Sibling Conflict Over Aged Care Decisions for a Parent With Dementia

The argument usually starts over something specific — whether Mum should go into residential care or stay at home, who is paying the Refundable Accommodation Deposit, whether the family home should be sold, or why one sibling is doing all the work while others have opinions but no involvement. Underneath, it is almost always about control, guilt, grief, and old family dynamics surfacing under extreme stress.

Sibling conflict during a parent's dementia journey is so common that aged care advocates, elder-law solicitors, and hospital social workers deal with it daily. Here is how to manage it before it damages both the family and your parent's care.

Why Dementia Makes Family Conflict Worse

With most family disagreements, you can defer to the person at the centre: what does Mum want? Dementia removes that circuit breaker. Your parent may express preferences that change hour to hour, agree with whoever spoke to them last, or lack the cognitive capacity to participate in the decision at all.

This creates a power vacuum. The sibling who lives closest often becomes the de facto decision-maker, which breeds resentment from interstate or overseas siblings who feel excluded. The sibling managing finances may be suspected of self-interest. The sibling who visits rarely may have unrealistic expectations about their parent's condition because they only see "good days."

Financial stakes amplify everything. Whether to sell the family home to fund a RAD, how to structure assets to protect the Age Pension, whether to pay the Daily Accommodation Payment instead — these are decisions worth hundreds of thousands of dollars, and siblings with different financial positions or inheritance expectations will see them differently.

Who Actually Has Legal Authority to Decide?

This is the question that resolves most disputes — or at least clarifies them.

If your parent executed an Enduring Power of Attorney (EPA) while they had cognitive capacity, the appointed attorney has the legal authority to make financial decisions. If they also appointed an Enduring Guardian (in NSW, WA, and Tasmania) or included personal/health decisions in their EPA (in Queensland, Victoria, ACT, and Northern Territory), that person has authority over care placement decisions too.

The appointed attorney is not required to consult with other siblings before making decisions. They have a legal obligation to act in the parent's best interests, not to achieve family consensus. This is a difficult reality for siblings who are not the appointed attorney, but it is the law.

If no EPA or guardianship instrument exists and your parent has lost capacity, no sibling has automatic legal authority. You will need to apply to the relevant state tribunal — NCAT in NSW, VCAT in Victoria, QCAT in Queensland, SAT in Western Australia, SACAT in South Australia, or TASCAT in Tasmania — for a guardianship or administration order. The tribunal will appoint a decision-maker, and it may not be the sibling who expects it. Any person with a genuine concern can apply, and the tribunal considers who is best placed to act in the parent's interests, not who is the eldest or closest.

Practical Steps to Reduce Conflict

Separate the financial decision from the care decision. Siblings often argue about residential care placement when they are actually arguing about money. Deal with the financial questions (how to fund the RAD, whether to sell the home, how the means test works) separately from the care question (what level of support does Mum actually need, and where is she safest). An accredited aged care financial adviser can present the financial options objectively — their $3,300 to $6,600 fee is far cheaper than the family solicitor bills that contested decisions generate.

Get independent information. Interstate siblings who believe "Mum is fine at home" may need to hear it from someone other than the primary carer sibling. Request a formal reassessment through the Single Assessment System — the assessor's clinical findings carry weight that a sibling's phone call cannot. A GP letter documenting cognitive decline, specific safety incidents, and care needs also provides an independent baseline.

Use family mediation before legal escalation. Community-based mediation services (often free or low-cost through state-funded programs) can help siblings negotiate care decisions in a structured setting. The Older Persons Advocacy Network (OPAN) on 1800 700 600 can also connect families with independent advocates who assist with care disputes — not as legal representatives, but as neutral facilitators who understand the aged care system.

Document everything. If you are the primary carer or the appointed attorney, keep written records of every care decision, every financial transaction, and every communication with other siblings. This protects you from future accusations of mismanagement and provides a clear trail if the matter ever reaches a tribunal.

When Conflict Becomes a Safeguarding Issue

If a sibling is suspected of financially exploiting the parent — misusing the EPA to access bank accounts, pressuring the parent to change their will, or making care decisions that benefit themselves rather than the parent — this crosses from family conflict into elder abuse. The Aged Care Quality and Safety Commission, state public trustees, and OPAN all have pathways to investigate and intervene. Any person can apply to the state tribunal to have an EPA reviewed or revoked if they believe the attorney is not acting in the principal's best interests.

Get the Family on the Same Page

The Dementia Care in Australia toolkit includes a family decision-making framework, a financial comparison worksheet for residential care costs, and a state-by-state guide to legal authority — giving every sibling the same factual foundation so decisions can be based on reality, not assumptions.

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