'Where do we go from here?' Decide as a family


The holidays are the time of year when most adult children visit their parents. Some are very surprised to see how their parents have aged and observe how much their function might have changed.

Consider the following scenario: Mom is in late stage Alzheimer's and lives with Dad in a small town. The four adult children live several hours away.

After a holiday visit by the oldest daughter, it has become apparent that Mom has declined significantly. Dad is exhausted. The daughter has contacted her siblings and expressed her concern about both parents and her anxiety about what needs to be done to help them.

The question arises: "Where do we go from here?" A family meeting to discuss how to best handle a loved one's declining health has the potential to build bridges or create divisions among family members.

To insure a successful meeting, all must collaborate. Get all family members involved, no exceptions. Having a clear purpose, a convenient time and location, and an attitude of teamwork motivates people to attend. Distance can be overcome via a conference call or Internet conference, such as Skype or Facetime.

Because Mom's dementia makes her incompetent to make decisions, Dad should ask a friend or hire a caregiver to stay with Mom so he can fully participate.

Discussion topics might include personal care, finances-bill paying, transportation, cleaning, groceries and cooking, legal issues, doctors' appointments, safety, emotional support and housing. Discussing everyone's expectations creates an atmosphere of honesty and a willingness to listen to each other.

Though this discussion might produce awkward and uncomfortable feelings for some family members, it helps to acknowledge and accept each person's feelings.

Written communication is vital. Designate a person to take minutes. After the meeting, copies should be sent to everyone to avoid any misunderstanding.

Second, organize. Questions to discuss: What are our options? What do we need to know? What can each of us contribute? "What if" such-and-such happens? Who else needs to be involved? How will scheduling or emergencies be handled? What community resources are available? Is it time for outside help?

Talking in advance about difficult situations will lessen future problems and clarify communications. Assess the best use of family members' skills and keep a record of who agrees to take responsibility for each area discussed.

Third, analyze. After gaining factual knowledge, agree ahead of time that everyone will try to work together and acknowledge that adjustments will have to be made. Analyze and reassess the plan as the situation progresses.

Fourth, recognize. Emotional factors underlie all family meetings. Members might be at different places emotionally. Respect the other person's right to express feelings, even to say no.

Use effective communication techniques such as using "I statements" and empathetic listening to strengthen relationships.

Recognize the grieving process - with all its emotional stages - is already happening.

For more information, visit www.HelpforAlzheimersFamilies.com and www.caregiverstress.com.

Rachel Carson is a Certified Senior Advisor and owner of Home Instead Senior Care, serving the Lowcountry since 1997.

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