“It’s so difficult to find the right gifts for loved-ones because what we really want for the holidays – connection, hope, faith, joy, wonder, magic – can’t be found on the shelves or on-line.” I’ve always remembered that insight – even though I can’t recall who said it!
This thought also relates
to the common family gathering scenario of seeing a parent or loved-one you
haven’t seen for a while and recognizing the challenges they were having last
year have now progressed to a level requiring action.
What happens next
can determine whether you move forward with connection, cooperation, and
support (what most people really want), or trigger conflict, anger, and
In a perfect world – long before the need arose – your family would have discussed
and planned for this type of scenario, but for the rest of us, a few do’s and don’ts
can help us navigate this experience.
Don’t Discuss Anyone in Their Absence
to mount a discussion about “what to do about Mom/Grandpa/whoever” without
including the person in question. A sure path to conflict is making decisions
for someone without respecting their right to be fully involved.
Don’t Take a Negative Approach
Using a person’s
inability to take care of themselves or their belongings, i.e., “your house/yard
is unkept, you’re not able to _________ anymore,” will not get you anywhere.
focused approach will result in either despondent acceptance or an angry denial
and demand to mind your own business. Both responses are equally destructive.
Don’t Blame It on Age
Assuming that your
loved-one’s decline is “simply age” is unwise and unhealthy. Age is not a
diagnosis, so don’t treat it as such.
Don’t Involve Connectedness
Many people tend to
regress into family roles that take the focus off of solutions. This is not the
time to compare how much better you know Dad than other family members, or air
Learn as Much as You Can About Your Loved One’s Daily Life
Gather as much
information as possible from your loved-one and those in his daily life about
how and what he’s doing. Consciously gather positives as well as negatives. Is
he staying connected to friends, helping others, staying active, etc.?
Stay Focused on Solutions
tempting – especially when you expect push back and denial– to generate an
irrefutable list of examples of how the person in question is unable to manage
on his own anymore.
Seek a Medical Evaluation
Make sure you have
the opinion of a medical professional, i.e., if your loved one is at risk for a
fall then physical therapy can help.
Discuss Ideal Care Options
How does each
person involved in decision making envision an optimal “care environment”? If
one person wants to create a “safety bubble” and someone else is willing to
accept risk in exchange for empowering the individual to do as much for
themselves as possible, that sets the stage for both immediate and escalating
Understand Quality of Life Values
Ask your loved one about
his most important values in regard to quality of life, and frame discussions
around how to support those values as much as possible.
The goal is to seek
adaptive strategies, assistance, and cooperation to help your loved one get
what he needs/wants from the living environment.
people want to retain control of their lives to the greatest degree possible so
before making decisions, consider how you would react in their shoes.
Remember, you are
seeking to create a conversation around this issue before it becomes a crisis
leaving few options. Here are 3 ways to go about it.
Culture of Well-Being
a culture of well-being rather than illness management. A culture of care can develop
by default out of a health crisis. Illness management “hitch-hikes” home from
the hospital and never leaves.
in all dimensions – physical, social, emotional, intellectual, spiritual, and
vocational – rather than allowing medication
management, doctor’s appointments, etc. to dominate the culture of care.
Create a care
partnership rather than a caregiver/care-receiver relationship. This helps
build a care environment that can be sustained over the long haul.
A care partnership
acknowledges that the needs of the person requiring care are often more urgent,
but they are not more important than the needs of others involved.
The person needing
care also has expectations for contributing to the best of his ability to his
own well-being and the well-being of others. This approach recognizes his need for
self-efficacy and to give as well as receive, regardless of challenges.
It may be as simple
as saying thank you, graciously accepting help when needed, or recognizing when
changes have to be made. A care partnership may also require respecting your
loved one’s choices even if it makes a care-partner uncomfortable.
Disability Movement Model
require a delicate balance. Consider how empowering people with disabilities
has demonstrated the critical need to uplift resilience, self-efficacy,
purpose, and self-esteem to support their quality of life.
In this model,
young people with severe disabilities are given resources, tools, and
encouragement to overcome challenges and live fully in spite of them. They are
provided adaptive strategies to help them participate in the broader world – not just strategies to make their world smaller and more
Adopt the same
approach with a loved one, regardless of their age.
The Aging & Family Resilience Checklist can help you evaluate your existing culture of care. For additional reading, you can delve into these two journal articles, Aging and Family Resilience Part 1 and Part 2.
What kind of
care environment do you envision for yourself if you ever needed assistance? Have
you articulated that to family or friends? Has your family or friend group ever
discussed the “what ifs” surrounding how to respond to a loved-one in need?
Please join the conversation, and let’s discuss this important topic!