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CynthiaM Asked July 2018

Setting up an agenda in preparation for our first family meeting among 8 siblings. Any guidance?

Hi everyone. I stopped working with home health care agencies 5 1/2 years ago to help care for my father. He's gone and I'm now helping care for our mother. I have 5 brothers and 2 sisters. My closest sibling, Susan, has moved in with our mother. She being single and able to work from home is a slam dunk to helping our mother and her staying at home.


She had a bad fall earlier this month-- so this has triggered the need of informing the family and beginning of all around family communication in helping my sister and I and yes, our mother. The difficult issue is that my mother is a private person and doesn't want anyone knowing her business. UGH!


Everything has started to snowball.. meaning 2 of my brother's spouses have texted each other about my mother's fall. UGH(again).


I'm seeking out counsel about having a family meeting. This meeting is for the purpose of caring for my mother and helping out the main caregiver - my sister living with my mother. My purpose is supporting and helping my mother and sister.


I have knowledge, but am asking for guidance, simple answers ie) why my siblings spouses are not to attend the actual meeting, and your prayers.


Our elderly need best care possible while maintaining their independence and dignity- this is a monumental task when it's your own mother of 8 kids.


Much appreciated ahead of time for your personal counsel!

imoekaye Jul 2018
Hi Cynthia. I have quite a bit of experience in this area as I’m the middle of 9 children and was part of our mother’s care for many years until she passed a few years ago. There were several of us kids that lived close by to her - she lived with my second eldest brother. At times and especially in the beginning of her needing care, it was challenging - so many opinions and often conflicting. What eventually worked well for us was the brother (#2) & his wife whom she lived with, primarily made her appointments and 2 of us - myself and brother #8 worked together to get her to/from her appts and would report to brother #2 & wife. The three of us siblings consulted often and between us 3, made the decisions. The others (who either lived far away or were very busy with life/families) were informed but not included in the decision making process unless it was as critical issue. In-law’s were not allowed in this process with the exception of brother #2’s wife who played a significant roll in her care & decisions as she was really, mom’s number one care taker (bless her heart!) it took a little while for some sibs to settle in and trust that mom was well taken care of but things settled in and this arrangement was finally agreeable to all. It’s important to find what works best for your sister who is your mom’s primary caregiver as she will need all the support she can get. Also, your mom needs to know (and experience) all the kids working in harmony. Otherwise, it will have a real negative impact on your mom - emotionally and physically. I hope this helps and best wishes to all your family at this difficult juncture.

PrairieLake Jul 2018
We had a meeting this spring and 5 of 7 siblings were able to make it. I called an elder law attorney and made an appointment. We all love each other and get along. But without an objective third party, I am sure nothing would have gotten done. The attorney even said “Stop it!” at one point when there were side conversations going on.
He told us what we should be focusing on, and what problems to let go. Since my Dad had been recently dx with vascular dementia and was very difficult to handle, he did not come to the meeting.

We we were able to get the process going, all had the same knowledge, and got our questions answered.
It hasn’t been all smooth sailing, but without the third party running the meeting, we would not have accomplished anything.

I think if you go into the meeting expecting everyone to help equally, you are going to run into a lot of anger and resentment. Some people just cannot be caregivers, and guilting them into that situation will create a bigger problem.

We we decided there would be no guilt put on anyone. 4 of the siblings had been dealing with Dad and his drama and craziness for 40 years.
Everyone had to be free to decide if they could do anything at all.

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anonymous594015 Jul 2018
I think it is a mistake to think that you will protect your mother's privacy better by leaving your brothers' wives out of the meeting. Do you think your brothers won't discuss their mother with their wives?

I heard a statistic that people who have four or more daughters and/or daughters-in-law are less likely to need nursing home care. Now this was about ten years ago, so maybe many more men are stepping up and providing the kind of care that keeps one from going to the nursing home. But that is not the experience I have or have seen in the families of my friends.

