ARE YOU LISTENING?

Recently the National Care Planning Council published an article discussing the old adage as we did not listen to our parents when we were teenagers, we are now concerned with convincing our parents to listen to US regarding their present and future care needs.

The article stated, “[Adult children] are finding themselves concerned about their aging parents and what their needs will be as their health and mental abilities fail them. In some cases the children must take the role as parent in securing the safety and well being of an elderly family member.”

I respectfully disagree. Although we are facing a reverse situation wherein our aging parents may not be using what we feel is good judgment, we should never presume to take a parental authoritarian attitude or approach toward our parents. In my experience, you will run up against a very thick brick wall.

While we need to ensure the safety and well-being of our parents and other vulnerable disabled persons in our lives, we should also defend their autonomy and right to self-determination to the furthest extent possible. Approaching an elder with concerns can be done in such a way as to accomplish this. If we try to force our authority and wishes on elders, they will dig their heels in further and become more wary and suspicious of any proposed intervention.

Elders are usually aware to some extent that their functionality is deteriorating. Fear of losing their autonomy can cause them to be very creative in their ability to hide their disabilities. When we call our parents, the conversation frequently sounds like this:

“How are you doing today Mom,” Julie asks? 
“Everything’s fine”, Mother replies. 
“Are you taking your pills?”
“Yes, everything’s fine.”
“Do you need anything?”
“Everything’s fine.”

Julie does not get much more conversation from her mother. Perhaps everything is fine, or perhaps Julie’s mother just wants Julie to think she can take care of herself. Even worse, mother could think all is fine and be forgetting her medication and not eating properly.

Is Julie really listening? ARE YOU LISTENING?

It may be time to put your face in front of your parent and listen. Assuming all is well and your elderly family member knows and does what is best for them, may be putting them at risk.

Rather than becoming authoritarian and considering yourself in a role reversal with you as the parent and they as children, become a partner with them in their care. The best time to form the partnership is before a crisis happens.

Donna Schempp, a licensed clinical social worker and program director at the Family Caregiver Alliance, states when talking with your parents, "The sooner, the better." If you bring up the subject before your parents need any extra support, "then it's not crisis driven," she explains. "It's not a way of saying, 'Mom, Dad, there's something wrong with you.”

A good way to begin this relationship is to sit with your parents and ask questions like, what are your concerns for the future. Do you want to remain in your home? Are you worried about losing your independence? Listen to their answers. You might relate your concerns as well, or your desire to be of help. LISTEN to what is behind their answers. Many elders will not come right out and list their fears; some do not really know what it is they fear. In their generation, most fears have to do with “being put in a home”. Their experience of long term care settings is rooted in the way nursing homes looked and operated several decades ago. They need to be educated about the options now available, and the cost affiliated.

The other part of forming this relationship and becoming a real partner in your loved one’s care planning is to understand what legal and financial arrangements are in place. Begin by asking, “What if you had a stroke, Mom? I need to know where your medical and insurance documents are and what you would have me do on your behalf.”
The next step might include accompanying them to their doctor appointment(s) so to understand the full scope of their medical needs and to be a part of creating a successful plan for future needs.

The National Care Planning Council's book “The 4 Steps of Long Term Care Planning” gives the following list of most common services family care givers will provide for their parents.

Feeding, walking, lifting, bathing
Using the bathroom, incontinence
Pain management
Preventing unsafe behavior, wandering
Providing comfort, assurance, professional counseling
Arranging therapy, meeting medical needs and appointments
Maintaining the household, laundry, phone
Shopping, errands, writing letters/notes
Providing transportation
Administering medications
Managing money, paying bills
Personal hygiene, grooming
Home repairs, yard maintenance

There are many resources available to help families in caring for their elder parents, including your local Area Office on Aging at 419-382-0624. Two great websites include www.longtermcarelink.net/8profiles.htm and www.caremanager.org. As you become involved you will know when it is time to include professional services or when the need to find new living arrangements is necessary. If you are not an expert in long term care planning and, or are having difficulty approaching your parents to begin these discussions, reach out to experts for assistance. Long term care expertise is fast becoming more complex and expansive and without professional involvement you may overlook important available resources.

Plan now to talk, listen and work together, but especially LISTEN – not just to the words that elders use, but to the potential hidden needs and fears that need to be addressed. Education and compassion are essential to promoting good decision-making with regard to long term care planning.