Indeed, Sal—it is a sad and often really dysfunctional time. And while I've seen family members at their worst, I've also seen roles soften over time, and the siblings start working together in a productive and supportive way. So, I hope this article reaches many people who need help and that they find something useful for their situation. Thanks for your comment!
Thank for this. Super insightful and reasonated so much with my experiences as a hospice physician. I will say on the flip side it's super beautiful when you see siblings show up for each other and care for each other in incredibly loving and supportive ways
Thank you for your “likes” and comments, Charlotte. I doubly appreciate them against the experience you live daily. Your work is so important. I completely agree with you about the flip side of sibling challenges and find myself wishing only there were more of those positives. Thanks for your comment and support.
What is not discussed is the DYSFUNCTION in families. The care-taking kid should NOT be the one that asks the other kids for HELP. The parents SHOULD have discussed and established this with ALL their kids when they put their trust, will and POAs in place. If expectations are clearly defined then NONE of what is described in this article needs to happen. The dysfunction falls on the parents NOT the caretaker kid. The caretaker ends up dealing with the brunt of the dysfunction. NO one should have this DUMPED on them because it is easier for parents to do a dump rather than face the reality that they have kids that may REFUSE to help. The other issue is that the siblings can’t differentiate between helping their parent(s) vs. helping the caregiver which is where things get resentful and ugly. Helping the caregiver makes the non-caregivers have to admit they are not helping which means it is much easier for them to ignore the situation and let the one responsible caregiver deal with the DUMP and all the CRAP that comes with it like sitting in a hospital room for 80 hours per week or making a once a month trip to the ER, getting home at 1AM and then working your full time job the same day with little sleep. I have personally had to deal with one parent in a SNF and the other in the hospital at the same time. This situation went on for four weeks. My siblings would show up for an hour or two just to visit and not even offer to buy me a cup of coffee after sitting in one place or the other for 80-100 hours per week.
Sibling tension around a parent’s decline often isn’t really about who’s doing more in the present, but a collision of old family roles with a new, high-stakes medical reality. I appreciated how you name the common pattern: uncertainty + anticipatory grief + logistical pressure pushes people back into childhood dynamics (the responsible one, the fixer, the avoider, the peacemaker), and suddenly every decision feels like a referendum on love, loyalty, and fairness.
From a physician-scientist lens, it also tracks with what we see clinically: chronic stress narrows cognition, amplifies threat perception, and erodes empathy, so siblings can sincerely interpret the same situation as neglect, control, or abandonment. Your piece does a great job validating that these reactions are human, while still inviting accountability.
The most useful takeaway for me was the shift from debating intent to building structure: clarify the decision-maker (HCP/POA), translate goals-of-care into specific thresholds (“what would mom consider an acceptable outcome?”), make tasks visible, and use regular, time-limited check-ins so conflict doesn’t hijack every interaction. I’d add one practical line I use with families: “We’re all on the same team, protecting Mom’s values and dignity, even if we’re coping differently.”
This is a compassionate, concrete roadmap for families at one of their most vulnerable inflection points.
Helpful for sure. And often it's not mostly the kids but a second wife and the kids going in different directions. We younger wives may not have understand what we would be called upon to do.
This should be talked about far more openly and directly. While caregiving for my mom, I resented the hell out of my brother (her son!) and her brother. My direct requests for financial assistance and occasional relief were flatly refused. She died in 2013 with my brother never having repaid my mom’s $40,000 loan and her brother ignoring requests.
At one point, we were a week away from being homeless.
I’m now working on a historical fiction novel loosely based on my life till age 29. I’m realizing as I write that my brother and her brother were that self-centered and selfish—forever. They didn’t become that way because of mom’s dementia. I just noticed it more because the impact was so devastating.
Thanks for expanding my view of who you are and what you’re building. Congrats on the historical fiction novel that’s coming. I think it’s true that writing’s cathartic… but that’s completely separate from being comfortable or pleased with what we dig up in research, even when it’s family history. Whoever came up with “skeletons in the closet” had the right idea, I believe. I certainly have my share! Good luck with your projects.
"Caregiving doesn't create family roles: it exposes them." That's the whole piece in one line. Everything else is the proof.
The Friday Happy Hour story earns its place. Not because it's heartwarming. Because it shows what months of phone arguments can't do and one shared dinner sometimes can. The resistant sibling needed to see his mother laugh, not hear another update about her vitals.
The line that stayed: "I don't even mind doing the work. I mind that they act like it's easy." That one's going to live in someone's head for a while.
