Watching a parent grow older, become more frail and maybe more vulnerable can be an enriching experience when there is a framework for understanding the stage they are in. Without understanding some of the common stages, however, it can be a time fraught with frustration and anxiety. This time of life for an elder is called “late life” and one of the books that best describes and supports this time is the pioneering book, “ My Mother, Your Mother”, by Dr. Dennis McCullough.
The stage that will be the focus of this article is the crisis stage. This stage is characterized by an acute medical episode such as a fall or a stroke. It can be something non-medical but just as devastating such as loss of driving privileges, loss of memory; some life change that has begun significantly altering the elders’ lifestyle. Typically the elder is in denial of the severity of the change and the children are overly anxious as they are projecting the worst case scenario on to the elder. Communications frequently breakdown as anxieties collide. The elder does not want the children telling them what to do and the children want a permanent solution placed on their parent so they don’t have to worry anymore.
Strategies for the Crisis Stage: Bring in an objective third party to guide these communications, which are usually fraught with emotions. Professional Geriatric Care Managers are elder care experts who understand the complex systems that care for the elder (hospitals, nursing homes, assisted living facilities) and can help the family successfully resolve the immediate problem and coordinate a plan of care for after the crisis is over. They listen carefully to each family member and the elder to help the family come to a consensus.
Family meetings for are set up on a regular basis for the future with the following recommended components. First, time in the beginning of the call should be allowed for each family member’s concerns to get verbalized. Secondly, prioritize the concerns and list the responsibilities associated with the concerns. Lastly, divide the responsibilities for the care of the elder. For example, long distance siblings may be responsible for communicating to other family members via e mail, phone or Facebook. They may also take on the insurance issues, or financial issues that arise. This leaves the hands on care for the child who lives locally. The Care Manager can be on the calls to help with the decision making and also provide guidance and assistance in implementing some of the solutions the family members decide upon.
After the crisis, the family meetings should be continued to maintain continuity of communication and to maintain the plan of care for the parent.
Amy Cameron O’Rourke, MPH, CMC
The Cameron Group
Orlando, Florida 32803