MGordon_MD
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May 8, 2009, 1:34 PM
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By Dr. Michael Gordon
It’s a familiar theme. When I speak to a child of one of my patients, he or she will mention the other siblings who live “away.”
It is a common phenomenon in North America that we have become increasingly mobile, and families often separate over the years. I am one of those children who have lived far away from my parents and sister most of my life: first during my studies in Scotland, then during my internship and residencies in Boston and Montreal, and then during my four years living in Israel.
When I settled in Toronto, my parents were relieved that they were only a 10- or 12-hour drive away, and about the same distance from my sister, who lived in Chicago.
As each of my parents declined in health over the years, the distance became more burdensome. After my mother’s death, my father was alone in Brooklyn and gradually failing. My sister and I did our best to attend to his needs. Ultimately, however, it became clear that a move to be close to one of us was necessary. He chose Chicago.
Since then, my sister has been the “it” sibling assuming the role of primary care provider, and I am the back-seat quarterback, trying to be available for advice and input, as well as periodic social visits and occasional urgent health-related trips.
In one of my clinics, I had two occasions where the “it” daughter expressed frustration at having her distant-but-loving siblings trying to second-guess and often be critical of her decision-making.
In one case, it was a brother and in the other a sister, who, away from the cauldron of challenge, potential conflicts and enormous calls on time and energy, were quite critical – and in one instance dismissive – of the “it” sibling’s decisions about care arrangements.
“My sister thinks I’m exaggerating. She doesn’t believe mom is at risk living alone and says I should just tell her to stop calling me 10 times a day. She saw her about seven months ago on a weekend visit and thought she was just fine – maybe a little repetitive, but that did not impress her as meaning anything serious. She could not understand that mom would call 10 minutes after a phone conversation and ask the same question, sometimes five times in an hour.”
The other complaint I heard was similar: “My brother does not think mom has dementia. He does not like me even to mention the word. He keeps telling me I have to find better ways to cope. I am struggling with my own family, two teenaged children and my husband who has been ill, and my brother and sister are happy to call and be critical of everything I do.”
This scenario is very common, and I recall being in situations where as my sister described what she was contending with, I could see myself slipping into my “expert” role and trying to give advice that was, in fact, off base, as I was hundreds of miles away. I learned that when advice was sought, I would give it, but always frame it as an affirmation of who she was, what her commitment and role were, and how being the “it” caregiver, her perspective was the most important one.
In practice, I always try to offer to meet with siblings who are out of town, to help resolve conflict and focus the family’s efforts on their parent’s primary care provider and treat their sister or brother with respect. Children who live at a distance must find ways to support siblings who are carrying out the family’s collective responsibility, especially when they are playing their role in long-distance mode.
This article originally appeared in The Canadian Jewish News
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Dr. Michael Gordon is Medical Program Director, Palliative Care Baycrest Geriatric Health Care System in Toronto, Canada and Professor of Medicine, at the University of Toronto. He is co-author with Bart Mindszenthy of Parenting Your Parents.
Parenting Your Parents is available in bookstores and online at: Indigo-Chapters, Amazon and Barnes & Noble. It is available in a US edition: Parenting Your Parents: Support Strategies for Meeting the Challenge of Aging in America.
For bulk orders email info@dundurn.com. Call: 416-214-5544 or Fax: 416-214-5556
Dr. Gordon is the author of the engaging memoir Brooklyn Beginnings: A Geriatrician's Odyssey, published by I-Universe.
Brooklyn Beginnings is available in bookstores and online at: Indigo-Chapters, Amazon.ca, Amazon.com, Barnes and Noble and I-Universe
Visit Dr. Michael Gordon's website.
(This post was edited by MGordon_MD on Jun 11, 2009, 9:55 AM)
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