Sometimes caregiving becomes a family affair, especially when difficult decisions regarding care and the care recipient’s future needs are concerned.
When I was 34-years-old, my dad had a massive stroke. It was a very challenging and emotional time for our family.
Not only did our family discover how fractured and disorganized our health care system was, we were left making some very difficult decisions around treatment, housing options, financial changes due to loss of income and perhaps the most difficult and painful decision, to take Dad off life support.
We were emotionally taxed too. Mom worked full-time and when she wasn’t visiting her Dad in hospital, she was visiting her frail mother with dementia in a long-term care facility.
Family meetings with adult siblings and other relatives are a useful tool when making key decisions about those being cared for. Typically, conversations are a little more serious than who will wash the dishes or who get to eat the last piece of cake. Caregiving families deal with tough issues, such as difficult diagnoses, financial losses, end-of-life care, dementia, selling the family home and at times placement in residential care. Not everyone is going to agree and yet, it is in the best interest of the person who is receiving care if consensus is reached.
Despite reaching mature adulthood, unresolved issues and sibling rivalry can resurface, resulting in emotionally charged discussions. It’s important to remember that the focus of your family meetings should be dealing with your family member’s care.
The Four Ps for a peaceful and productive family meeting
The four Ps outlines some basic strategies to arrive at productive, focused and somewhat peaceful family meetings. This approach is primarily directed at families dealing with the care of a family member who is resisting care and/or experiencing cognitive impairment. It is always important to include the care recipient in the decision making process; however, at times, families need to work through some strategies and possible intervention prior to this point on their own.
Managing someone’s care with family is just like collaborating with a team at work. Appoint a family member, who is not the primary caregiver, to take on the role of being the project manager.
Ask siblings to list their concerns ahead of time. Develop a short agenda. Include the list of concerns brought forward by each family member.
Identify areas of agreement and disagreement. Generate and prioritize a list of problems and conflicts. Allow for back-and-forth between family members by discussing options and solutions until some form of consensus is reached.
Document a time-sensitive action plan. Include what each family member has offered to do and how often. Set a review date.
Gather as much information as possible on the medical, health, emotional, social, legal and financial issues at hand. Share the information with family members ahead of time. Write a daily or weekly care-and-support schedule to provide an objective view of what care is involved. Research services and support programs in the community.
Allow everyone at the meeting to have the same amount of time to have his or her say. It builds team spirit, accountability and a “we’re-all-in-this-together” attitude. Encourage everyone to be honest about limitations when identifying roles and responsibilities.
Set ground rules. If everyone can’t play nicely or share, consider involving a professional. Case managers, eldercare planners, social workers, or a minister can facilitate the process objectively, keep the meeting focused, quickly identify priorities, and provide clear action items for families to follow up with.
Use this system to facilitate family decision making about care. It won’t be easy, there will be conflict, but when everyone or most of your family members can approach difficult decisions relating to care in a team, or businesslike, manner, it can alleviate some of the stress.
Do you have questions about making difficult decisions as a family? Ask in the comments below!