Cindy, such a succinct and compassionate article and a must read for carers of aging parents. I've seen so many cases of decades-old family fractures rearing their ugly heads when siblings are working out who and how to care for an aging parent. For primary care givers, just knowing you are dealing with siblings' old childhood dynamics can dissolve some of the tension. And, of course, these behaviours extend to what happens after a parent dies
You’re so right, Wendy — the relationships never truly become what we want or need them to be on a permanent basis, but I often find myself wanting something less and yet improved. I want to believe that some of us, as adults, can step beyond the tragedies (big and small) of our youth to bridge the divide and create something good… most especially for someone in need who’s a part of our history together. Mom, Dad, Grandparents, Aunt, Uncle, another sibling, the label doesn’t really matter. But they need help, and someone has to lead the charge, with others hopefully responding appropriately. Hope springs eternal, I guess. Thanks for understanding and letting me know you do. 💛
Great article as always, Cindy, with actionable tips.
I've witnessed this several times. I appreciate the way you've described the dynamics and offered compassionate perspectives. I'd say those dynamics also extend beyond siblings to other family members who have opinions and unsolicited advice.
I'd add a couple of additional threads of dynamics that I've seen repeatedly play out:
- the old social conditioning that the single, childfree woman will be the caregiver for parents
- cultural expectations that the woman is the caregiver in the family
These caregivers were caresplained repeatedly with little hands-on support. I know you've seen these scenarios too! These led to rifts that were too big to heal. Sometimes, creating healthy boundaries is the only way to go. It's all heartbreaking.
As an only child, caregiving has been both easier and harder.
I'm so glad you liked my newsletter, Victoria — your praise always means a lot to me. And I so agree: this does go well beyond the sibs to the far reaches of family mapping. I'm sorry to say, beyond family as well, to people who actually have no business insisting on adding their two, three, four cents or more into the mix. Everyone knows the answers to caregiving issues, whether or not they've worked a day in our shoes (and paradoxically, those with little to no experience holler the loudest). This is a book-sized topic with numerous offshoots. Maybe a new type of collaboration?? 🙄
This is so validating for anyone who’s been “the first one to see it”.
What you captured beautifully is that caregiving doesn’t create sibling conflict so much as it turns up the volume on old family roles. The responsible one becomes hyper-responsible, the avoider avoids harder, and the “controller” often reads as controlling because fear is driving the wheel. That framing alone can lower the temperature, because it helps the primary caregiver stop interpreting every disagreement as betrayal and start seeing it as coping styles colliding under pressure. 
I also appreciated how concretely you named the loneliness of “clarity”. The person noticing the repeated stories, the unopened bills, the wobble in gait… is often carrying not just tasks, but the emotional weight of being dismissed (“you worry too much”). That’s such a specific kind of grief, and it’s common.
The practical guidance is spot-on too, especially the emphasis on:
1. dividing responsibilities by strength and proximity rather than a forced 50/50,
2. making specific asks (which reduces the “I thought you had it” ambiguity),
3. and using structure/agenda when emotions are high. 
And your closing matters: “You are paying attention”. For a lot of caregivers, that sentence is the difference between spiraling into resentment and taking the next step with steadiness. 
Thanks so much, PCP, for a gracious note full of kindness about some of the smaller topics that tend to fly over the heads of many readers. You, my friend, caught every one of them and gave them weight, highlighting their part in the morass that is family caregiving and noting the impact each can have. I really appreciate your time and thoroughness—it means a lot to me.
I watched this play out when my grandmother was dying. It was gut wrenching. She had 14 kids and before she got sick the family was so close. It didn’t take long for the cracks to show. The family hasn’t been the same since.
Wow so heartbreaking ❤️ im hoping to have all lot of kids but always try to talk about my end of life care wishes and preferences (I'm a hospice doctor after all ☺️)
I really appreciate your concrete, historical example, MG, and have to say, holy cow: 14 kids! I can imagine their difficulty coming together with a plan for their mom, with all sorts of traps for disagreement and hurt feelings. And I can see why this one would be tough to heal. I'm so, so sorry this one's part of your family lore. 🤗
It was hard. I was 13 years old and I adored her so I was devastated by her illness. Watching my aunts and uncles suddenly arguing and my 50+cousins taking sides was so difficult to understand and so unnecessary.
Terribly sad & a time of family collapse
Indeed, Sal—it is a sad and often really dysfunctional time. And while I've seen family members at their worst, I've also seen roles soften over time, and the siblings start working together in a productive and supportive way. So, I hope this article reaches many people who need help and that they find something useful for their situation. Thanks for your comment!
