In our last newsletter, we discussed having tough conversations with aging parents about care:
If our parents live long enough, they may likely need the care, oversight, and assistance of another person to meet their needs. Transportation, medication management, meal preparation, housekeeping, dressing, bathing, toileting, transferring, and feeding assistance—just a short list of tasks that more than 52% of today’s older adults will need help with at some point in their lives.
Many older adults have the awareness, willingness, and ability to plan and execute their own long term care plan. We have worked with many older adults that selected their own assisted living community or initiated the hiring of a caregiver on their own. There are quite a few older adults, however, who have left the hard decisions up to their loved ones, usually an adult child
You may be one of the thousands of adult children who are stuck, feeling lost and overwhelmed by this situation.
Waiting for the Crisis
In reality, many families just wait for a crisis that will force a major change or transition to a higher level of care. Our healthcare system is set up to respond to crisis situations. Every day an older adult enters the ER with a preventable issue—a fractured pelvis, shoulder or hip, a medication mistake, or a UTI and dehydration. This crisis springs the older adult into the acute care and then long term care systems. From the hospital to short term rehab in a nursing home to assisted living care, to memory care, or to in-home care, the older adult is finally getting the care he needs. For some families, things have to get worse to get better.
Taking this approach works to some degree—the older adult is not confronted with the painful realities of their situations, the family members avoid uncomfortable conversations and tough decisions, and the older adult ends up in a higher level of care as a course of fate.
Although it works, waiting for a crisis is unlikely to result in the best outcomes. When reacting to a medical emergency or a quick discharge from a hospital or nursing home, most adult children find themselves scrambling to set up the appropriate level of care. Additionally, the older adult may now be recovering from a preventable surgery or illness.
Making Hard Decisions
When your parent or loved one needs more care, you may have to force the issue if they are not taking any steps or making any decisions. You may be one of the many adult children who have to make decisions for an aging parent.
You may be in the position of having to initiate discussions on long term care needs, select long term care providers, handle all decisions and logistics, urge a loved one to accept more care, and convince others (like siblings or spouses) of your plans.
No one wants to tell their parent that they need to move, that they can no longer care for themselves adequately, or that they have to do something they don’t want to do. When safety is a primary concern, though, hard decisions have to made.
Feeling like a Traitor, a Failure, or a Terrible Human Being
You may have to make a hard decision for your aging loved one. And you can expect that it will not feel great. Many adult children report feeling guilt, shame, grief, and resentment about having to interfere in their parents’ lives. Dealing with the realities of caring for an aging parent often brings up some strong emotions.
Know that just because it feels awful, it isn’t wrong. You haven’t failed as a daughter, you’re not a failure of a son. Moving your loved one to assisted living or memory care doesn’t mean that you’ve failed to take care of them. It means you’re making a smart decision to get them the level of care they need. As a family member, your responsibility is to make sure your loved one gets the needed care but not necessarily to be the one to physically provide it yourself.
There is hope. This will get better. Adjusting to living in an assisted living community, memory care unit, nursing home or with regular caregivers is a huge transition. Acknowledge that this is necessary but awful. See it for what it is and know that you have done everything that you can. Your heart may need time to heal and to catch up with what you know to be true and right in your head.
Reaching out for Help
At some point on this journey, you may need help. Moving to an assisted living community, memory care unit, or personal care home, hiring private duty caregivers, or even planning for the future can cause tension, stress, and friction in families. Geriatric social workers, aging life care specialists, and other trained professionals can help you and your family navigate the complex elder care world.
Mindful Transitions is a team of clinical social workers that is dedicated to helping older adults and their families. We provide on-site mental health services, and we offer a Family Care Counseling package that includes 3 family sessions. This service is most helpful for families that have a hard time communicating about elder care needs. If you’re interested in learning more, please call visit our website or call our office at (678) 637-7166.