Sibling Rivalry
When Siblings Can't Agree About Care for Mom and Dad
As an executive coach assisting clients with career transitions, I have spoken with many who have significant caretaking responsibilities and family support conflicts and issues. Some of the most vulnerable conversations I have had are about aging parents and the siblings who can’t find common ground on how to care for them. If you’re in this situation right now, I want you to know that you are not alone, and what you’re feeling is not a personal failure.
When your parents’ health begins to decline, it has a way of unearthing every old family dynamic you thought you’d outgrown. The responsible eldest child, or those in closer proximity, and typically women, become the self-appointed caregiver. The youngest sibling may fall back into the role of the one who “doesn’t understand.” Old rivalries, unresolved resentments, and long-standing patterns of communication (or the lack thereof) resurface with surprising force. Suddenly, you’re not just coordinating doctors’ appointments and medication schedules — you’re also navigating decades of family history, all while trying to show up with grace for the parent who needs you most. The emotional weight of this dual burden is immense, and it’s one that many of my clients carry quietly, often without realizing how much it’s affecting them.
One of the sharpest points of conflict I hear about is financial. Who pays for what? Is it fair that one sibling lives closer and absorbs more indirect costs — the time off work, the gas, the lost productivity — while another writes a check from across the country and feels their contribution is equally valid? What happens if our parents run out of money? Behind these money factors, there are issues related to equity, sacrifice, and whether the people you grew up with truly see and value what you’re doing. I try to encourage my clients to approach these discussions not as negotiations, but as honest conversations about capacity that come from a place of love. Not everyone can give the same thing, and that’s okay — but it must be called out openly, without assumption or accusation or judgment, before resentment takes root.
Then there are the support decisions — who does what, and how often. One sibling may live an hour away while another is across the country. One has flexible work, and another is managing a demanding career or young children of their own. These practical differences are real, and they matter. But what often gets lost is the invisible labor: the phone calls that happen every single day, the mental load of tracking every prescription and every appointment, the emotional labor of being the one Mom calls when she’s scared. I remind my clients that caregiving equity doesn’t always mean equal — it means intentional and acknowledged. When siblings take the time to name what each person is doing, and genuinely express appreciation for it, the dynamic shifts. Feeling seen, supported, and appreciated can defuse conflict before it ever starts.
Perhaps the most painful disagreements come at the end. End-of-life decisions — whether to pursue aggressive treatment, not try to save the family member when the outcome is hopeless (typically done with a Do Not Resuscitate Order (DNR)), when to consider hospice, what Mom really meant when she said she “didn’t want to be a burden” — these are conversations that cut to the very core of love, loss, and what we believe it means to do right by someone. And when siblings disagree in these moments, the pain is compounded by grief that hasn’t even fully arrived yet. It’s important to distinguish between what their parents actually wanted and what they themselves need. Sometimes our disagreements with siblings aren’t really about medical decisions at all — they’re about our own fear of losing someone irreplaceable. Naming that fear, out loud and with compassion, can open doors that logic and argument never will. I experienced such a situation between a daughter (the primary caregiver for her mom) and her brother. The mom was 95 years old, in deteriorating health, was fed with a feeding tube, and on oxygen with Alzheimer’s. The daughter wanted to put a DNR order in her mom’s record should she experience a severe event, but the brother was adamantly opposed to it. Think about this. The mother had so many tubes running in and out of her that it was almost inhumane. But the brother was having a hard time letting go, possibly because of the conflict and guilt he had about ignoring his mom when she was in a good state.
Conflict between siblings during a parent’s care may not be a sign that your family is broken. It may be a sign that multiple people love the same person deeply, and that love is being filtered through very different life experiences, fears, and capacities. The goal isn’t to win the argument — it’s to keep the relationship intact on the other side of it, because when your parent is gone, you and your sibling remain. That doesn’t mean you have to agree on everything. But it does mean choosing, again and again, to come back to the table with curiosity instead of certainty, and with compassion and love, instead of judgment. These choices — small and hard and deeply human — are the most courageous things family members can make, as difficult as they may be at the time.