Thank for this. Super insightful and reasonated so much with my experiences as a hospice physician. I will say on the flip side it's super beautiful when you see siblings show up for each other and care for each other in incredibly loving and supportive ways
Thank you for your “likes” and comments, Charlotte. I doubly appreciate them against the experience you live daily. Your work is so important. I completely agree with you about the flip side of sibling challenges and find myself wishing only there were more of those positives. Thanks for your comment and support.
What is not discussed is the DYSFUNCTION in families. The care-taking kid should NOT be the one that asks the other kids for HELP. The parents SHOULD have discussed and established this with ALL their kids when they put their trust, will and POAs in place. If expectations are clearly defined then NONE of what is described in this article needs to happen. The dysfunction falls on the parents NOT the caretaker kid. The caretaker ends up dealing with the brunt of the dysfunction. NO one should have this DUMPED on them because it is easier for parents to do a dump rather than face the reality that they have kids that may REFUSE to help. The other issue is that the siblings can’t differentiate between helping their parent(s) vs. helping the caregiver which is where things get resentful and ugly. Helping the caregiver makes the non-caregivers have to admit they are not helping which means it is much easier for them to ignore the situation and let the one responsible caregiver deal with the DUMP and all the CRAP that comes with it like sitting in a hospital room for 80 hours per week or making a once a month trip to the ER, getting home at 1AM and then working your full time job the same day with little sleep. I have personally had to deal with one parent in a SNF and the other in the hospital at the same time. This situation went on for four weeks. My siblings would show up for an hour or two just to visit and not even offer to buy me a cup of coffee after sitting in one place or the other for 80-100 hours per week.
I really appreciate this, thank you xx
Thanks, Elizabeth! I’m really glad you found it helpful. I appreciate your comment. 🤗
Sibling tension around a parent’s decline often isn’t really about who’s doing more in the present, but a collision of old family roles with a new, high-stakes medical reality. I appreciated how you name the common pattern: uncertainty + anticipatory grief + logistical pressure pushes people back into childhood dynamics (the responsible one, the fixer, the avoider, the peacemaker), and suddenly every decision feels like a referendum on love, loyalty, and fairness.
From a physician-scientist lens, it also tracks with what we see clinically: chronic stress narrows cognition, amplifies threat perception, and erodes empathy, so siblings can sincerely interpret the same situation as neglect, control, or abandonment. Your piece does a great job validating that these reactions are human, while still inviting accountability.
The most useful takeaway for me was the shift from debating intent to building structure: clarify the decision-maker (HCP/POA), translate goals-of-care into specific thresholds (“what would mom consider an acceptable outcome?”), make tasks visible, and use regular, time-limited check-ins so conflict doesn’t hijack every interaction. I’d add one practical line I use with families: “We’re all on the same team, protecting Mom’s values and dignity, even if we’re coping differently.”
This is a compassionate, concrete roadmap for families at one of their most vulnerable inflection points.
Helpful for sure. And often it's not mostly the kids but a second wife and the kids going in different directions. We younger wives may not have understand what we would be called upon to do.
This should be talked about far more openly and directly. While caregiving for my mom, I resented the hell out of my brother (her son!) and her brother. My direct requests for financial assistance and occasional relief were flatly refused. She died in 2013 with my brother never having repaid my mom’s $40,000 loan and her brother ignoring requests.
At one point, we were a week away from being homeless.
I’m now working on a historical fiction novel loosely based on my life till age 29. I’m realizing as I write that my brother and her brother were that self-centered and selfish—forever. They didn’t become that way because of mom’s dementia. I just noticed it more because the impact was so devastating.
Your post deserves a wider audience.
Thanks for expanding my view of who you are and what you’re building. Congrats on the historical fiction novel that’s coming. I think it’s true that writing’s cathartic… but that’s completely separate from being comfortable or pleased with what we dig up in research, even when it’s family history. Whoever came up with “skeletons in the closet” had the right idea, I believe. I certainly have my share! Good luck with your projects.
"Caregiving doesn't create family roles: it exposes them." That's the whole piece in one line. Everything else is the proof.
The Friday Happy Hour story earns its place. Not because it's heartwarming. Because it shows what months of phone arguments can't do and one shared dinner sometimes can. The resistant sibling needed to see his mother laugh, not hear another update about her vitals.
