Lucy clung to her coffee mug, gripping it so hard she was afraid it might shatter.
“I’m telling you, Lucy, Mom and Dad made me promise that we would not put them into a nursing home,” her sister, Samantha said. “They need a caregiver. And since you’re a stay-at-home mom, we think you’d be perfect for the job.”
Lucy glared at her sister. “I agree Mom and Dad need a caregiver, but I am taking care of four kids, a husband, and I work part-time as a freelance writer. I hardly have the time for their care.”
“Oh, pshaw. I am sure you can put aside your writing for your parents,” Lucy’s brother, Jim, said. “And your kids are in school. What else do you have to do during the day?”
“Are you kidding me?” Lucy’s husband, Mark, said. “Between you and Samantha, you could pay for a caregiver. Stop dumping everything on my wife. We’re the ones who do their grocery shopping, run their errands, and help with yard work. You two do nothing. Heck, when was the last time one of you even visited?”
Samantha tossed her head. “I hardly have the time, being a lawyer and all. I call when I can.”
Frowning, she pretended to examine her fingernails.
Jim laughed. “I run a business with 20 employees. When would I have the time?”
“You also have a wife who is a stay at home mom for one child,” Lucy said. “It seems to me she could help out once in a while. And you, you run a landscaping business. Did it ever once occur to you that maybe you could send an employee over to mow the lawn or trim the bushes?”
“Well, Susy is busy with her charities and things. She wouldn’t have the time—”
“Enough!” Mark said. “The fact is, you both want someone else to take care of this problem and once again, you are dumping it on Lucy. Either you two pony up some money to hire the help your parents need or you start showing up on a regular basis and get your hands dirty. You two have lots of opinions, but neither of you has been pulling your weight. That stops now.”
“Well, I never—” Samantha sniffed.
“That’s right,” Lucy said. “You never help out.”
Perhaps one of the most contentious issues families face is providing care for elderly parents. Everyone has an opinion, but not everyone has the means or the desire to do what’s necessary to ensure that proper care is provided.
Among the key issues:
- How much care is needed? It is not unusual for family members to disagree on how much and what type of care is required. Family members may have varying levels of exposure to a senior family member or lack the ability to accurately assess ongoing needs. It may be necessary to seek expert guidance. A primary care physician or a visiting nurse trained in elder care can evaluate elderly family members and make recommendations for appropriate care. In addition, the desires of the senior family member, when practical, must be considered. For example, a senior may want to stay in their home or an elderly couple may wish to continue to live together. Those desires may be more important than those of family members.
- Who will provide the care? It’s easy to assume that one sibling should do the heavy lifting because they live closer or have more time, but the fact is, serving as a caregiver is not only time consuming, it is extremely stressful. And when that caregiver is required to move a senior family member into their home, the burden can be overwhelming. Balancing elder care with raising a family, taking care of home, and managing a career increases the possibility of burn-out. It is important for family members to understand that people—even well-meaning sisters or brothers—have limits. If other family members are not able to share the burden of care, other options should be considered. The process begins with carefully identifying the needs of the elderly family member and then determining how those needs are best met—physically, financially, and emotionally. Then a care plan should be developed and each family member should commit to their well-defined roles. When no consensus can be reached, however, it may be necessary to bring in a third-party—such as senior advisor, a minister, attorney, or family friend—to mediate. The priority should always be the needs of the senior who requires care.
- Who will pay for the care? Elder care comes at a cost and it is important to determine what that cost will be upfront. After reviewing the senior’s financial resources—retirement income, long-term care and medical insurance, veteran’s assistance, existing assets—it falls to family members to determine how any shortfalls will be met. Sometimes, family members can contribute financially to care, while others may be able to contribute in other ways. In addition, senior living advisors are often available through private or county-based agencies on aging to acquaint family members with available governmental assistance or alternative financing options.
- Who will oversee the care? What happens when you have too many cooks in the kitchen? Nothing gets done well. The same holds true for family-caregiving. After a plan is developed, appoint one or two family members to ensure that it is properly executed. When changes are required, new needs develop, or problems arise, they should be addressed as a family, unless those overseeing the care are entrusted with such decisions. However, it is important that those who assume responsibility for care communicate openly with other family members to ensure that everyone is singing from the same songbook and there are no surprises that may erupt into more disputes.
- End of Life decisions. The worst time to make decisions about end-of-life care is when an elderly family member is at death’s door. That’s when emotions run high and people tend focus on their own needs, rather than those of the person who is dying. An Advance Healthcare Directive that clearly delineates a senior family member’s desires for end-of-life care should be in place before it is needed. That takes critical decisions away from family members and keeps it in the hands of the person who should be the priority: The person approaching death. Similarly, all estate planning documents, including wills and trusts, should be in place long before they are needed.
When it comes to senior care, it seems everyone has an opinion. Thankfully, there are many resources available to assist in exploring options and tailoring care for the senior in your life. Not all decisions will be easy, but when a family communicates and strives to reach a consensus, the process proceeds much more smoothly. That benefits everyone.