are new overwhelming duties to divide.

Twins, turn your life upside down. If you are or your wife are type a -get ready to switch to type C or D. Twins hit your house like an earthquake.

 

Through tension and fog of bleary-eyed stress- there is a very good rule of thumb for Dad’s of twins.  Both the Dad and Mom must show respect for each other, remember they love each other and work as a team.

 

My daughter and her husband Dan play tag team with their twins Dylan and Liam.

Kali works all-day and so does Dan. They have a nanny three days and family coverage on other days as the Murphy family lives nearby. My husband is also here for two months this summer and I come down every 10 days from Santa Cruz, Ca.

 

Both Dan and Kali care for the twins as soon as they get comes from work, because it takes a parent team to get dinner, play, bathe and get two babies to sleep. Dan reads them to sleep every night with Mark Twain’s Tom Sawyer. I love that.

 

Both Mom and Dad get up at night as needed. You need 4 arms to manage twins at this stage.  Both Dan and Kali put those schedules together as a team and change them together as more or less family is available.

 

Now that’s just if you simply have twins.  In spite of the tsunami that has hit your life, if you have new twins, plus other kids, you as a Dad have to offer the whole young family, a secure. nurturing environment.

 

It can test any relationship to the limit. So Dad’s need to keep romance alive and strengthen their relationship as a couple by keeping channels of communication open through all the stress. Children learn from this openness and gain respect for themselves and others by the way their parents interact. My husband and I are babysitting tonight so the parent’s can go to a much-needed party.

 

So involve Dad’s more especially new Dads of twin siblings and congratulations to my son in law Dan for being such a wonderful new Dad.

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