Growing old takes a lot of courage. It involves successive losses of physical stamina and strength, vision, motor skills, and often memory. As our family members age, their needs can change dramatically and quickly. Aging almost always brings with it a loss of independence that is downright humbling. At the same time as their independence is waning, our elders lose the very companions, spouses and friends upon whom they have relied, to whom they have looked for comfort in their adult lives. The need for assistance, love and caring from family peaks. This new level of need and reliance may come as a shock to family members if the elder has been very independent and/or family bonds have been historically weak or more currently stressed. Resources available to meet the elder’s needs vary greatly, as does a family’s ability to identify and employ appropriate resources. While the elder may not wish to be a burden, it’s almost inescapable that one or more family members will assume a decision-making role at some point.
A family’s ability to meet their elder’s needs will naturally depend upon resources, including both money and time, as well as proximity to their elder. Medical and financial issues are frequently complicated, and here the family’s ability to assist their elder is heavily dependent on time, savvy, and often sheer tenacity. While resources available to seniors and their families are growing rapidly, they are not consistent in quality and convenience, and can vary greatly by location. Services exist to help seniors and their family find suitable providers; however, identifying the best care providers for a senior’s needs requires time too. An elder’s need for assisted living for skilled nursing care may frequently require a move to senior housing. Unfortunately, very few families have conversations with their elders before a need arises, and many seniors are inclined to resist until a crisis occurs and placement options are limited to what’s available.
Each family has a set of skills and inabilities that they will draw upon as they attempt to meet their elder’s needs. I define skills in this context as the ability to do something well. In contrast, I use the term “inabilities” to refer both to the absence of one or more skills and to behaviors or personalities that complicate meeting the elder’s needs or prevent meeting them altogether. Most often, inabilities surface as multiple family members interact. Quite simply, siblings (or others as the case may be) often disagree, or just do not get along, and interactions can become unpleasant. In my experience, some level of disagreement almost always exists between siblings; if you think your family is alone in this, you are wrong. Do this: Think about your own family members for a moment. Imagine them interacting to make decisions about the housing or care for you. Think about a worse-case scenario, just for a moment. Consider which family members may have the skills and time to help you, or how you might otherwise meet your needs. Thinking about these issues in the context of our own lives can give us compassion and insight as we help our parents and other senior family members in this process as well.
Everyone should have a will and/or trust, elect a health care agent, and create a durable power of attorney enabling someone to take care of financial matters in the event of incapacity. These actions are an excellent start, but not enough. It is neither brilliant nor novel to exclaim that communication is the oil that keeps the machinery of relationships from breaking down. Why is it, then, that we forget or ignore that fact? Why are we more apt to believe that someone can read our minds or should know what we want, than to express how we feel and what we want? Why is that talking about money seems so taboo? Perhaps because these matters are particularly laden with emotion. Consider beginning your process by writing, then sharing your written thoughts with your family.
Providing family members with guidance for our last decade
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