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As baby boomers, you are faced with the heartbreaking prospect of watching your parents decline in health, vibrancy and independence.

A 2007 USA Today/ABC News poll showed that 48 percent of surveyed adults ages 42 to 61 provide a parent with financial help, personal care or both. Another 19 percent expect to do so in the future. And nearly half of them are worried about fulfilling their various responsibilities as caregiver. Of those surveyed, 65 percent have made personal sacrifices in quality of life, while 24 percent feel guilt over not doing more.

A 2004 National Alliance for Caregiving/AARP study (PDF) found the typical caregiver is a 46-year-old employed daughter who takes care of her widowed mother, living separately but nearby. To help her parent, she most likely has adjusted her work hours, taken time off or quit a job. She spends less time with her spouse/children/friends, and on hobbies and vacations.

The negative impact on physical and emotional health is staggering – more so for caregivers who don't feel they had a choice in taking on that role. Once designated as caregiver, about twice as many people develop high emotional stress compared to those who have options in arranging care. Primary stressors include not finding time for yourself, juggling work and family and worrying constantly if your parent is safe and comfortable.

The Emotional Toll

Once you begin taking care of an aging parent, his/her needs take more and more time. What starts as running a few errands can quickly expand to handling the shopping, transportation to doctors' appointments and help with meal preparation and housework.

Being able to afford a paid caregiver can help tremendously, but requires time to select, transition and supervise. Then there's moving the parent into more accommodating housing, helping with estate planning and daily money management, making major health care decisions and meeting daily personal care needs. Perhaps most meaningful to the parent is filling the companionship void left by being widowed and/or separation from friends who have moved or passed away.

The emotional toll on you, the caregiving child, can be a wicked mix of sadness, worry, anger and guilt. It is torturous to see your parent gradually become frail, lonely or fearful or to watch dementia erode the rational independent person you've known all your life. There is always a nagging fear that the parent won't be safe or careful, and that you should be more involved than you are. Being thrust into a new role can create real resentment. Financial burden may increase and your other relationships and commitments may suffer. And guilt inevitably results after you snap at what can't be helped or regret not doing enough.

Living far from aging parents makes it much harder to cope with their needs, and you regret not being close enough to help more. You may move closer and try not to blame them for the upheaval it causes in your life. Maybe you move them near you, making them unhappy, which makes you feel resentful or guilty. Maybe they move in with you, and you argue about lack of privacy or the demands that come with access or additional expense. Or maybe you move them into an assisted living or nursing facility, and you feel guilt, expense and pressure to visit often.

These reactions are often heightened by the presence or absence of siblings – and the grass is always greener on the other side.

It's Lonely As An "Only" —

"I'm drowning in decisions about Mother's health care that I don't know how to make – her finances are a mess since Dad died – I have no time for my own life … I'd give anything for a sister or brother right now!"

The only child may be lucky enough to have cousins/aunts/uncles that are willing to help, effectively filling in for supportive siblings. But barring that luxury, the "only" often operates in a vacuum of making tough decisions, bearing any financial burden, giving up work and family time and coping with stressful emotions.

Guilt runs incredibly high with an "only" because if something goes wrong, there is no one else to share blame. It has to be your fault for neglecting, ignoring or just not having known. And guilt is a great catalyst for physical exhaustion, inadequate sleep, and, ultimately, depression and anxiety. There has simply never been that lifelong peer to bounce things off of and enlist for support.

On the plus side, the "only" is free to make choices for parents' best interest without having to lobby for sibling support or consensus. No arguing or reverting to a childhood pecking order simply to elect a co-signing child to be added to their bank account.

— But Siblings Can Interfere or Disappear

"Dad wants me there every day, but I've already missed so much work. My sister barely calls to check on him and my brother lives closer, but Dad tells him I've got things covered. …. Why is it assumed I do the legwork, then they second-guess my decisions?"

There are many times with an increasingly dependent parent that it does, indeed, take a village. But despite the existence of several siblings to share the responsibility, one almost invariably ends up as the primary caregiver. It's typically a daughter and often the oldest child – although living close by and having more time/resources certainly factor in.

The challenges stem from how the other siblings see their roles once they realize they are not primary. Often they simply sit back and allow the primary to do it all, offering little or no assistance or input. Or they might be content to let the primary spend the money and time, but feel utterly entitled to give direction or criticism as their way of "helping." The childhood pecking order may be resurrected, with emotional tension getting another shot in the arm. If you're the primary caregiver, the stress of your parent's difficulties are substantial without anger at siblings or your parent who may, to your dismay, cater to the least helpful sibling.

When siblings cooperate, it is such a blessing. Hard decisions get talked through and consensus helps alleviate lingering guilt over things that end badly. Just being able to talk to each other about frustration and other ambivalent feelings is cathartic and healthy. And even with a primary caregiving sibling in place, the others can find different ways to help out in ways that still have great value in reducing overall stress.

Caring for aging parents has countless rewards but is inescapably stressful. That's why it's so critical to protect your health and find supportive resources to help you be the effective caregiver your parents need.

(Dr. Amy Gilbert Pollard is a clinical psychologist in private practice at Arkansas Psychiatric Clinic in west Little Rock. She has practiced in Arkansas since 1998, working with adults and teenagers. She is an only child who relocated her parents to Arkansas seven years ago. Her mother has since died, and her 97-year-old father lives nearby.)