The suffering of the dutiful daughter

Nursing homes, adult foster homes, and assisted living arrangements are the public face of long term care for the elderly. In the real world, however, most long term care is performed by families. When there are siblings charged with taking care of a parent the duty usually falls upon the eldest daughter. This is statistically true across cultures and across generations. It is true even when a younger daughter or a son might be the more qualified care giver, a fact that often leads to strife among the siblings. In my own family, I have seen a younger daughter chafe under the injustice of seeing her parent and the other children all looking to the older sister for leadership regarding care issues, ignoring the superior capabilities of the younger. It isn't fair, and it isn't likely to change.

More often than not it is the oldest daughter who comes to me to say that the family can no longer handle the pressures of providing long term care. The crises is often the direct result of  increasing levels of dementia in the elder--loss of cognitive ability that makes the elder increasingly incapable of cooperating in her own care. In these cases the daughter faces asking the court to appoint her conservator to take control of the parent's money and use it for the costs of professional long term care. When I explain the process for becoming a conservator, I must also explain the curse of the dutiful daughter.

It is not unusual, I  explain, that the one person willing to stand up and protect the elder ends up hated by everybody. A court proceeding is public, intrusive and embarrassing for the elder. The dutiful daughter--the only member of the family willing to step up and do the right thing--ends up hated by the parent because he or she cannot see through the fog of dementia that the proceeding is meant to help. Other family members turn on the dutiful daughter as they see the parent's money being locked away to be used only for the long term care needs of the elder. Family members who have been using that money as if  it were their own will not be above holding a grudge against the person responsible for bringing the gravy train to a stop.

Relatives, whether or not they be dutiful oldest daughters, seldom refuse to proceed with court action out of fear of the curse, but it is important that they be steeled for it before we sign the papers.