04/03/2010 05:12 am ET | Updated Nov 17, 2011

Supporting Elderly Parents: Adult Children And The Emerging Care Crisis

When my parents got old, my sister was the one helping them. I was really clueless about what was expected of me. I thought I'd escaped my family. Silly me. I had no idea that a new life-crisis was coming and that one way or another, my family would ambush me with my oldest, deepest feelings.

When I say, "escaped," I mean that I moved two hours away, called on Sundays and visited every few months. It was hard being around my mother's criticisms and demands, my sweet father's taking it all, and my sister's resentment. Most of all, it was hard to be me when I was around them, bristling at my mother's every word, walling off the fear she aroused that who I was just wasn't okay.

When my mother finally died after a year in a nursing home, I watched my father and my sister weep and hold each other up, and I was pierced to the core. I suddenly understood what an ordeal they'd been through without any support from me. I also felt like a stranger and outcast--a searing desolation which stripped away my self-deception about being "free" of my family.

How could I have gotten it so wrong? Me, who was so tuned in to my own and others' feelings! I did a lot of soul-searching, struggling to understand why I'd behaved as I had. As a writer for Time magazine on the boomer beat, I also noticed other siblings wrestling with similar issues. Not surprising if you look at the latest stats: about 43.5 million people taking care of their parents, 85 percent of them with siblings, but a majority claim they do it alone. Even among those who get help, 91 percent say the job is not shared equally. Just ask anyone with an aging parent about their siblings. Some will say their siblings are a godsend, but others will roll their eyes, laugh bleakly or start to rant. Inevitably they will say: "Oh, boy, do I have a story for you!"

It wasn't just the numbers that got me started on what became my book. It was my raw feelings and the anguish and fury I saw in the people who wrote to me at my "Ask Francine" column or the siblings I interviewed for a story I wrote on sibling conflict over parent-care: "Who Cares More for Mom?" This piece was something I wrote as much to help myself as anyone. I interviewed as many people as I could find--and when possible, their siblings. I became convinced that rarely was one sibling completely "right" and the others all "wrong."

I talked to experts of every kind--family therapists, geriatric care managers, elder attorneys, you name it--and the more I learned about the emotional side--the psychology--of siblings dealing with their parents and each other, the more I saw the subject was huge and would take a book. That's how I wrote They're Your Parents, Too! Just in time, it seems. Whenever I tell people what my book is about, I see an instant gleam of recognition.

Our generation of siblings is caught up in a kind of perfect storm, with every social, historical and psychological force converging to suck families into an emotional tornado. Our parents are living decades longer with chronic illnesses while the revolutions that started with boomers--more education, geographic mobility, women working, complicated family structures--have created a caregiver shortage. You can read everyday about the caregiving burden, the sandwich generation, the dilemmas of medical care and cost, but what nobody was talking about, what was under the surface of the headlines, was a new life-crisis --for the family we grew up in and for everybody in it. Trust me, it can be explosive.

Think about it. Our original family, which had a way of working when we were kids, with each person playing certain roles, well...that family hasn't interacted intimately for 30 or 40 years. Some people are missing; others are changed. How are we supposed to work together now?

If all this weren't enough, each of us siblings is going through our own developmental crisis, watching our parents fade and die--and being confronted up close and personal with our own mortality. On one level we may act more maturely than ever before; on another, we can feel like five-year-olds whose Mommy is about to evaporate in a puff of smoke. Feelings can spiral out of control. All the old stuff bubbles up: ferocious sibling rivalries, often disguised as disagreements about a parent's care or housing. Old family beliefs and ways of talking (or not talking) create misunderstanding, gridlock, and conflict. Fantasies about how we want our siblings to be collide with the reality of who they are, with disappointment, loneliness and rage often overwhelming rational thought. Different facets of this journey with our parents set off different flashpoints: caregiving, powers of attorney, dementia, end-of-life decisions, death, mourning, inheritance. I devote whole chapters of They're Your Parents, Too! to each of these crises, what they bring up, and how to deal with them.

Everything I learned helped me with my own family--better late than never, I guess. Immediately after my mother's death, I became more present for my father. My sister was so furious with me then that no peace was possible. But the more I learned from other families, the more I understood her sense of abandonment in dealing with my parents' ordeal alone. I wished I'd been able to give her emotional support, at the least, been a little more the sister she yearned for. I also understood that family dynamics are very complicated, and that what happened with us was way bigger than my own mistakes. Still, I regretted my part, very much, and about a year after my father's death, I made my sister a profound apology, which she accepted. And so, in our imperfect way, we are now connected as the top generation of our family--and even manage to laugh now and then over some long-ago family foibles and comic mishaps that we are the only ones who share.