My sister and I had a big advantage when it became clear to us that our mother, then in her early 80s, no longer was independent enough to live on her own: We were great friends.
As our mom became increasingly forgetful and confused, my sister and I were confronted with a dizzying number of questions: Can anything be done to treat her condition? Does she need to go into a nursing home? What can we do to keep her in the home she loves? Does she need help right away, or can we wait a while? Does she have enough money to pay for the services she’ll need? How do we explain all of this to her?
Our mother’s dementia also confronted us with the painful reality that she was slipping away from us. Needless to say, it was a chaotic and emotional time for my sister and me, who also were juggling busy careers and families of our own.
If my sister and I hadn’t been close friends – if we didn’t see eye-to-eye on most things – I’m not sure how we would have gotten through that difficult period. If there’s one thing I learned caring for my mother in her final years, it’s the importance of communication among family members and friends.
A mountain of research and professional advice support this idea. A Place for Mom, a national agency that offers advice on senior living, warns that caring for elderly parents can lead to conflicts between siblings and other family members – which can make the job at hand a great deal more difficult.
“As elderly parents begin to rely on family for more support, the amount of conflict between adult children can increase. Dealing with a parent’s care can rekindle sibling rivalries that have lain dormant for years, and the discord can tear families apart.”
That may sound extreme, but many experts agree. One organization, the Family Caregiver Alliance, goes so far as to suggest that “a drink may make everyone more comfortable and more able to talk.” But, of course, “overconsumption should be avoided.”
Columnist Jim Zientara, a financial advisor who often writes about issues facing the elderly and their families, says caring for an aging parent or relative can put tremendous strains on family relationships. “One sister may live miles away and pay next to no attention to the parent, yet demand things be done her way instead of letting the local sister do what she feels is best,” he writes.
And make no mistake, he adds: It’s usually women who bear the brunt of the burden.
His advice: “Encourage open communication with your family to figure out ways to share the financial, emotional and time burdens. Hold regular meetings on the telephone or via email to discuss issues, set priorities and delegate tasks.”
Most experts agree that holding a family meeting, preferably in person, is an essential starting point. I remember meeting my sister for dinner in Red Bank after we visited our mom at Riverview Medical Center early on in the process. Those two hours we spent alone, uninterrupted by children or other distractions, allowed us to connect emotionally and share ideas about what to do next.
The Family Caregiver Alliance offers a comprehensive “how-to” guide on planning and conducting a family meeting. “When taking care of an elderly parent or another relative, family members need to work cooperatively,” the alliance notes.
Holding a family meeting is key to getting everyone on the same page. Although it may sound simple, organizing a constructive meeting that produces results is harder than you might think. To start with, who should be invited?
“In some families, only a husband/wife and their children are considered family. In other families, aunts, uncles, cousins, current and ex-in laws, and close friends may be included in the definition of family. When planning a family meeting, it is important to include everyone who is or will be part of the caregiving team.”
Then there’s the question of whether to include the elderly parent or relative who is the subject of the meeting. That will depend on his or her mental state. Elderly family members “usually do not want to be excluded from family events, and their preferences for care must be considered. However, if someone has dementia or another condition where he/she might misunderstand the purpose of the meeting, it might be appropriate to hold at least the first meeting without him/her present.”
If certain family members have trouble getting along or communicating, the alliance recommends engaging the help of an outside facilitator. This could be a priest or minister, family doctor, psychologist or social worker.
The next step is to draw up an agenda – yes, an agenda. Just as in the business world, a family meeting will be much more fruitful if there’s a list of priorities to guide the discussion. An agenda might include some or all of the following topics:
In many cases, such meetings will bring out long-simmering tensions and conflicts among family members, possibly triggering emotional outbursts and hurtful comments. That’s why the alliance suggests not trying to pack too much into the first meeting, and instead plan on holding a series of meetings. Even if some family members can’t physically attend each meeting, they can listen in remotely or get briefed later on.
“Remember that you can’t resolve long-standing family issues with one such meeting. The task is not to ‘fix’ the family, but rather to have everyone on the same team, as much as possible, in caring for someone who is ill.”
A final piece of advice from the alliance: Memorialize decisions made in the meeting by writing them down and sharing copies with all family members. This will help keep everyone focused on achieving the main goal: ensuring that an elderly parent or other relative receives the comfort, support and love they deserve in their final years.
Written by T.J. Foderaro