The line that stayed: "I don't even mind doing the work. I mind that they act like it's easy." That one's going to live in someone's head for a while.
Cindy, such a succinct and compassionate article and a must read for carers of aging parents. I've seen so many cases of decades-old family fractures rearing their ugly heads when siblings are working out who and how to care for an aging parent. For primary care givers, just knowing you are dealing with siblings' old childhood dynamics can dissolve some of the tension. And, of course, these behaviours extend to what happens after a parent dies
You’re so right, Wendy — the relationships never truly become what we want or need them to be on a permanent basis, but I often find myself wanting something less and yet improved. I want to believe that some of us, as adults, can step beyond the tragedies (big and small) of our youth to bridge the divide and create something good… most especially for someone in need who’s a part of our history together. Mom, Dad, Grandparents, Aunt, Uncle, another sibling, the label doesn’t really matter. But they need help, and someone has to lead the charge, with others hopefully responding appropriately. Hope springs eternal, I guess. Thanks for understanding and letting me know you do. 💛
Great article as always, Cindy, with actionable tips.
I've witnessed this several times. I appreciate the way you've described the dynamics and offered compassionate perspectives. I'd say those dynamics also extend beyond siblings to other family members who have opinions and unsolicited advice.
I'd add a couple of additional threads of dynamics that I've seen repeatedly play out:
- the old social conditioning that the single, childfree woman will be the caregiver for parents
- cultural expectations that the woman is the caregiver in the family
These caregivers were caresplained repeatedly with little hands-on support. I know you've seen these scenarios too! These led to rifts that were too big to heal. Sometimes, creating healthy boundaries is the only way to go. It's all heartbreaking.
As an only child, caregiving has been both easier and harder.
I'm so glad you liked my newsletter, Victoria — your praise always means a lot to me. And I so agree: this does go well beyond the sibs to the far reaches of family mapping. I'm sorry to say, beyond family as well, to people who actually have no business insisting on adding their two, three, four cents or more into the mix. Everyone knows the answers to caregiving issues, whether or not they've worked a day in our shoes (and paradoxically, those with little to no experience holler the loudest). This is a book-sized topic with numerous offshoots. Maybe a new type of collaboration?? 🙄
This is so validating for anyone who’s been “the first one to see it”.
What you captured beautifully is that caregiving doesn’t create sibling conflict so much as it turns up the volume on old family roles. The responsible one becomes hyper-responsible, the avoider avoids harder, and the “controller” often reads as controlling because fear is driving the wheel. That framing alone can lower the temperature, because it helps the primary caregiver stop interpreting every disagreement as betrayal and start seeing it as coping styles colliding under pressure. 
I also appreciated how concretely you named the loneliness of “clarity”. The person noticing the repeated stories, the unopened bills, the wobble in gait… is often carrying not just tasks, but the emotional weight of being dismissed (“you worry too much”). That’s such a specific kind of grief, and it’s common.
The practical guidance is spot-on too, especially the emphasis on:
1. dividing responsibilities by strength and proximity rather than a forced 50/50,
2. making specific asks (which reduces the “I thought you had it” ambiguity),
3. and using structure/agenda when emotions are high. 
And your closing matters: “You are paying attention”. For a lot of caregivers, that sentence is the difference between spiraling into resentment and taking the next step with steadiness. 
Agreed with all this!!!
Thanks so much, PCP, for a gracious note full of kindness about some of the smaller topics that tend to fly over the heads of many readers. You, my friend, caught every one of them and gave them weight, highlighting their part in the morass that is family caregiving and noting the impact each can have. I really appreciate your time and thoroughness—it means a lot to me.
I watched this play out when my grandmother was dying. It was gut wrenching. She had 14 kids and before she got sick the family was so close. It didn’t take long for the cracks to show. The family hasn’t been the same since.
Wow so heartbreaking ❤️ im hoping to have all lot of kids but always try to talk about my end of life care wishes and preferences (I'm a hospice doctor after all ☺️)
Thanks, Charlotte... you have the right key to preventing these troubles. I appreciate all you do!
I really appreciate your concrete, historical example, MG, and have to say, holy cow: 14 kids! I can imagine their difficulty coming together with a plan for their mom, with all sorts of traps for disagreement and hurt feelings. And I can see why this one would be tough to heal. I'm so, so sorry this one's part of your family lore. 🤗
It was hard. I was 13 years old and I adored her so I was devastated by her illness. Watching my aunts and uncles suddenly arguing and my 50+cousins taking sides was so difficult to understand and so unnecessary.