A family visit can range from fun to extremely stressful for all sorts of reasons, but one common outcome is that adult children who haven't seen their aging parents in a while to come away with feelings of surprise, fear, shock and even anger.
Aging loved ones often do an excellent job of "hiding" their declining physical or cognitive abilities from their families—especially from those who live far away. They do this for a range of reasons – from not wanting their family "in their business," to an outright denial that there is a decline. They may even lack the cognitive ability to recognize that they have a problem.
If a recent holiday visit with an aging family member has caused you a bit of panic, here are ten steps to create a plan and avoid a new caregiver crisis:
- Assess the situation: Do you have a crisis on your hands? An urgent situation? Or an ongoing chronic decline? Your answer to this very important question will determine how quickly you must act and make decisions, and how much collaboration with other family members you can afford to engage in. The more urgent the situation, the less time you will have to allow your parent and/or your siblings a lot of input. If you find yourself in this place, make sure that you are, in fact, the person with the legal authority and responsibility to be making decisions. If you aren't, then it is imperative that you immediately get the person who has this authority to get involved. If no such person has been named, your loved one should formally select someone right away, if they still have the cognitive capacity to do so. If not, you may have to seek a court-appointed guardianship or conservatorship.
- Prioritize their needs: Make a long list of everything you can think of that needs to be done, fixed, solved or otherwise handled. Prioritize this list according to what needs to be accomplished right now and what can wait (it is essential to distinguish between wants and needs). Also, consider those things that are best taken care of "on the scene" and which things can be handled from afar.
- Remember that safety must come first: As you are prioritizing, don't forget that your job is to make sure that your loved one stays safe. Anything that is now, or could become, a safety issue should be near the top of your list.
- Make efforts to prioritize your parent's independence: Remember that whenever you can make a choice or recommendation that prioritizes your parent's independence you will generally get less resistance when it comes time to implement that decision. The most difficult aspect of aging for many older adults is the real (or perceived) loss of independence, so if you can keep your loved one safe and as independent as possible it is almost always the better choice.
- Get organized: Now that you have made a ranked list of all of the current and impending needs, it's time to get that list organized. At a minimum, make a sheet with three columns. In the first column, list the needs in order from highest to lowest priority. In the second column, write down your proposed solution, if you know it (leave it blank if you don't). In the third column, write down the next step you need to take in order to work toward that solution. Discover other strategies for getting (and staying) organized while caregiving.
- Figure out what resources you have available: Add a column to your list and fill in the resources you already know your family has. For example, if the issue is grocery shopping and your loved one already has a trusted housekeeper who comes once a week, maybe you can ask that person to take your loved one shopping, or do it for them. If the issue is how to pay for care, you might write down that your parent is a veteran and may be eligible for veteran's benefits that would cover the cost. If you are not sure what resources your family has to deal with a particular need, leave it blank. Here's a helpful list of resources every caregiver should know.
- Make a plan: Look at that prioritized list. If there are a lot of blanks, your first step is to begin to fill them in so that you can create a more comprehensive plan. If the list is pretty well populated, now is the time to figure out how you might be able to divide and conquer.
- Build a team for now and later: Identify family, friends, neighbors and volunteers, along with other trusted advisors and professionals who will help you execute the plan. If you don't know these people, network and find them. Once you know who they are, make a comprehensive list with names, contact information and notes regarding who is available to do what.
- Communicate with both your loved one and the rest of the family: Don't do any of this in a vacuum. It is imperative to include both your loved one (assuming they are able to participate) and the rest of the family in the process of developing the plan. The more inclusive you can be, the less likely you will later face roadblocks.
- Execute your plan!
While each of these steps can seem overwhelming, if you try to tackle them one at a time in a logical order it will be much less so.
You may find that you need to do a "deep dive" into one of the steps; if that's the case, try to assess whether you should stop everything to do so or whether you should simply put that step in the "parking lot" and come back to it after you have moved through the others. Remember that any plans you make and implement will need to be revisited from time to time as your loved one's needs or resources change.