As an elder law attorney concentrating my practice on aging in place planning, I frequently guide families through the emotional, financial, legal, and practical challenges of caring for aging parents. One of these challenges is family unity. Family disagreements arise from differing views on care needs, financial burdens, or roles, often exacerbating stress during an already difficult time. These conflicts can be avoided and mitigated with proactive communication, collaborative planning, and a strong emphasis on legal and financial tools that honor and protect a person's autonomy and wishes. Below, I'll share essential tips for managing these disputes, while highlighting the importance of incorporating specialized tools like private care agreements and reviewing advance directives to ensure decisions align with your parents' expressed preferences and best interests. These strategies work when children are caring for parents, but apply in all kinds of family caregiving circumstances.
•Foster Open Communication: Start by encouraging honest, respectful conversations among siblings. Share concerns, needs, and preferences openly to reduce misunderstandings and build collaboration. During these discussions, review your parents' legal and medical documents, which include advance directives, such as a Health Care Power of Attorney (HCPOA), Living Will (LW), or Advance Directive for Dementia, to ensure everyone understands their wishes. If aging in place is a priority outlined in a trust, General Durable Power of Attorney (GDPOA), or separate document, reference these explicitly to keep the focus grounded in your parents' directives, preventing debates from veering into personal agendas.
•Appreciate and Respect Differences: When implementing any complex plan, differences of opinions and approaches are inherent; you are often balancing different considerations (e.g., care quality versus cost of care; independence versus safety), so there may not be bright line answers to every challenge. Embracing a process of identifying differences and openly and honestly exploring options, approaches, and solutions, without characterizing ideas (e.g., as unhelpful, self-interested, or lazy), permits every interested and contributing party to participate. That does not mean that if you are a fiduciary you should fail to recognize these for what they are or may be, but evaluating them without aggressively dismissing them or characterizing them is a more diplomatic approach.
•Don't disband the Team Before the End of the Season: One of the most common mistakes fiduciaries make is "going it alone." Being the boss in an organization doesn't mean that you are the only person necessary in the organization; family members may be needed to perform a variety of tasks, and their input and support may be valuable for a variety of reasons. Good planning acknowledges and plans for the worst-case scenario, which must consider your inability to perform all tasks necessary for the entire duration of time during which a parent or loved one may need help. Building a team is not only wise to support your good work, but it is also necessary to permit continuation of your good work in the worst case: your absence or loss.
•Respect Authority, Designated or Otherwise: When managing care for aging parents, for example, respect their authority to make their own decisions, and once they are no longer able, respect the authority they have designated through legal documents. This respect is paramount to honoring their wishes and maintaining family harmony. An adult must never be treated as a child (no adult would accept this relationship with another adult), and doing so is likely to result in the parent, a spouse, and/or other children seeking to remove the offending person as a decision-maker. There is no more certain path to discord than ignoring a parent's wishes and decisions. Documents like a Health Care Power of Attorney (HCPOA), General Durable Power of Attorney (GDPOA), Living Will (LW), Advance Directive for Dementia, or trust provisions often name specific individuals, such as a sibling, spouse, or trusted friend, to make financial, medical, or care-related decisions. These designations reflect your parents' deliberate choices and carry legal weight under state law. Below, I outline the importance of respecting these roles, how to address concerns about their performance, and the legal steps to take if the designated agent proves unwilling or unable to serve.
- Honoring Designated Authority: Your parents' advance directives or trust documents specify who holds authority to act on their behalf, whether for healthcare decisions (via an HCPOA), financial matters (via a GDPOA), or trust administration. Respecting these designations avoids undermining their autonomy and prevents disputes among siblings or other family members. For example, if one sibling is named as the healthcare agent in an HCPOA, others should defer to their decisions regarding medical care, even if disagreements arise, unless the document allows for co-agents or specifies otherwise. Similarly, a trust may designate a sibling or third party as trustee to manage assets for aging in place, and their authority should be upheld unless legally challenged. Open communication, as discussed earlier, can help family members align with these roles by clarifying expectations and ensuring decisions reflect the parents' wishes, such as a preference for aging in place outlined in a separate directive.
