Tips When Making Elder Care Decisions

Posted on December 2, 2012

Making care decisions when elderly parents’ declining health threatens independent living is a challenge that many families face. For adult children, it can be emotionally wrenching to witness parents’ physical and mental decline. Balancing the need for safety, while preserving independence and honoring elders’ wishes, is daunting. In navigating this difficult course, each family must make careful decisions best matched to their needs and resources. Here are some tips to consider:

1)    Plan to have conversations in advance of a medical crisis, about elders’ long-term care needs, values and care choices. The “Conversation Project” offers detailed guidance on structuring these important conversations.  http://theconversationproject.org/starter-kit/intro/. Encourage and support elders to discuss their care preferences and complete advance directives and health care power of attorney. Listen to the elders’ needs, acknowledge the difficulty in making these decisions, offer support and encourage them to participate in decision-making as much as possible.

2)    Making these sorts of care decisions may dredge up past emotional issues for adult siblings.  Strong emotional reactions can quickly derail these sensitive conversations. A self-monitoring strategy that may be useful is, as soon as you feel the emotions rising use that as a signal to stop short. Emotional reactions have no place in wise decision-making; work to regain a rational perspective. Then objectively reflect on what is the best choice weighing all evidence. Open honest communication and respectful compromise are critical. This process can be made easier when the central focus for all family members is on what is in the best interest of elderly parents. Elders’ preferences, resources, safety and quality of life issues ought to drive the care decisions.

3)    Carefully weigh the pros and cons of each viable care option.  Balance the needs of elderly parents with available resources and adult siblings’ caregiving abilities. Family caregivers can take on responsibilities matched with their talents and strengths, e.g., one sibling may manage health care decisions while another manages financial issues.

4)    If an impasse is reached, consider seeking professional advice.  For example, geriatricians, geriatric care managers, or elder law attorneys can provide important information and guidance.