Balancing Difficult Family Dynamics When Providing Home Care for an Aging Loved One

i-social-2Every Thursday, my brothers and sisters, our wives and husbands and kids, go over to my mom’s for dinner, a routine that was established before my dad died, but has been solidified in the years since then. Not everyone can make it every week, of course, but regardless of attendance, there is always a point where my mom says that her biggest fear is that we won’t all still hang out and see each other after she is gone, and lets us know that she has already taken care of everything related to her needs when she gets older. This is a slightly irrational fear—we’re not going to stop hanging out—but it speaks to a common and pervasive problem: the tension, anger, and outright dissolving acrimony that can develop when an aging loved one needs care, and the family doesn’t know how to handle it.

These problems can come from a variety of sources, but they all spring from a well of guilt, frustration, overwhelmedness, sadness, and long-buried family dynamics. They can compound the misery of seeing a loved one slip away and can harm a family for years. One person feels they are doing everything and another person feels like even if they aren’t always there, they are paying for everything, and still another feels that they can’t do anything, and so harbor resentment as a way to displace guilt. It is a complex and devastating cocktail of emotions, but one whose impact can be lessened by communication, trust, and openness. It is best to plan ahead, but it is never too late to start.

The Common Problems Families Face

There are a few normal factors that come into play when families are in conflict over the health and well-being of the older generation. They include, but are not limited to:

Money
This is usually the toughest situation. Paying for health care, for a professional caregiver for in-home services, or for an expensive home can be draining if the older relatives don’t have a means to do so. After all, in what family is everyone on the same level, socioeconomically? One brother may be doing well, but he and his wife have three kids, so it isn’t like they have extra income. The sister may not have any kids, but she’s still barely getting by, and shouldn’t have to feel guilty about pursuing her dream. Even when starting out with the best intentions, money can tragically turn families against each other.

Time
Like with money, people have unequal distributions of time, and everyone begins to feel that their time is, of course, the most precious—and it is; everyone’s life is equally important to them. The escalating misery is that those with more time to help can potentially start to feel angry and resentful at both the loved one they are taking care of and the siblings who aren’t pulling their weight. On the flip side, the siblings without the time feel guilt, and that can possibly turn into resentment toward all parties. Time is enhanced by distance—“You expect me to drive three hours every day?” or “I can’t move home from California!”—but it’s essentially the same dispute.

Decisions About Placement
Deciding what to do with an aging loved one can be a challenge if their wishes and needs aren’t clear. Some people may want to move a family member to a home, others prefer home care, and still others might insist that dad moves in with them. In all of these situations, there are emotions about what is best for the older generation mingled with the fear that you are making the wrong choice, and any decision pulls in the factors of time and money.

The Power of Honesty: What Can Be Done

Okay, so we’ve dealt with the potential miserable parts, and while in every situation there will be potential pitfalls, the big problems can be avoided with communication. This means arranging more meetings. If you are not at the point yet where decisions have to be made, you are ahead of the game. Talk to your parents and talk to siblings. It doesn’t have to be a painful conversation, even if the subject matter is potentially painful. It’s a natural and normal part of life, so preparing for it in advance is the best solution. If you are already at, or past, decision points, if you think the tension is coming or if the storm has already broken, it isn’t too late.

Handling these problems at any stage requires one important thing: being honest. Honesty is the best and only policy here. You need to be honest about:

  • What the aging loved one needs: This is an assessment that combines their wishes with the reality of the situation. Oftentimes those line up, and sometimes they don’t. This means taking into account their finances, mental and physical state, quality of care, quality of life, and what they want for the future. It means assessing their care management. It can be about what they need to be comfortable at home and the amazing technology that can keep them happy and healthy there. This can be a challenging conversation, but it is one that is vital to have, at any stage.
  • What each person can bring to the table: No one is helpless and no one can do everything. Be honest. “At this point, I can only see mom once a week, but I can take care of home food delivery through this great website, so you don’t have to cook for her.” “I can go over and take care of things during the day, but right now I am strapped for cash.” We aren’t saying that everything will fit together like a jigsaw puzzle, but if families are open and honest about what they can afford to do—financially, time-wise, and emotionally— then everyone will know what to expect and what needs to be done.

Finally, remember that no plan is ever perfect, and things change when the rubber hits the road. Be flexible. Know that situations can be altered quickly, whether in the lives of your siblings or the condition of your loved ones. The first meetings aren’t going to result with a plan that is in stone. What is in stone, however, is the atmosphere of honesty, openness, courage, empathy, and love. There will always be rough times. But being open can get you through them, and can make life better, more fruitful, and more joyful for everyone involved.

Proper planning is key in determining the what is best for an aging loved one. At the Institute on Aging, we work with families so that they know what is needed to ensure as much comfort and health as possible. Contact us today to learn more about our programs.

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