- Recognizing Signs of Unwillingness or Inability: While respecting designated authority is critical, there may be instances where the appointed agent is unwilling or unable to fulfill their duties effectively. Signs to watch for include:
- Unwillingness: The agent refuses to act, ignores requests for updates, or fails to engage with healthcare providers or financial institutions, delaying critical care or asset management.
- Inability: The agent is incapacitated, lacks the capacity to make sound decisions (e.g., due to cognitive decline), or mismanages responsibilities, such as neglecting bills or misinterpreting medical directives.
- Conflict of Interest or Abuse: The agent prioritizes personal gain, misuses funds, or disregards the parents' wishes, such as ignoring an Advance Directive for Dementia that specifies care preferences. If these issues arise, document specific instances (e.g., missed medical appointments, financial irregularities) and discuss concerns with them and others to assess whether the problem is systemic or situational. Avoid unilateral actions, as they could violate the legal authority granted them and spark disputes or cause your exclusio.
- Exploring Legal Options with Counsel: If the designated agent is unwilling or unable to serve, or their actions harm your parents' interests, consult an elder law attorney promptly to explore legal remedies. Potential steps include:
- Requesting Resignation: Encourage the agent to voluntarily step down, as allowed under most powers of attorney or trust agreements. This may require a notarized resignation letter and notification to financial or medical entities.
- Activating Successor Agents: Many HCPOAs, GDPOAs, or trusts name alternate or successor agents. Review the documents to confirm if another sibling or individual can step in without court intervention.
- Petitioning for Removal: If the agent refuses to resign or is unfit, file a petition in probate court to remove them. This requires evidence of misconduct, incapacity, or neglect, such as bank statements showing mismanagement or affidavits from healthcare providers. In Ohio, courts prioritize the principal’s intent, so reference the parents' directives to strengthen the case.
- Seeking Guardianship or Conservatorship: If no successor agent is named or the situation is urgent (e.g., immediate health risks), consider petitioning for guardianship (for personal/health decisions) or conservatorship (for financial matters). This is a last resort due to its invasiveness and cost, as it overrides your parents' autonomy and may conflict with their aging in place wishes.
Engage an attorney early to navigate these steps, as unauthorized challenges to an agent’s authority can lead to costly litigation or family rifts. The attorney can also review Private Care Agreements or advance directives to ensure any transition aligns with your parents' wishes, such as maintaining aging in place through tech solutions or home care funding.
- Reporting Abuse: If you suspect financial exploitation or neglect, report to Adult Protective Services statewide, toll-free help line at 1-855-644-6277, contact your county Department of Job and Family Services, or use the Ohio Adult Protective Services Online Referral tool. Use the Elder Abuse Reporting Checklist to gather and report information that will help investigators take action.
- Integrating with Family Collaboration: When addressing concerns about a designated agent, involve all interested parties to maintain transparency and avoid accusations of overreach. Reference the care plan and legal documents discussed earlier, ensuring any challenge to authority respects the framework your parents established. For example, if a sibling is the GDPOA agent but fails to fund home modifications outlined in a trust, use mediation (as outlined in your care plan) to address the issue before escalating to court. This approach reinforces teamwork while safeguarding rights and interests. By respecting the authority your parents have entrusted, while staying vigilant for signs of failure, you uphold their legacy and ensure their care aligns with their directives. If issues arise, our firm or another attorney can guide you through the legal maze to protect your loved ones.
•Involve Care Recipients in Planning When Possible: If your parents, for example, are still capable, include them in discussions to minimize trauma and clarify their wishes directly, updating documents like LWs or Advance Directives for Dementia as needed. This can preempt disputes and reinforce family unity.
•Develop a Comprehensive Care Plan Together: Work as a team to create a detailed care plan covering healthcare, finances, and living arrangements. If tensions run high, involve a neutral third-party like a mediator, geriatric care manager, or elder law attorney to facilitate. A key element to consider is a Private Care Agreement, a formal contract that outlines care responsibilities, expectations, duties, goals, and even compensation for siblings providing hands-on care. This can prevent resentment over unequal burdens by treating caregiving as an integral role, while permitting payment complying with Medicaid rules to avoid future penalties. Always cross-reference the plan with your parents' directives, such as a GDPOA for financial decisions or aging-in-place wishes in a trust, to ensure the plan respects their autonomy and avoids legal pitfalls.
