When Siblings Can’t Agree on Caregiving in a Dysfunctional Family

When someone in your family becomes sick, it often reveals existing cracks in the family system. Even in healthy families, caregiving is rarely balanced. But in dysfunctional families, the imbalance tends to be more extreme.

It’s common for siblings to fall back into familiar childhood roles: the parentified child who steps up and takes on most of the caregiving, the avoiding sibling who stays distant, and sometimes, the peacemaker or scapegoat caught in between. These patterns don’t disappear just because we’re adults. In fact, illness often intensifies them.

Three Common Roles in Dysfunctional Family Caregiving

In many families, two contrasting roles emerge during illness:

1. The Overburdened Caregiver: This is the person who knows everything, gets all the updates, makes the appointments, manages the medications, and holds everyone’s emotions. They’re exhausted and often resentful. They may feel trapped and wish they could step back, but also fear what would happen if they did.
2. The Left-Out or Excluded Sibling: This sibling is kept in the dark. Information is withheld, calls aren’t returned, and they learn things secondhand. They feel disconnected, unloved, and powerless. They may even feel jealous, not of the caregiving itself, but of being trusted enough to be included. This can happen even when the adult has willingly decided to be left or has become estranged. It’s complicated.
3. The Distant Sibling: This sibling doesn’t want to be involved for a variety of reasons. They may be protecting themselves from further harm or abuse. Some adults are too sensitive to the fact that their family member is sick and they avoid this reality (and facing it) by completely removing themselves from the dynamic. Sometimes this avoidance is rooted in self-protection and absolutely necessary. And, even when justified, it can cause issues between siblings.

All these roles come with their own unique pain. One person feels invisible, while the other feels indispensable. And because these roles mirror old family dynamics, it’s easy for resentment, jealousy, and competition to build between siblings who are already carrying decades of emotional history.

Why This Happens

There are many reasons these patterns form:

• Comfort and familiarity: The sick family member may feel most comfortable confiding in one child, especially if they’ve historically depended on that person.
• Gender and relational dynamics: Sometimes a parent prefers to talk about health issues with a same-gender child, or the “favorite” child, leaving others excluded.
• Estrangement or boundaries: The left-out or distant sibling may have chosen distance or set firm boundaries in the past, and being left out now is both painful and protective.
• Communication patterns: Some families are simply not skilled at transparent, group communication. They operate in triangles, engaging in one-on-one conversations that fuel tension between others.

Recognizing why this dynamic is happening doesn’t make it easier, but it helps you make sense of your feelings.

If You’re the Overburdened One

You might feel like the only adult in the room. You may think, “If I don’t do it, no one will.” That may be partly true, but it doesn’t mean you should do everything alone.

Try this:

• Name your limits out loud. “I can handle the medical appointments, but I can’t manage her bills.”
• Document and delegate. Keep a shared notes app or spreadsheet so everyone has access to updates. This helps reduce the power struggle around information.
• Let go of being the ‘only one who can do it right.’ Sometimes, good enough has to be good enough.
• Acknowledge your resentment instead of shaming yourself for it. Feeling angry doesn’t make you ungrateful or unloving. it makes you human.

If You’re the Distant, Left-Out, or Excluded One

Being excluded can trigger feelings of childhood invisibility and rejection. You might think, “I guess I never mattered enough to be included.” You may know your distance is necessary, but still wish things were different.

Try this:

• Ask directly for updates. Don’t wait for information to trickle down. A simple, “Can you keep me in the loop about Mom’s appointments?” can go a long way.
• Clarify your capacity. You don’t have to overcompensate to prove you care. You can say, “I can’t be there in person, but I’d like to contribute by managing paperwork or checking in on weekends.”
• Process the grief of being left out. Sometimes your exclusion is self-protection. If you were looped in, you’d also be looped back into old pain. It’s okay to feel both sad and relieved.

When You and Your Siblings Disagree

Caregiving conflicts often aren’t about logistics. They’re about perception, who’s the “good” child, who’s “selfish,” who’s “always been difficult.” But you rarely solve emotional history in the middle of a health crisis. You can, however, focus on clarity and containment.

Tools that can help:

• Hold a caregiving meeting (even if it’s just two of you).Write down what needs to be done and divide tasks based on skills and availability, not guilt or birth order.
• Use “I” statements, not “you” accusations.Try: “I feel overwhelmed when I have to make every decision alone,” instead of, “You never help.”
• Make a shared family agreement.This could be a written list outlining each person’s responsibilities and limits, including emotional labor, not just physical care.
• Separate your parent’s needs from your sibling dynamics.Ask: “What does Mom actually need right now?” and “What do we need from each other to make this sustainable?”

If You’re Estranged or Protecting Yourself

For some adult children, being involved in caregiving isn’t safe. You may want to know what’s happening, but not at the cost of your mental or emotional health. It’s okay to stay informed without becoming re-entangled. You might say:

• “Please keep me updated about major health changes, but I can’t participate in decision-making or day-to-day caregiving.”

And then, let yourself grieve what you wish could be different — the relationship, the family cooperation, the sense of unity that may never come.

Illness brings out the best and worst in families.

It can reopen old wounds, expose resentments, and reveal who still feels responsible for everyone else’s happiness. You can’t make your family functional overnight, but you can choose to respond differently with boundaries, clarity, and compassion for yourself and your siblings. Caregiving isn’t just about who shows up physically. It’s also about emotional presence, communication, and recognizing that everyone is carrying their own invisible load.