It’s going to happen to almost everyone: Conflicts with family in dealing with a sick and ailing parent. The parent’s illness itself may cause disagreement and strife, but this issue is best handled well before illness and disability occurs—through thoughtful discussion and careful planning. But there are other factors, dealing more with the children themselves, that complicate matters.

A family I know had vast income discrepancies among the children. The eldest, who asserted herself and coerced the ailing mother into giving her power of attorney and making her executor, got the mother to agree to give her an extra $50,000 payout at the time of the parent’s death. This obviously did not sit well with the other children. Because she had made less money than the other offspring, she thought she was somehow justified in this. The siblings disagreed, and things were unpleasant for a long time thereafter.

Another situation involved a family where the three daughters were in very different places in their lives. One had severe OCD and was in need of help herself. Another was a jet-setting Wall Street type who lived in another country and had little to do with the family. The third child lived locally with their mother and was compelled to do much of the coordinating of care and the mother’s finances. Clearly, conflicts arose regarding the role each child should or could play regarding care of the ailing mother.

These are typical examples of what can happen when rivalries, unresolved grievances and income disparities reemerge when parents get sick.

As Belinda Hulin wrote recently on, there are 3 main factors that cause problems when a parent is failing: Roles and rivalries…sharing responsibilities…and spending and needs assessments. How families deal with these issues will dictate how smoothly things will go when a parent is sick and dying.

When there is more than one child in a family, there will be more than one opinion on decisions as diverse as doctor and hospital choice…hospice or no hospice…advanced directives…power of attorney…finances…and funeral arrangements. Old rivalries are likely to emerge, and power struggles between children as well as between children and their parents will emerge.

These struggles, of course, only add to the stress of dealing with the illness at hand.

Oftentimes one child will live closer to the ailing parent than the other(s) and this will often dictate who becomes the care coordinator or even primary caretaker. Resentment over this issue can be intense and lead to further conflict and argument between the offspring.

Children often have vastly differing financial situations, and this often results in disagreement over how much money is spent—and how it is spent—for the care of the sick parent. Many children today are poised to inherit considerable funds and this possibility results, many times, in bitter disputes over spending.

What to do? There are no easy answers. One approach is to have children and their parents sit down and hash out these issues long before the need arises. Although uncomfortable and difficult to do, this approach can save a lot of headache and heartache down the line. Enlisting the help of an eldercare attorney and the family’s financial advisor can also be beneficial. Even clergy can have a role.

But communication is vital. Honest and open discussion between parents and all their children as to living wills, power of attorney, advanced directives, financial constraints and limitations, choices as to who and where healthcare will be delivered and, perhaps most importantly, the role each child will play in the process, will go a long way in making a difficult situation a bit easier.

Don’t wait until an elder parent is ill. The time to talk is now.

For more with Dr. Sherer, click here for his podcast and video interviews, or purchase his memoir, The House of Black and White: My Life with and Search for Louise Johnson Morris.

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