•Determine Role of In-Laws Early: The role of a parent's daughter- or son-in-law can be contentious, children often bristling at a brother-in-law or sister-in-law having any role whatsoever. Every family dynamic is different, so address the issue early. Frankly, some families do a disservice to their efforts by summarily excluding in-laws from any discussion or consideration, and often act surprised when needs arise and in-laws previously excluded are "suddenly" unwilling to help. Navigate the waters early and develop an understanding that best serves the most vulnerable- the poerson for whom you are caring.
•Respect Individual Roles and Strengths: Acknowledge that family members bring different skills to the table; one might excel at financial management via a GDPOA, while another handles daily caregiving. Assign tasks based on capabilities, availability, and proximity to minimize resentment. If a Private Care Agreement is in place, it can formalize these roles, providing structure and fair compensation. Remember to consult advance directives like an HCPOA or LW when roles involve medical decisions, ensuring no one oversteps boundaries that could lead to disputes or legal challenges.
•Prioritize Your Parents' Well-Being and Wishes: Shift the conversation away from "winning" arguments by centering on your parents' needs and preferences. Remind everyone that the ultimate goal is quality care, guided by their documented wishes, whether it's an Advance Directive for Dementia specifying care in cognitive decline or aging in place instructions in a trust or separate document. This focus not only eases tensions but also protects against future conflicts by providing a clear, legally binding roadmap.
•Seek Professional Guidance When Needed: If disagreements escalate, don't hesitate to consult experts like family therapists, geriatric care managers, or elder law attorneys. These professionals can mediate, assess care needs objectively, and help draft or review legal tools such as Private Care Agreements or advance directives. In my practice, I've seen how early intervention prevents small issues from becoming court battles, especially when directives like an HCPOA or GDPOA are unclear or outdated. Approaching elder care with empathy, teamwork, and a commitment to your parents' legal directives can transform sibling challenges into opportunities for stronger family bonds and better outcomes. By incorporating Private Care Agreements and faithfully reviewing advance directives, you honor your parents' autonomy while safeguarding family harmony.
•Address Past Family Dynamics and Emotional Baggage: Unresolved childhood rivalries or longstanding resentments often resurface during caregiving. Consider family therapy early to unpack these emotions, as they can fuel conflicts over decisions like living arrangements or medical care. This is especially relevant when interpreting ambiguous directives in a trust or GDPOA.
•Account for Geographical and Lifestyle Differences: Siblings living far away may underestimate daily demands, leading to friction. Use video calls or shared apps for transparency, and factor in proximity when assigning roles in a Private Care Agreement. Also, discuss cultural or personal values that might influence views on aging in place versus facility care.
•Investigating and Deploying Technology for Safe Aging in Place: In addition to addressing sibling dynamics and legal directives, incorporating appropriate technology can significantly enhance your parents' ability to age in place safely and independently. I often recommend that families investigate tech solutions tailored to individual needs, such as mobility challenges, cognitive decline, or chronic health conditions. The key is a thoughtful approach: start by assessing specific care requirements through discussions with family, healthcare providers, or a geriatric care manager. Research options through reliable sources like AARP's AgeTech Collaborative or specialized blogs on aging technology, and always prioritize user-friendly devices that respect privacy and integrate seamlessly with existing care plans.
When deploying tech, involve all interested and relevant family members to ensure buy-in, test for ease of use, and consider ongoing costs or training. Below, I outline key technologies, drawing from emerging trends like AI and smart home integrations, to support daily living while minimizing risks.
- Security Systems for Real-Time Monitoring: Smart security systems (e.g., ADT, Vivint), deploying video doorbells (e.g., Ring) or indoor cameras with motion sensors, allow family members to monitor a home remotely through phone or computer apps. These provide peace of mind by alerting siblings to unusual activity, like unexpected visitors or wandering at night—a common concern in dementia cases. Benefits include deterring intruders and enabling quick responses to emergencies. When investigating, look for systems with two-way audio for communication and end-to-end encryption to protect privacy. Deployment tip: Install with professional help to avoid overwhelming your parents, and tie alerts to a shared family app for coordinated monitoring.
