One Sibling Shouldn't Have to Carry It All

When Mom or Dad Needs Help…

By Kim Brant-Lucich and Alexander Nury, authors of Survival Guide to Caring for Aging Parents

I want to talk about something that happens in almost every family eventually — and that almost no family is prepared for.

Mom falls down. Dad is diagnosed with an illness. Maybe there are no dramatic events at all, but there is a steady increase in phone calls asking for advice or assistance, or your parent becomes more and more confused over time. It becomes clear that your parent needs more than occasional checking in with you or your siblings. They need real ongoing assistance.

And in that moment, one of the most overlooked, albeit important questions a family can face surfaces quietly, even imperceptibly: Who is going to do this? Who is going to pay for this?

The Sibling Who Lives Closest Gets Volunteered (or is it Voluntold?)

First, one sibling starts to do more, typically the sibling who lives closest. As time goes by, they begin to do more and more. When multiple siblings live close, it seems to fall to the sibling with the more flexible job, or the historically responsible sibling. No one really talks about it, and it is often too late by the time it is finally discussed. The other siblings intend to be there for their brother or sister, but are preoccupied with their own lives, and don’t want to be bothered with the details, even though things may not be that bad … yet.

The sibling who has taken on the bulk of the responsibility claims not to mind, saying that they are happy to be of service, so more and more responsibility comes their way as their parents’ health needs increase. Before long, they are managing doctor appointments, coordinating medication, handling household tasks, fielding late-night calls, and quietly rearranging their entire life around a parent who needs progressively more help every month. And their siblings are sending the occasional text asking how things are going.

This isn’t a story about bad people. It is a story about what happens when families do not decide at all, since the act of not deciding is itself a decision. And it almost always lands heaviest on the person who was least able to say no.

The Weight Nobody Talks About

I have spoken with many individuals who are caring for family members and are exhausted, feeling like they are carrying the load of caring for a parent alone. While they would not trade their experience for the world, and they love their parent(s), they are burnt out — physically and emotionally exhausted, and financially stretched. Many have put their careers on hold to care for their parent and are feeling lonely. Some of the caregivers I speak with have siblings who are rarely available to help or who make excuses to avoid helping. In other cases, they are angry with the caregiver or parent for any number of reasons, or they may have a spouse who isn’t supportive. I even heard a story of a brother who said, “Mom and dad don’t need our help,” while his sister had been coordinating at-home caregivers, conferring with physicians, doing the grocery shopping, and all kinds of other assistance that their parents were unable to do on their own.

There are roughly 53 million unpaid family caregivers in the United States in 2026. Most didn’t plan to be caregivers. Research on the 2+ million paid family caregivers has consistently found that the costs of taking on this role can be higher rates of depression, financial strain, and career disruption. 

Perhaps most disturbing of all is the fact that there is often a huge gap between what siblings report they are doing and what their siblings perceive is being done. Meanwhile, the primary caregiver feels underappreciated as their non-caregiving family members underestimate just how much work is involved. This can cause long-term family estrangement, creating rifts that come from resentment. This can be a slow-building process and can last for years, until the family members who once loved and cared for each other can no longer be in the same room together. I heard another story recently about a woman who asked her brother for help with their elderly mother. He told her that he would pay her back out of his share of the inheritance from their mother, if there was anything left of it by the time their mother passed away. Can you imagine?

Fair Doesn’t Mean Equal

Equitable distribution of family responsibilities is extremely difficult to attain, even impractical. Many factors are beyond anyone’s control and are in constant flux. It is difficult to divide things in half or thirds based on the number of siblings. The issue here is one of fairness and how best to divide up responsibilities for a parent’s care. Fairness doesn’t mean everyone does the same things; it means everyone contributes in the ways they actually can, and it is not always equal.

The person living nearest to the parents is generally in charge of the hands-on, daily care, while another sibling may be in charge of financial support to cover the cost of any additional help that their parents need. Additional help can be a respite worker to allow for some much-needed relaxation time, a home health aide to assist with bathing, dressing, and feeding, or durable medical equipment, including wheelchairs, walkers, canes and other items to help manage their health issues. Coordinating all of the medical information, doctors’ appointments, and calls is also a huge responsibility and one that someone will need to take on. Many siblings can commit to flying in to be with their aging parent for two weeks every three to four months to give their primary caregiving sibling a much-needed break.

