This is a column about caregiving for aging parents. I write mostly about long distance caregiving issues because my dad is 1000 miles or so away in Kansas. There are a lot of parallels between long distance, and shorter distance caregiving, such as this month's topic. I'd like to propose a new support group: Adult Siblings of Aging Parents, or ASAP! (With apologies to the very fine Children of Aging Parents, CAPs, which offers support groups for persons to talk about issues with their aging parents.) ASAP would address issues between siblings.

Have you noticed how, even though your role as a daughter or son may have evolved somewhat over the years, that your birth order is still encumbering your ability to effectively relate to your siblings to make meaningful change with your aging parents?

My only brother, and the only sibling in Kansas, is my father's Power of Attorney. He's the second oldest in the family, and until now, I never new that he had a secret vice for power. Recently I called my dad and asked to be included in any future meetings with physicians, via speaker phone, so that I could help in my professional venue as a care manager to ensure that he was fully educated regarding his choices and consequences of his decisions. Every surgery he has had this past year has been a fiasco of recovery and misinformation, it seems. In response, I received a telephone call from my brother, giving me the schedule of events to come. There will be a meeting between all of Dad's doctors and the surgical team on Thursday, then there will be a chest x-ray and EEG on Monday, and if all is well, his ileostomy will be reversed next Wednesday. Oh, and by the way, "you're not invited."

Remember what it felt like for your big brother to push you down a hill? Well, I remember now! Okay, bro, message received. Luckily my brother's message was on my answering machine. If he had said such a thing to me directly, my answer might have been, "Oh yeah? Well, yuh-huh!"

So enough complaining. Gary has the brunt of the work handling my dad's needs, and I've praised him to the masses as the primary caregiver. Now let's talk about another example of the Sandwich Generation and lighten up the discussion a little.

My middle sister, Bette (I'm the youngest, of course -- spoiled rotten if you ask anyone), turned 50 last January 1, and on May 29 of this year a dream came true for her. Through embryo cryogenics and surrogacy, she brought home her very own baby daughter. Rosemary Margaret was named after our departed mother. Bette finally has her baby, but missed out on all the attention that I got from our mother. If she were here, Mama would have been on a plane to California as soon as Bette said she was ready for a visit (probably immediately). Mama would have showered her with unusual and yet highly desirable gifts such as tiny shoes and thermal blankets. She would have called Bette, "Little Mama," and shown her how to properly burp a newborn.

Instead, no one from our family had visited little Rosemary as of October. We have all been so busy making trips home to visit Daddy that no one has made time to visit the new mom.

Bette was really there for my dad when our mother died almost three years ago now. She stayed with Daddy, for almost 6 weeks, unencumbered by children or a demanding career (albeit her husband often attempted to "demand" her return). The exemplary middle child, Bette saw that Daddy acclimated as a widower. She helped settle some of Mother's affairs, helped sort through copious piles of "stuff' and steered Dad towards some important estate planning issues, such as appointing a POA.

Bette was instrumental in getting Dad settled into a comfortable lifestyle. Emotionally, she's been the closest to Dad ever since, and I think she helped him open up to feelings a little more, such as being able to say "I love you" on the telephone. She calls him more often than any of us, at least every 3 or 4 days, and she doesn't mince words with him. (I'm still careful how I phrase any sentence for fear of incurring his wrath -- it's a daughter/dad thing.)

Since Dad's been sick, it's probably been hardest on Bette emotionally as well. Here she wants to share this new grandbaby with him, and he's been too sick to travel, and she has no desire to travel these days with a baby (who can blame her).

So, it finally dawned on me that it was time to do something to welcome Rosemary into the family. I had a National Association of Professional Geriatric Care Managers conference in Denver in early October, and decided Denver was close enough to Riverside, California, to take an extra few days. And what a treat it was.

Bette and I reconnected as sisters often easily do. We went clothes shopping. Twice. We had two fashion shows afterward in her massive bedroom. She re-packed my clothes for me and had to loan me an extra suitcase because I bought so many outfits and she even gave me a few that fit me better than her (sorry, Bette!).

And I got to hold a baby. Rosemary is the fattest, cutest, sweetest, best-natured baby that I've ever met, and of course I have no bias whatsoever. It's not unusual that we Wilsons produce beautiful offspring. The most amazing thing is what a well-adjusted, happy mother that Bette is. She missed out on the physical act of carrying her baby in her womb, but the benefit to that was that she had no hormonal changes due to childbirth, and experienced no post-partum depression. Her age and desire for this child has produced a mother who is sincerely relaxed and grateful for each second that Rosemary is with her. Before my visit, she would call me at odd hours and say, "Listen. Rosemary's grunting.." and the phone would be silent except for odd creaking noises that were Rosemary's voice.

Sometimes when you have an ill parent, siblings forget to interact as siblings. You get so caught up in the duties and necessities, the chores and the decisions, that you forget to just be together. Daddy's being ill this year has affected all of us profoundly. Gary's life has been concentrated on Daddy's care; he has given up all of his vacation days and many more besides, to be at Dad's side and arrange for all of his care. My oldest sister, Pam, in Tennessee has felt the helplessness of being far away. She has a daughter in Middle School who needs her at home, but even so she has made at least two trips to visit Daddy this year. I've tried to help in my own way, and have succeeded in alienating my brother and annoying my father. I'll have to work on making amends. And Bette has sat alone in California, with no one to share her joy, and feeling half guilty for selfishly yelling at daddy that, "You'd better not die during Christmas!"

So Bette and I reconnected and had a great time being sisters together. I was in California for my birthday and she treated me like a queen. Tiny Rosemary went everywhere with us, quite the shopper herself, and an angel in restaurants. Plus we spent time at Bette's home where we just lounged around playing with Rosemary and Bette's kitties, and watching HBO.

The holidays are coming up. Look past the concerns that you and your siblings share about your parents, and connect with them as siblings again. Brothers and sisters are precious things, even though you can't pick and choose them. You're stuck with what you've got, and there's probably a lot there that you don't know about. Find out what your siblings have to offer you, and brighten their lives with yours. ASAP!

Debra Sorensen, MSW, LISW, CMC, is a professional care manager and owner of Debra J. Sorensen & Associates Inc., a private geriatric care management company serving Northwest Ohio and Southeast Michigan. She can be reached at 419-367-8835 or e-mail Debra@professionalcareforyou.com.