As part of WGBH News' ongoing series You’re Not Alone we explore how siblings share the workload of taking care of their sick parents. Cristina Quinn brings us a story of a sister and brother, whose relationship has been tested by the kind of heartache unique to family. Please note that the names in this story have been changed to protect the identities of those involved.

It was a complicated childhood to begin with, but when April and her brother Mark weren’t fighting, they’d bond over their love of music and spend hours playing the latest album topping the charts in 1970s’ New York City. 

"He can be a really funny guy. We had things in common from growing up- shared memories. I mean, nobody knows better than your sibling the environment you grew up in," April said of her brother.

Like most siblings, their relationship had its ups and downs throughout their adulthood and during the physical decline of their parents. After their father died in 2009 from a decades-long battle with Parkinson’s, their mother’s descent into Alzheimer’s got precipitously worse.

Their mother started no-showing at appointments, mixing up dates, and repeating herself, April said. This crisis was compounded by the fact that April lives in Boston, Mark on the other side of the country, and their mom in New York City. When their mom could no longer run her company, April and Mark were forced to make a decision.

"I think at some point my brother and I did connect over the urgency of it and in some ways, it drew us closer but the money part is what drove a wedge in that," April said.

They had very different views on the type of care their mother should receive. April had found an assisted living facility with a dementia ward in a Boston suburb, but she says Mark, who was not as financially secure, had another idea.

"He helped with the move, with cleaning out the apartment. And then he started saying, 'this should be really short-term. The next step would be to move her overseas, somewhere in central or Latin America, where the care will be almost nothing.'"

Mark declined to be interviewed for this story but April said whatever connection they had quickly dissolved after their disagreement.

What seemed to me very callous and unacceptable was perfectly fine for him. I think that amongst siblings, that if you have a different perspective on what your responsibility is to your parents, when it comes down to this caregiving piece, all of that gets amplified.

Experts said it’s in moments of crisis that past family history is resurrected. Sarah Langer is a geriatric social worker at Mass General Hospital:

"That’s when all of these unspoken issues come to rise," Langer said. "If one got more attention. If there were issues to where one did better in school than the other. Now you’re coming together with this serious issue, and now what happens? It tends to fall on one person more than another."

It all fell on April. After she refused to consider Mark’s idea, they stopped speaking to each other. Since she had power of attorney, she had the final say on where their mother was going to live. This kind of fractured relationship among siblings is not uncommon, says Langer.

"It is rare to find families where all siblings get along. It is more common that they don’t get along," she said.

It saddens April when she thinks of the losses in her family. First her Dad, now her mom and her brother. She said she’d like to make peace with him and yet she’s not sure if she has the emotional capacity to deal.

"Our relationship has become so difficult that I don’t know if I could handle going back and forth with him or engaging in arguments over it. There are times when I wonder how could it end up where all of this responsibility is on one person. How did this happen? And what is the meaning of it in my life?"

Some days it means feeling absolutely overwhelmed, but the daily demands of family life don’t give April much time to dwell. Instead, she finds humor in the little things-- like on Saturdays when her mom comes over and reads the Sunday paper.

"I kept the Sunday paper from the week before, knowing that the date would mean nothing, but just that it was a Sunday paper. In fact, I could probably keep the same Sunday paper for weeks and weeks. And that’s actually funny, right? And she was so happy with the Sunday paper from the week before, it didn’t matter!"

What does matter is sustaining the relationship she has with her mother, who will be over on Thanksgiving. Though Mark won’t be joining them again this year, April is hopeful that he’ll come next time. Maybe they’ll dust off those old records and reflect on a time when things were just a little bit easier. 

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