None of these things looks the same, but they all can be meaningful contributions to your parents’ care. However, they can only happen if you talk openly and honestly about them before it is too late and has become a crisis. As long as you approach the conversation with love, you should be able to work through any difficult dynamics that are part of your family.

The Conversation Nobody Wants to Have (Until It’s Too Late)

When it comes to facing reality and having a conversation about the care your parent might need, most families want to avoid it. It might bring up old issues and conflicts; most of all, it leads to the acknowledgment that one’s parents are growing old and that they need to be cared for, which can cause a lot of grief. Therefore, many families avoid the conversation altogether, often waiting until a crisis has occurred and they are forced into a conversation amid the chaos and feelings of shock, anger, denial, and grief. This is not an optimal time or situation in which to have a conversation. The best approach is to have the family talk before it is needed. No family conversation is going to be perfect, but it is best to clear the air before vital decisions have to be made. This does not have to take place in person; it can be done over the phone, on Zoom, or on FaceTime.

The first question is what we can do, and how we can commit to it. And what is our parent really needing right now, and what might they need in a year? How will we handle it when things get harder, because they will? These conversations might be uncomfortable for about an hour, but the rest of your parent’s life can be very uncomfortable if you do not have those conversations.

When You Need Someone to Help Facilitate

There are times when the dynamics of siblings are so charged that it is not healthy for the family to go through these conversations alone. Years of resentment can surface. A sibling can shut down or become defensive in a split second. Although the conversations are intended to determine the best care for your parent, the conversations can turn into old unresolved issues from 20 years ago. That’s not a failure — that’s just families being families. That’s when it is useful to have neutral third-party assistance. A family coach, a geriatric care manager, or a social worker can help facilitate a very productive conversation. They are not a part of the family’s history; therefore, they are better equipped to make the unseen expectations apparent to family members. They can help keep the conversation on track before it becomes hostile. Agreements reached as a result of a well-facilitated dialogue can usually be kept by family members long after the facilitated conversation has occurred, while agreements reached during heated conversations in the kitchen after dinner are not usually held by family members for very long.

Put It in Writing — Even if it is Informal

Putting something in writing may seem too formal for some families. But as time passes and circumstances change, roles can shift. And before you know it, someone has taken on more than their fair share of responsibilities, and no one has even acknowledged it. Writing down your agreements gives you something to refer back to. Even if it is just a simple email, having something in writing can provide a solid foundation for making changes as needed. This also serves as a “starting point” for future conversations, management, and adjusting as circumstances change. For example, a child loses his or her job; a parent’s needs dramatically increase; or a family member’s health declines in a way that requires more support. Agreements are never set in stone; something decided today will certainly change in a year. It’s easier to return to a written agreement than it is to return to a verbal agreement.

It may also be useful to create a spreadsheet; put in writing how much money each person is contributing to care for your parents. If one sibling is paying bills, the money imbalance can create a lot of tension, so it should be acknowledged and agreed upon by all. Often, people are afraid to bring up this subject because they fear that others will not contribute. Even if that is the case, it is better to acknowledge the financial imbalance and work together to create a fair plan. That way, the financial contributions become something that the family can manage and adjust as needed, rather than becoming a source of hidden resentment.

This Is About More Than Logistics

Here’s an important takeaway. Determining who is going to take your mom to her doctor’s appointments and who is going to pay for the home health aide is more than simple scheduling. It is about the relationship between the adult siblings. It determines whether or not the adult children will become closer or grow apart, and whether or not the child who shows up most often will feel recognized, appreciated, and supported for their efforts. 

Caregiving for aging parents is one of the hardest things a family goes through together. It asks something of everyone. It may bring up old wounds and old patterns, and it forces conversations most families have spent decades avoiding. However, it can also create the opportunity for a family to demonstrate their love and support for their parents and each other by working together to care for their parents. It can also bring siblings closer together as they deal with the many challenges of caregiving. That’s worth the hard conversation. That’s worth asking for help to have it.