Dear Dutiful:

As a caretaker, your number-one priority is to take good care of yourself. Look at your family history: Do you have a pattern of always being the caretaker, the one who makes sure that everyone is doing OK? What roles have your brothers taken in the past? It’s helpful to know yourself and not fall into old dysfunctional family patterns. How can you balance the needs of your partner, your kids and your parents? Start by not doing it all alone. Bring your partner and brothers into this (and if your kids are old enough to understand, include them too). Let your kids and wife know just what you’re dealing with. Maybe the kids can help more around the house to decrease your stress. If you don’t tell them what’s going on, how can they pitch in and help? Even little kids can understand that “grandpa and grandma aren’t so strong and need help sometimes.”

At San Diego Hospice I often facilitated family meetings when a family member was ill or dying. Everyone in the family gets together and does specific problem solving. In this case, the focus would be how to best assist your parents with possible health/financial/quality of life concerns. The result of a family meeting is a “family plan” that is specific on who will do what for whom and when. For example, you will visit your parents every other weekend and stay overnight one night. Your brothers will call your parents twice a week and visit in person once a month, etc. If your brothers can’t make it in person, include them on a conference telephone call or speakerphone.

A big part of caring for our aging parents is money. Financially, do your parents need help, and if so, who is able to help them and how? Perhaps your brothers have financial resources that you and your wife do not. Perhaps they have more flexible jobs and could come to L.A. for a week or two at a time to see how your mom and dad are doing.

Get help. Make a list of who can help your parents. Find out what’s available in their area. Do they have neighbors that they’re close to? Neighbors can often help you keep an eye on them. Do they have friends they see regularly? Do they belong to any social groups, bridge clubs or senior centers? These are all resources that your family can tap into so you don’t end up burning yourself out.

Get information. In the family meeting, really talk with your parents and find out what they want for themselves. Talk with their doctors (with their permission). Find out what financial resources they have (I know it can be tricky, but it’s important to see the complete picture), and get their insurance information to find out what it does and doesn’t cover. Do they have a will or a durable power of health care? Talk with them about these important documents. Consult an attorney if necessary.

Get respite for yourself. You can’t do this alone. Do your parents qualify for hospice or palliative services, Meals on Wheels, public transportation? Much of this information is available on the Internet. If your kids are old enough to be computer savvy, let them help you with this. Get them involved in problem solving (Remember: They may be doing this for you and your wife some day).

Be flexible. Parents get sicker (or healthier) and your own family situation is likely to change over time, too. Can you anticipate the future, discuss possible scenarios and get everyone involved in talking about what the options are and how the family will choose among them?

Monitor your caretaker/codependent tendencies. You can’t do it all, no matter how much you (or they) think you should. Get a periodic reality check from your wife and kids. All caretakers need to up their self-care.