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My parents moved to be close to me eight years ago when they were in their mid eighties and moved into an independent living facility. I have two sisters whom I talk to often, but who live several hours away.

Everything went very smoothly, for the first five years. However, their health has declined a lot and they now reside in the assisted living section of the facility where they require considerable additional help and services. There isn’t a day when there isn’t a “crisis du jour.”  

My siblings visit a few times a year, but they seem to come for  “vacation” and when they leave I am more frazzled then before they came. It would be so much better if they came to help me and to give me a break.  I don’t seem to be able to get the message across. What can I do to get them to pitch in and give me some relief?  JoAnn G., Boca Raton, FL

It’s not unusual for one sibling to shoulder most of the responsibilities of caring for their aging parents. Often it’s because he or she lives closest to where the parents reside or has the most available time to devote to their ongoing care. But as you have learned, it can leave you feeling unappreciated and unsupported by those closest to you.

I have a hunch that because of your competence and generosity towards your parents, you might not have communicated to your sisters just how challenging the situation has become for your parents, now in their 90s, and for you, their primary caregiver.

Your sisters may also believe, mistakenly, that because your parents are residing in an assisted living facility that most, if not all of their physical needs are being met. Melissa A Friedman a psychologist at Mt. Sinai Medical Center in South Miami told me that she has observed this same dynamic in many other families and offered this advice;

"Be mindful of the perception you are giving your siblings.  For instance, you may be giving them the impression that you are fully in control of matters, organized, and comfortable with your role as the primary caregiver.  They may not know how unhappy, tired, or in need of help you are."

If they’re unable to pitch in on a regular basis, their visits should be able to relieve you of some responsibilities and give you a much needed break. Here is some further advice from Dr. Friedman on how to better communicate with your sisters:

“It’s great that your sisters come to visit a few times a year, but it’s important that you communicate clearly that you would like them to do tasks or activities, to give you relief from the caregiver role. Don’t assume they know what you are expecting or wanting. 

Better yet, ask them if they’d be willing to make a plan for their visit, which will enable them to supervise or monitor your parents’ care during their visit. Then firm up the plan and obtain each others’ formal agreement to it.”

There’s a good chance that your sisters will appreciate your taking the lead in involving them in your parents’ care, and they might even surprise you by making more frequent and longer visits in order to make a real difference to your parents and to you.