- Medication Dispensing Machines: Automated pill dispensers, like those from Hero or MedMinder, organize medications, dispense doses at scheduled times, and send app notifications if a dose is missed. They track usage to prevent overdoses or over-utilization, which is crucial for parents managing multiple prescriptions. These devices can integrate with health apps to log adherence, reducing the burden on caregivers. Research models with tamper-proof locks and refill reminders; for deployment, sync with your parents' HCPOA or GDPOA to designate who receives alerts, ensuring compliance with their wishes.
- Passive vs. Active Fall Detection: Falls are a leading cause of injury among older adults. Fall detection and prevention tech is essential. Active fall detection requires user action, such as pressing a button on a wearable pendant (e.g., traditional medical alert systems like Life Alert), are suitable for alert individuals who can self-activate. In contrast, passive fall detection uses sensors, often in smartwatches (e.g., Apple Watch), security systems, or home devices with AI, to automatically detect falls via motion changes or impacts, alerting emergency contacts without input. Passive systems are ideal for those with cognitive impairments, as they don't rely on memory or manual effort. Investigate accuracy rates and battery life; deploy by testing in real scenarios and linking to a family response plan outlined in advance directives.
- Health Monitoring Devices: Wearable tech like Fitbit or Oura rings tracks vital signs like heart rate, blood pressure, sleep patterns, and activity levels, flagging anomalies via apps. For broader monitoring, smart scales or blood glucose monitors integrate with telehealth platforms for remote doctor consultations. These tools support proactive care, aligning with Living Wills or Advance Directives for Dementia by enabling early intervention. When researching, prioritize FDA-approved devices with data-sharing features. For deployment, ensure data privacy complies with HIPAA and involve siblings in reviewing trends to avoid disputes.
- Other Technologies to Assist Aging in Place: Beyond the basics, consider these innovations to promote independence:
- Smart Home Devices: Voice assistants like Amazon Alexa or Google Home control lighting, thermostats, and appliances hands-free, reducing physical strain and enhancing safety (e.g., automated lights to prevent trips). AI-powered companions, such as ElliQ robots, offer reminders, companionship, and even mood-tracking for those with dementia.
- GPS Trackers and Wander Management: Devices like AngelSense provide location alerts for parents prone to wandering, with geofencing to notify if they leave a safe zone. Our family uses Life360, a phone application, so that we can find each other. We receive alerts when a person arrives or leaves home, the supermarket, and/or the doctor's office.
- Telehealth and Virtual Care: Platforms like Teladoc enable video visits, integrating with health monitors for seamless care without travel.
- Hearing, Visual, and Cognitive Aids: Advance hearing aids with Bluetooth connectivity or brain fitness apps (e.g., via Lumosity) address sensory losses, with AI adapting to user needs. Meta AI glasses are being utilized to assist those with vision impairments.
- Social Connection Tech: Video call setups or apps like GrandPad combat isolation, fostering family ties as per aging in place wishes in trusts.
By investigating these technologies, starting with a family tech audit, and deploying them thoughtfully, you can align with your parents' directives while easing sibling responsibilities. Remember, tech should complement, not replace, human care. Consult an elder law attorney to integrate these into a Private Care Agreement or GDPOA for legal protection.
•Prepare for Specific Flashpoints: Conflicts often arise over issues like driving cessation, asset management, or end-of-life care. Proactively address these in the care plan, using tools like a geriatric assessment to provide objective data.
•Monitor for Burnout and Self-Care: The primary caregiver sibling or spouse may face exhaustion, breeding resentment. Encourage regular check-ins and respite options, perhaps funded through a Private Care Agreement, to maintain balance.
We are experienced in helping families like yours protect what matters most, from drafting Trusts, Private Care Agreements, Powers of Attorney, and advance directives, to reviewing existing documents for seamless aging-in-place planning. To learn more about how we can assist you, call our office at 330-896-09300 to schedule your complimentary strategy session with one of our team members. Let us help you find solutions to ease the task of caregiving. Take the first step toward peace of mind today!