But maybe you and your sister do not want anyone else providing hands on care. You said the meeting was to design ways to support your sister. I wish you the best of luck. If you are asking your brothers for their time, or their money, they are most probably going to need to discuss it with their wives. You may get more cooperation from the wives if you haven't made them feel as though they are not part of your family.

rocketjcat Jul 2018
Not sure why you want to exclude the SILs from the meeting? If you are just trying to control the scope or duration of the meeting, I’m not sure that’s the best tactic. Your brothers are definitely going to discuss the meeting with their wives, as they should. Especially if time or money commitment is your goal. The thing is, my DH has no clue what would be involved in caregiving, and he’s not really comfortable discussing it. Leaving me, his wife, out of a meeting like that wouldn’t be beneficial toward your goals, and getting something accomplished right there at the meeting. And he would clear time or $$ with me before committing anyway, and your brothers might too.

So how can you control the scope and duration of the meeting with everyone there? I would suggest approaching this just like I would hold a meeting at work, and collaborate with your sister to develop a good agenda:
1- Have your sister detail the current state: what does she (and you perhaps) do for your Mom on a daily basis. Hygiene, feeding, dressing, shopping, cleaning, whatever. How much do these services cost your sister? Cost your mom? Is money a problem? Who has POA? Can she show a current budget with expenses if asked? Is your Mom happy? Is sister happy? Is she healthy and thriving? How is the current state working out for her?
2- What does your sister need help with right now? Money? Respite? Someone to handle dr appts? Shopping? Appointments? Ideas?
3- What do you see as your Moms future needs? More help at home? Assisted living? Nursing home? Medicaid? When do you see these changes happening? Timetable? What will she need to make that happen?

If she can can develop an agenda and stick to it, you both might get the most out of a meeting with the entire family.

Isthisrealyreal Jul 2018
You are asking for contention by excluding spouses, they are a team and anything they do for you, your sister or their mom will have an impact on their homes and families.

Your mom is private, okay, tell them no Facebook postings and ask for discretion as mom doesn't want everyone to know her personal business. Mom doesn't need to know what they know.

I would never interfere with my husband and his helping his family, but I would think you were trying to create a separation and I would think you had a lot of nerve to try and separate us.

Let them come if they choose, open the meeting with some ground rules about privacy and deal with things as they come up, alot of "what ifs" never materialize.

Hard feelings last a long time, please try to avoid creating any with your siblings spouses. The wives may be more hands on help then your brothers, so you could essentially be cutting your helpers in half.

richamj Jul 2018
My biggest piece of advice is to bring in a professional to mediate the meeting. A professional can keep the meeting on track, redirect if things start to devolve or if old wounds/resentments get brought up. A professional can also be an objective, third-party person to hear all sides and try to combine everyone's input into a plan that is the best compromise if there are differing views. In order to find someone to mediate, you could contact your local Area Agency on Aging to see if they can direct you to someone--such as a professional mediation business, social worker, family counselor, or even sometimes a spiritual leader like a minister/pastor/etc.

Gardens Jul 2018
Cynthia,

You are being so mindful in managing your mom’s care. You will surely do well by her. 

Because she is your mother, it is natural that first responses, from everyone, will be emotional.  Care decisions also involve money, which can be a difficult issue to discuss openly with family, and when in-laws/spouses are affected. 

Your siblings will want to know details of mom’s fall and be ready to jump into decisions. 

But, I suggest that you begin the meeting by getting agreement on one thing first- 

This is everyone’s mom, and everyone’s thoughts will be heard without interruption.

Then, come to agreement on what your collective goals are for mom’s care. 

This means everyone must be given a chance to speak, and someone must write down the key words that are said. 

It would be wonderful if you could ask your Mom ahead of time what she wants for herself so it can be shared with everyone and included.

The list is then prioritized by the group and the group should agree that the list will guide the decisions you make going forward. 

The list might look like - 

Our goals are that Mom will...
BE SAFE from harm. 
BE FREE FROM PAIN
PARTICIPATE IN DECISIONS about her care as long as she is able. 
LIVE AT HOME with family for as long as physically or financially possible. 
BE SUPPORTED IN DOING things she loves for as long as possible. 
NOT HAVE HER AFFAIRS discussed with spouses or other relatives. 

