Getting the Family to Agree on a Care Plan for an Older Adult

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Tempers can run high when an aging relative falls into a crisis and different family members have varying opinions. Generally, disagreements about money—who is in charge of it and how it will be used—and housing—should our parents stay at home or move—are the two most common family arguments.

But don't despair! There are strategies to effectively communicate and provide care and support for your loved one during a stressful situation. So what are some steps to reduce family conflict and improve communication?

Step 1: Hit the pause button

Making a decision impulsively or when you are feeling emotionally charged can backfire. When possible, stop and take some time.

You can always say, "I need a minute, a day or a week to think things through."

It is essential to schedule a time to re-visit the issue, so all family members know that there will be a discussion coming shortly and that you are not avoiding the problems.The follow up can be a phone call, email or (if possible) a family meeting. All family members must be included. Leaving someone out will only lead to resentment, and additional communication and relationship problems.

Step 2: Create a cheat sheet

Everyone in the family, including the older relative, makes a list of the symptoms or problems that they have observed. You can do this prior to your meeting or together as a family.

Remove your feelings or hypotheses about the problems and just list the facts such as, "Mom is losing weight. Mom is falling a lot at home. Mom is not taking her medication." If you focus on symptoms and remove yourself, you are less likely to start blaming others and causing more family strife.

Step 3: Include a mission statement

State what you want for your parent. Do not include an outcome or who is to blame. For example, "I want mom to be safe." Not, "I want her to be safe at home, or in a residence."

In this way the family discovers that they share a common mission, which can help to diffuse conflict and align everyone's objectives. Yes, there may be differences of opinion on HOW to meet that goal, but usually all family members are focused on the safety and happiness of their loved one.

When tempers flare, return to the family mission statement to realign and refocus.

Step 4: List the possible solutions for each symptom

Don't forget to list every solution available before making a decision about which one is right for your loved one.

Step 5: Do the research and set a time frame for the research follow-up

Each family member will volunteer to research a solution. Notice, that I wrote volunteer. People like to choose what they do and they do not want to feel like they are being told what to do.

Make sure to include the older relative in the entire process. After all, it is their life and they should be the team captain, if possible! At the follow-up meeting, options are presented and the family can now look at which one may work best. If necessary, the family can start again with a cheat sheet in order to formulate who will take on which responsibility to implement the plan.

Your cheat sheet might look something like this:

Care Plan Cheat Sheet
SymptomsSolutionsResearch
Weight lossFamily brings mealsPlan meal schedule
Order mealsSusan to compare prices
Hire help in homeJeff to research agencies
Move to residenceTodd to research options
FallsInstall equipment/make adaptationsTodd research/install
Hire help in homeJeff to research agencies
Personal alarm systemSusan to look up companies
Move to residenceTodd to research options

In the end, if some family members don't want to participate, those who engage must focus on the mission statement and reaffirm to themselves why they are doing this. Try not to resent those who won't help by continuing to be someone who will.

Stephanie Erickson, MSW, PSW, LCSW specializes in working with seniors and their families. She founded Erickson Resource Group, hosts a free weekly podcast “Caregivers’ Circle” on WebTalkRadio.net and is a frequent TV and radio guest. She has a clinical practice and trains financial institutions, community groups and professional organizations.

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4 Comments

I would say the best thing to do is keep the elder at home with family. Cause I have seen to many bad things happen involving nursing homes. If sedative overdoses and powerful drugs like haldol are banned then maybe nursing homes could be safer but I'm still not sure I would trust one at all
Good suggestions. Problem is when one person wields all the legal power... :(
Good idea to involve the whole family early to choose and let your elderly relative help choose the home care provider carefully or the Residential care home, it's not about brand (although it helps), it's about the people who will be giving the care, the person recovering/receiving care needs to use their intuition, if they have a bad feeling about the person providing the care, speak up and ask for someone else.
The business were in loved with "My SOS Family" which meets lots of elderly and their family always advices that the independence and dignity of the elderly are a priority, they need to be involved every step and that's why they've created a personal alarm pendant that helps them stay connected to their loved ones.