Planning together aids communication

As the first month of the new year draws to a close, perhaps we contemplate how our resolutions have held up. Of course, if you're a family caregiver -- local or long-distance -- you're probably thinking, "Resolutions -- you're kidding!"

My friend Isabel announced that she's not making any resolutions. Another commented, "So you're making a resolution not to make any resolutions!"

Lest we lose heart, what about a different idea? Why not begin this year with a plan of action? Caring for parents who live far away requires special efforts on the part of long-distance caregivers in order to avoid a stressful, crisis-centered visit.

The crisis begins around the holidays when family members visit their parent(s) and are not prepared to see change or decline in their living situation. Trying to solve all problems in four or five days or less is virtually impossible. This kind of crisis-centered care causes much stress and pressure on all family members involved. It also puts a strain on the relationship with older parents if they are made to feel inadequate, helpless and useless.

In one instance, a very concerned 85-year-old woman contacted me to state her case. "My children think I need a lot of care and want me to change the way I live. I do have the concerns of old age, but I'm happy for a while, at least. I live alone, once in a while forget things, had a fall, but that was last year, and I don't see as well as I used to. But my children don't understand that I want to be independent. I feel I have a few more years and want to continue to do as much as I can for as long as I can."

She went on to ask, "How do I help them understand that I can accept help when I'll inevitably need it, but I wish to stay independent as long as I can?"

It is necessary for older adults to maintain their independence for as long as they are able. Out-of-town family members who try to provide a quick fix by taking over may be unrealistic to expect an older person to be happy with family trying to make major decisions, take care of all needs, make changes and solve all problems in a short period of time and without knowing all the facts and options. It is also vital to talk with children about future plans. This puts everyone at ease, most especially the long-distance caregiver. Finding out what all family members have to say and discussing their suggestions for the future is important. There is wisdom in planning before there is a crisis and urgent needs arise.

True independence for older adults means they are the ones who could be talking about and looking for retirement living options or finding out about home services. If older parents join their children in the dialogue and search for services plus other personal arrangements, it helps all in the acceptance of a future reality.

One fun-loving couple, both 84, had faced reality. They had sold their home and were living in an apartment until they found just the right independent facility with assisted living. They sold their home because the upkeep was too much. Their health is good, but they know it's declining, and they are lonely and inactive. They had made plans, made a deposit and were ready to move to a place where they would be more active, enjoy social activities and transportation, have meals prepared and assistance when they needed it. Then their son came for the holidays. He criticized their decision and talked them out of the move. Then he left.

Their decision was based on their feelings of security and open-mindedness, but the son's opinion caused them to be confused, and they put their move on hold. Knowing how well an older person is managing his or her life can be difficult at a distance. Emotional issues that need to be faced by adult children are difficult, too.

Time spent with parent(s) or adult children is essential because it can help all to understand that change is a part of life at any stage. With time and observation, any interference and disruption can be prevented because each member of the family assumes a responsibility for change and works to formulate a plan of action by making decisions together.

Taking a proactive stance when it comes to planning is essential. Most people, and certainly older parents, find it difficult to have open communication or have a family member initiate a discussion about their health care, legal matters, finances, end-of-life decisions and other personal matters. But ongoing conversation and planning before a crisis happens can relieve the burden on everyone. Strength comes from facing reality.

Open communication enables proper planning and the gathering of all important information. It helps both the older person and family members feel organized. Duplicate information for both the parent(s) and adult children:

Keep an updated notebook. Outline personal topics to be discussed. Be ready to listen to needs and personal concerns. List them. Headings could include financial and legal matters; health care; end-of-life decisions; bills; house information.

Keep observations updated concerning health, condition of home, nutritional intake and quality; list all bills with names, numbers and balances. Gather information such as insurance policies and numbers, an updated and valid will, a durable power of attorney document and advance directives -- the living will and health-care surrogate. Make several copies. Make an appointment with a lawyer.

Establish a list with addresses and phone numbers of friends, family or neighbors who live nearby with whom you can connect in case of trouble. On each visit spend time with them, perhaps inviting them for dinner or just for a visit. You must have an answering system. Leave them your home, office and cell-phone numbers. Leave a duplicate key with a trusted friend or neighbor.

Compose a list of all doctors, their names and phone numbers. List all current medications. In advance of a visit, set up appointments with doctors or health care providers so you can meet them, express concerns, verify medications and listen. List local services, housing options, in-home care, adult day-care centers or activity centers in your area, Meals on Wheels or other meal deliveries, and volunteer organizations.

Buy a medical alert system.

Explore housing options in your area of the country for a possible move in the future.

Having a plan of action prepares you for any crisis that may happen and enables you to spend quality time with your loved one while opening up avenues of real personal communication, bringing all closer together.

Remember, caregivers make the present moment count.

-- Ethel M. Sharp is executive director of Aging Matters Inc., a nonprofit network for family caregivers and elder care. You can write her in care of Seniority, the St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731. When seeking more information, please enclose a stamped, self-addressed envelope and include your telephone number, with area code.

© 2006 • All Rights Reserved • Tampa Bay Times
490 First Avenue South • St. Petersburg, FL 33701 • 727-893-8111

Contact the Times | Privacy Policy
Standard of Accuracy | Terms, Conditions & Copyright