When emotionally, morally or financially difficult decisions arise, the list will be your True North. When disagreements arise, your list will be a reminder of what your agreed upon goals are for mom (not for the group), and what mom wants for herself.

There may come a time when you cannot provide or meet every goal on your list. But, if you’re still meeting the higher priority goals, you will find reassurance that your decisions are in her best interests. 

Once you have your list, ask family to allow you, without interruption, to explain the current situation. You’ll be starting from a place of agreement and focused on agreed upon goals, which more empowering to everyone.

Later, I suggest that you share the list with everyone in writing, and bring it to any future meetings (along with a POLST or Advance Care Directive if Mom has them) where it can be visible - not as “rules” but, as a reminder of what you collectively want most for your mom. 

Lastly, if Mom does not have a Power of Attorney named for 1) financial and 2) healthcare decisions, it would be important to have her do this now. Then, you will all understand who has the legal authority to carry out decisions on mom’s behalf. 

Good luck! Your mom is so fortunate to have you.

Tothill Jul 2018
We are a much smaller family. I no longer have a spouse, my brother is married to a doctor. Db has all POA.

My former mil has 2 sons, only her dils have ever done anything at all for her.

i cannot imagine not including the spouses of your siblings in the meeting. More so if they have been part of the family for many years. They could well be your biggest supporters.

I do not understand the concern about sils texting each other about your mother’s fall. Of course they should be included in the phone tree. Or do you expect your brothers to not share with their wives? Are you married?

ChiGirl68 Jul 2018
As a business owner who has worked form home for seventeen years, I saw a red flag when I saw that your sister will be caring for your mother and works from home. I will say that, when my mom fell in December and suddenly became an invalid, my first thought was to move in with her and care for her since I work from home and it would be "easy" for me to do this. I don't know what state your mom is in or what kind of personality she has, but this situation soon became a nightmare. I was at her beck and call 24 hours a day and I almost went out of business because I simply could not work. I don't want seem to be negative, but maybe be sure to discuss this at the family meeting: that this is definitely a trial run and also, your sister is going to need someone every day for a few hours to completely take over. Also, many people on here have found out the hard way that there has to be a caregiver agreement--done very legally, notarized, etc--and your sister should be compensated by your mom for her care. Good luck. I am in awe that your family is even agreeing to this. I finally walked away from my mother and brother earlier this week because I've given everything for twenty years and my mom would not even give me shared power of attorney for her medical care while my brother was cutting me off from talking to her doctors. Things can get ugly fast. I hope you can all work things out! xoxo

partsmom Jul 2018
This was a number of years ago, but my MIL was diagnosed with lung cancer and was in and out of hospitals and various homes for her last year, most of her time she was at our house (my husband was the oldest son and had been pretty much the one everybody depended on for years). My FIL had heart issues and mild Parkinsons, so was pretty much useless, and they didn't get along well. She had ten children, one of whom lived out of the country. We found out as we worked through the situation was that the oldest daughter and two DIL's wound up taking care of her. She was no longer able to keep up her house, so her youngest daughter lived there (whole different story). Part of the problem was that most of the daughters were emotionally unable to deal with her decline in health. We did have a daytime caregiver through the county who was really good when she was at our house, as both my husband and I were dealing with our own business during the day, but one or the other of us could get loose for part of the day occasionally. There was no money available; she was on SSI and they got minimum Social Security and Medicare and Medicaid, and the oldest son and daughter took care of whatever came up, and the youngest son and his wife took her at the end, as she was home during the day with her kids. (BTW, her kids and our kids were a lot of help, just fetching things and doing simple care.)

In our case, the family dynamics were such that a family meeting would have been a disaster; the emotional issues were too much. (It took that whole year to work it all out, but at the end of the year everybody was speaking to everybody, which was a miracle.)
Families are all different, with different dynamics. What might seem logical on the surface might not work at all, especially with large families with their own histories.

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