Sibling Dynamics When You Are the Caregiver: Reimbursement, Division of Labor, and Resentment

The most common conflict among adult siblings of a very old parent is not whether to care for her. It is who is doing the work, who is paying for it, and whether the person doing the work will be repaid or recognized. National Alliance for Caregiving data show that in 80 percent of families with multiple adult children, one child does the majority of hands-on care. That child is most often the daughter living closest to the parent. By the time the parent reaches 95, the imbalance has often been going for five or ten years. Resentment has accumulated.

The research-backed approach has two parts. First, the work needs to be counted and the costs need to be tracked. Second, the family needs a conversation, sometimes several, with a neutral structure. Some families bring in an elder mediator or a family social worker to make the conversation possible. Most do not, and most families struggle with the conversation. This guide walks through how to have it.

Financially, the caregiving child has often spent thousands of dollars of her own money on her parent's care: gas to drive to appointments, groceries, copays not covered by insurance, home repairs, hired aides. Many caregivers also lose income because they reduce work hours or retire early. The 2022 AARP Family Caregiver Spending and Strain study put the average out-of-pocket caregiver spending at $7,242 per year, and that number is higher for caregivers of the oldest old. None of this is usually tracked, and none of it is reflected in the parent's eventual estate plan. When the parent dies and assets are divided equally among siblings, the caregiver child often comes out behind.

There are several ways to address this. One is a personal care agreement (also called a caregiver agreement), a written contract between the parent and the caregiving child specifying duties and pay. The contract has to be signed while the parent is still mentally competent. It allows the parent to pay the caregiver an hourly or salary rate from the parent's own funds during her lifetime. The Internal Revenue Service treats this as taxable income to the caregiver. But it also creates a paper trail that protects the family if the parent ever needs to apply for Medicaid. Without a written agreement, large transfers to the caregiver look like gifts to Medicaid and can trigger a penalty period.

A second approach is an updated will or living trust that distributes assets unequally, with the caregiving child receiving a larger share or a specific asset (the family home, for example). This conversation has to happen with the parent and ideally with an elder law attorney present. Many parents are willing to do this if asked. Many adult children do not ask because they feel uncomfortable, and then resentment grows after the parent dies.

A third approach is non-financial: explicit acknowledgment, division of remaining tasks, and a family meeting that gives the non-caregiving siblings specific jobs (handle the taxes, manage the patient portal, fly in monthly for two days of respite). Often resentment dissolves when there is a clear assignment, even a small one.

The one approach that does not work is staying silent and hoping. Silence keeps the imbalance growing. The hardest conversation in family caregiving is the one about money. The second hardest is the one about effort. Both have to happen. The steps below give a structure.

(Sources: AARP Public Policy Institute Family Caregiver Spending and Strain; National Alliance for Caregiving 2025 report; American Bar Association elder law section on personal care agreements; Eldercare Mediators Network)