Differences of opinion often come with the territory when dealing with relatives. But family disagreements about senior care can be a huge problem when there’s a health crisis and a loved one’s best interests are at stake.
Unfortunately, this is a fairly common situation. But with a bit of guidance and a collaborative approach can make a world of difference.
Carolynn Nagao-Marcotte is a dementia certified Aging Life Care Manager for the CLO program at Somerville-Cambridge Elder Services
I recently worked with a woman in her early 90s, who was living at home and maintaining an active social life. But her husband had died the year before and her children worried about her living alone.
Some of the children wanted her to move into assisted living. Others wanted her to receive in-home services. Meanwhile the mother was happy living at home and didn’t feel that she needed any help. Nobody could agree on what was best.
The conflict and arguing was starting to take a toll on their relationships. But, working together, we eventually reached consensus on a plan that addressed the most pressing needs—and now they can enjoy being best possible version of a sister, daughter, and mother.
It wasn’t quick or easy, but here are 6 strategies for navigating this kind of family disagreement about care:
Consider the elder’s wishes regarding their care Overlooking this is a common mistake, especially when there’s a health crisis. It’s natural to have strong feelings about the health and well-being of a loved one, but it’s also vital to respect that person’s autonomy and wishes.
Asking for help isn’t easy and it’s fairly common for people to initially refuse in-home assistance, even if they need it. So talk with your aging relative about their concerns and fears, hear them out, and really listen. Remember that you’re both on the same side, and that trying to force somebody into a situation they don’t want often creates more problems than it solves.
Plan ahead Discussing the elder’s wishes in advance is crucial, but it’s just as important to record those wishes and designate a trusted Power of Attorney and Health Care Proxy to ensure those decisions are carried out.
People often procrastinate on this, but a bit of preparation here can make all the difference. Instead of being divided by perceptions of what the elder may have wanted, the family can unite to carry out that person’s wishes. It’s huge.
Respect all opinions When are health concerns and it’s not clear what the elder wants, each family member may have their own opinion on what to do next.
Talking things out is a good way to defuse things, but only if there’s trust that everyone’s opinions will be respected. Identifying the concerns and goals of each family member is often a crucial first step toward finding consensus. And keeping everyone in the loop can go a long ways toward warding off resentment.
Find shared goals/interests This is important for several reasons. First, for families who have a history of poor communication and problem solving, the stress of making big health decisions may bring up old resentments and power dynamics. Focusing on a shared goal can help minimize the chance of bringing up old conflicts.
Be open-minded Family members may also disagree on how to achieve the goaland become attached to just one solution, when it’s possible that alternative measures can deliver better outcomes. This is when an aging life care manager can help families evaluate the pros and cons of each option without bias or self-interest. They can also offer additional options that may serve the elder better.
Hire a professional An Aging Life Care Manager (ALCM) can provide an objective perspective to the problems elders face, information and solutions that families haven’t thought of, and experience with helping families reach agreement on health decisions that are in the best interest of the elder.
Whatever course of action you take, it’s important to have realistic expectations, and understand it’s entirely possible your loved one isn’t going to want drastic changes over the short term. A more productive tack is to identify the highest priority needs and try to address those first, with the hope of opening up an ongoing discussion about what’s best for future.
Carolynn Nagao-Marcotte is a dementia certified Aging Life Care Manager for the CLO program at Somerville-Cambridge Elder Services, a non-profit elder services agency dedicated to supporting the independence and well-being of older adults. For more ways on handling family health disagreements, call CLO 617-756-1026.
