Talking with aging loved ones about their need for support and assistance when seniors are making poor decisions can certainly be a challenge. However, with some planning and preparation, discussing poor decisions among elderly can become much more manageable for all involved. Whenever possible, begin the process of providing support for important tasks, like bill paying, health care management and driving, before parents reach a crisis stage. This may not always be feasible, but even if the need for assistance is sudden and immediate, remember diplomacy and tact will generally elicit a significantly better outcome than issuing overt directives.
Determine When Support Is Needed
Sometimes family members have difficulty agreeing when and what kind of support may be needed to ensure their loved one's safety and well-being. Adult children may be unable to accept that their parent is no longer able to do things with ease and may initially respond by denying the problem. This can create dissension in the family and can further complicate making tough, but vital, decisions and plans.
In general, if your aging parent is making choices or engaging in behaviors that threaten her physical safety or the safety of others, her financial stability or her overall health, it is time to step in and provide some support. It is essential any disagreements among family members are resolved prior to discussing your concerns with your parent, so all members present a united and solid front. Before beginning any discussions, it may be advisable to brush up on effective communication strategies so decision-making can progress smoothly.
Develop a Plan
The first step is to develop a plan for both when to talk to your family member and the specific topics that need to be addressed. This plan should be created by all the family members who are reasonably able to participate. Involving family members from different generations can help broaden perspectives and make identifying the issues a less strenuous task for everyone. It also places accountability for care over a greater number of people. A good plan may take considerable time to develop, but it is time well spent. Having an 'off-the-cuff' conversation may lead to feelings of hurt and betrayal and it will accomplish little.
Write It Down
Write down each issue that needs to be addressed. Be specific and concrete about your concerns and avoid criticism or blame. It is better to use 'I' and 'We' statements to express concerns rather than to place blame on the aging relative, even when you are just in the beginning phase of planning a talk. For example, if your loved one is attempting to cook, but has set small fires, or burned herself, write how you are concerned for her safety instead of saying, "You set the kitchen on fire."
Once the issues have been identified, come up with at least a few ways to resolve each issue. Use brainstorming and try to think outside of the box. When everyone puts their heads together, you may find some creative solutions that are less invasive and more inviting to your aging parent. For example, in the situation mentioned above, each family member could provide a cooked meal a few times per week, which the relative could then simply heat in the microwave. Better yet, plan a day to cook together, so you can supervise and ensure safety as well as have fun together.
Once the family has determined what responsibilities need to be taken care of, it is time to decide who can execute those responsibilities most effectively. Sometimes the burden of care falls predominantly on one family member. This is not only unfair, it can lead to burnout and hard feelings. Everyone is busy, so dividing the tasks among several family members helps to alleviate the burden and can make providing care a joy rather than an obligation. Thinking outside the box and utilizing all available resources can help everyone. A few examples may include:
- Transportation can be carried out by high-school or college-age relatives. They generally have more convenient times available to take their aging relative to social events, medical appointments or shopping. Including a once-a-week lunch or dinner date is a great idea too. Chances are, your loved one will appreciate having the opportunity to spend time with younger family members and planning some social time together will help alleviate the sting of losing driving privileges. As a family, provide compensation to help offset the costs of gasoline and meals; all working family members can contribute a nominal amount so no one is overburdened.
- Accompanying your relative to medical appointments may become necessary, but this can be tough to do when you work. Some medical practices offer after-hours appointments, but many do not. Try spreading this task out over several adults. If you are the only person available, consider hiring an advocate to take your place. Advocates are trained professionals who not only understand common medical conditions that affect the elderly, they also have significant knowledge about medical insurance, billing and other related health matters. They can be an invaluable resource even when you are managing most of the direct care yourself and there are numerous options available; some are even free.
- Advocates can also monitor medications and ensure they are taken properly; however, you can also load weekly, bi-weekly or monthly pill cases that separate needed medications by dose and time. These cases are available in a wide variety of styles to fit almost any scheduling need. There are also many pharmacies that will load medications in a blister pack so they can easily be taken according to the correct schedule. You should make periodic checks to ensure your loved one is able to manage this arrangement. If you have any concerns, make someone else responsible for administering daily doses.
- Housekeeping and lawn maintenance can be overwhelming tasks for anyone, but keeping the home and yard clutter-free and clean is important. This is another set of tasks younger family members can take care of, or you can hire a professional crew. These services offer good value and are not cost prohibitive in most cases.
- Keeping track of these allocated responsibilities is important, and fortunately, technology makes it easy. Choose the most tech-savvy person (maybe your teenager) to create a spreadsheet in a cloud-based resource, like Google Sheets, so you can all log in the tasks you have completed. If you have family members who aren't computer-able, then assign this task to someone who is. This will allow all family members to stay in touch and keep informed without having to impose on anyone's schedule. When possible, it is still a good idea to touch base face-to-face with one another to iron out any problems, but a spreadsheet will go a long way in helping you to understand what is working effectively and what is not.
These are just a few suggestions for managing some of the most common issues that affect the elderly. Keep in mind your aging family member may have some great ideas as well, so allow him to have input whenever possible and remain flexible and open.
Choose the Time and Place Wisely
When deciding when this conversation will take place, keep in mind your elderly person's schedule may not be in accordance with yours. Choose a time your family member will be most receptive and well-rested and when you won't be thinking of other obligations. For many aging people, the morning hours are when they are most alert and less likely to be forgetful and irritable. If possible, elect to have this conversation in your loved one's place of residence, so she will have the comfort of familiar surroundings and privacy.
Choose a Spokesperson
While it is important that all concerned family members contribute to the planning, it may not be advisable for everyone to do the talking. Limit the discussion to one or two spokespeople and remember to allow everyone time to speak, particularly your loved one. State concerns in a non-threatening manner and offer a variety of solutions. Whenever possible, encourage the aging relative to come up with alternative solutions herself. After all, she has a lot of life experience and may have some great ideas.
Before you even begin the conversation, make sure you have set up a distraction-free environment. Turn off the television, radio and cell phones. Allow ample time for your family member to process the information you are presenting and be prepared to answer any questions candidly, but kindly. Try not to appear rushed or frenzied. If possible, take the day off work so you will have all the time you need.
Alternatives to Family Supports
Most adult children want to be there for their aging relatives, both emotionally and physically, but sometimes it simply isn't feasible. Living in a different town or having small children or other family responsibilities to manage can impede the amount of time that can be devoted to directly caring for aging family members. There are a number of other solutions families can use as well as a variety of support organizations that can help with both advice and with direct support.
Even when you can provide some support directly, having an additional pair of hands and some expert guidance can help busy families manage the care of an aging loved one with greater ease. This is particularly helpful when family members can't agree on what needs to be done. An objective voice can help keep the family working together and moving in the right direction.
Implementing and Evaluating the Plan
Whether you have come up with ideas and strategies or have used other support services, it is important to remember the plan for support will need to be assessed and possibly tweaked on an ongoing basis. Try to elicit feedback from your loved one on how she thinks things are going and what she may want to change. Keep family members informed as well. If you are using a spreadsheet or other tracking document, you can readily find out what is working effectively and make changes as needed.
With aging relatives, care needs will most likely increase as time passes. Don't hesitate to make use of all available resources if you are having trouble. Also, don't be afraid to seek outside help when you need it. There is no badge of honor for doing it all alone. Even professionals caregivers can be challenged by the complex needs of the aged and you will likely only exhaust yourself without help. Just remember to be patient, be kind and be flexible with both your loved one and yourself.