William Penn may have branded Philadelphia the City of Brotherly Love, but in 1996 I came back to my hometown out of affection for my sisters. After spending almost two decades in New York, Boston and pre-Portlandia Oregon, I returned to where Margaret and Diane, and our long-divorced parents, had continued to live. I was still there eight years later when our father’s long-dormant prostate cancer resurfaced, crashing into his and our lives with an inoperable stage 4 vengeance. Because he was dying and needed help, my sisters and I stepped into what some call the parallel universe of caregiving, a labyrinthine shadow world we couldn’t see until we entered it. The two bewildering, infuriating and grace-filled years that followed not only required us to figure out how to navigate it all—the catastrophes and confusion and looming sorrow—as we supported our father up to his last breath but also permanently shifted how I feel about my sisters.
Plenty of life events come along to shake up grown siblings’ relationships—marriage, addiction, illness and economic misfortune among them. But nothing destabilizes the status quo like having to care for aging and ailing parents, a domestic situation that’s spreading at an astounding rate in this country, thanks to the baby boomer population bubble and humanity’s ever-increasing life span. By 2050 the number of Americans age 65 or older will be more than double what it was in 2000, according to the U.S. Bureau of the Census. “Our data is showing that if you haven’t been a caregiver already, one day you will be,” says Nancy Thompson, a spokesperson for AARP, the nonprofit organization for people 50 and over.
Caring for elderly parents is a monumental rite of passage, one that requires adult children to confront kaleidoscopic loss and an encroaching sense of their own mortality. “Without a previous generation to provide a protective cushion, you no longer feel invulnerable and invincible,” says Geraldine Alpert, PhD, a psychiatrist in private practice in San Francisco. “There’s also a feeling that the universe has lost its rightful order.”
Nearly 80 percent of Americans lived with a sibling when they were growing up. Being an only child could present certain advantages in negotiating the eldercare enterprise—such as having no one to second-guess you—but I was glad to have “the power of three,” as my older sister, Diane, called it. Together we faced the constant stresses of a health care system we knew nothing about; a father who was irascible and demanding (characteristics that had preceded his illness); and the cancer itself, with its attendant drug interactions and strokes and bedsores, incontinence and discomfort and extraordinary fatigue. Having experienced so many unexpected twists and turns during that time, I’m not surprised to learn that 40 percent of sibling caregivers end up having serious conflicts with each other, most of which magnify long-held resentments: You may think you’re arguing with your brother about which nursing home is best for Mom, but the emotions escalate because one of you never felt listened to while growing up.
“The quality of the sibling relationship is cast in bas-relief by the demise of a parent,” says psychologist John Caffaro, PhD, a specialist in mediating sibling strife and a professor at the California School of Professional Psychology in Los Angeles. To paraphrase the late Steve Jobs, “Death is a change agent.” Some relationships crumble under the pressure; others not only survive but flourish. Under the klieg lights of tragedy, negative patterns can be transformed.
NEW CRISIS, OLD ROLES
In his now-classic 1995 book, Sibling Relationships Across the Life Span, Purdue University psychologist Victor Cicirelli, PhD, pointed out a basic but stunning truth: The most enduring relationships in life are with sisters and brothers. We will know them longer than our spouses, he wrote, longer than our friends and our children. It is not unusual, in fact, to know them twice as long as our parents.