How Families Prepare For The Decline Of Their Older Family Members

nFamily interactions concerning parents typically evoke myriad emotions -- obligation, guilt, devotion, concern, anxiety and embarrassment. These sentiments, often deep-rooted in our very essence, often dictate our response when we face the reality that a parent needs our assistance. A host of obstacles may threaten our ability to care for our parents in the manner to which they (or others) expect. These obstacles include sibling rivalries, work obligations, family duties, long-distance.nnMix those obstacles with physical and/or cognitive impairments –and that’s what routine caregiving for older adults entails. Even the strongest families struggle with aging issues and experience distress when parents’ needs escalate. Families that have planned well generally face such situations with a bit more composure, though a new twist could send the family into an unexpected impasse. nnHow do families prepare for the decline of their loved ones? First, they talk. Healthy families have open conversations about medical conditions, financial situations and declines in abilities. The older generation shares with younger generations about their estate planning (wills, trusts, advanced directives and living wills), their struggles and their expectations and desires for the future. These families do not require their children to promise that they will never place them in a nursing facility. Such a promise may need to be broken if finances sufficient to hire 24-hour nursing care are not available and/or if the family is not available to care for the older adults twenty-four hours a day.nnPreparation is also key for healthy families. In such families, the estate plan is complete and it is updated regularly. Physician visits are up-to-date; medication and treatment regimes are adhered to. These families also understand the value of friends, hobbies and social activities, for all family members. Adaptations for any deficits are readily available for family members, such as devices to assist those who may be hearing-impaired or sight-impaired. Alternate transportation is sought for those who are (or should be) refraining from driving. nnPrepared families also have contingency plans. Older adults may have emergency response systems in place, in case they fall and they can’t reach the telephone to ask for help. Parents have ongoing, healthy relationships with their children, who check on them frequently. If the children are out-of-town, neighbors and friends are available both to assist the older generation and to inform the younger generation when cognitive changes may occur.nnSome families have the ability to converse fluidly, to develop plans that work for everyone and to create options when faced with complications. Other families don’t work that way. Elder mediation can help these families fill-in the gaps to face the challenges of aging more effectively. Even healthy, dynamic families may benefit by sharing concerns candidly with an impartial third party versed in eldercare issues. n nFrequently, families haven’t talked, prepared or created contingency plans. When facing a crisis, each member brings their own perspective. Often, many different views are brought to the table. The issues may revolve around caregiving, residency options, medical decision-making, or probate issues. When family members come from different positions, it is difficult to work on the actual issues confronting the older adults. An inability to resolve these issues harmoniously may impact the quality of life for older adults.nnElder mediation provides a non-adversarial approach to help families resolve differences. By allowing everyone to tell their story, mediators offer all participants an equal footing, removing potential struggles. The mediators guide the participants to identify common issues and help them to move from their rigid stances. Often, new ideas are generated through an exchange of ideas that would likely not to have occurred with the prior dysfunctional communication patterns. Rather than a win-lose, the mediation process allows the family members to create win-win options, benefiting the older adults and the family as a unit. With any luck, dysfunctional families that have experienced a successful mediation process will be able to talk openly (on an ongoing basis), to prepare (fully) and to develop new contingency plans.nnnnnnn