Question: Our parents, in their mid 80’s, are failing both physically and mentally. My brother, who lives a few hours drive away, visits every month or so for a couple of hours. He and I have had huge arguments about what to do for them. Despite our folks’ obvious declines, he makes sure to let them know that I am trying to take them from their home and “put them in an old folks’ home”, as he puts it.

In addition to not being truthful, my brother refuses to face the reality of their condition that my husband and I deal with seven days a week. These conflicts are causing my parents not to trust me, and my brother and I are not getting along. His wife tells me on the side that that she can’t talk to him, either. I set up a meeting with a lawyer for all of us to talk, but he refused to attend. Our parents are not wealthy by any means, and have refused to sign any documents about their finances and health care. I have no clue what is causing this bizarre activity by my brother. Do you have suggestions about how to break this logjam?

Answer: Unfortunately, most family conflicts arise when the now elderly individuals have refused to engage in creating written plans, leaving their loved ones to guess what they want, how to pay for it, and who should be in charge of implementing their plans should they become incapacitated or unable to act on their own. In other words, the house is already in flames when the owner decides that he needs smoke detectors.

And, without a written plan in place, the adult child who attempts to handle the situation is often vilified by parents and siblings alike, regardless of good intentions. While it is human nature not to want to lose independence that driving and staying at home provide, if those affected fail to create an effective plan for long-term care, a greater burden is placed on family members who try to assist.

Moreover, when one sibling doesn’t want to relinquish control to another, or fears that the sibling will loot the modest estate (which will probably be decimated if both parents are chronically ill), it is most difficult, if not impossible, for anyone to identify, assess and address the needs and take steps to try to solve them.

So, you have a planning nightmare on your hands. And without independent assessment of your parents’ conditions and needs, we don’t believe you will be able to solve it. Some of the issues involve how to preserve assets for both parents in order to fund their long-term care; whether home care is an economic option; and whether your parents will ultimately give up control of their finances and, if so, to whom.

While everyone wants the best care available for their family, as with any commodity, the more you get, the more it costs. Therefore, whether your parents will be able to stay at home and, if not, what are the options, must be determined in conjunction with what care can be afforded that will meet the family's budget based on their unique circumstances, which you don’t know.

You, your brother, and your parents must first face the question of their needs as opposed to their desires as opposed to their ability to pay for their care. No one we know wants to leave home to be in an assisted living facility or nursing home, but, unfortunately, some people need to be there. In other words, the perception of your parents’ health and the ability of the family to care them may be very different from the true facts.

We don’t believe that you and your brother will be able to solve these matters without outside assistance. Moreover, we don’t think that even the most knowledgeable lawyer can assist you without the conflict first being diffused. You and your brother must remember that the goal is to provide the best care for your parents at the best price.

We suggest that you engage an experienced geriatric care manager (www.caremanager.org) who will independently assess your parents and then try to negotiate a truce between you and your brother. Otherwise, you and he can look forward to a long, difficult, and expensive conflict that will not end at your parents’ deaths.