Caregiving 101: Adult children and their parents

Note: Diane E. Schaefer is president of Schaefer + Associates, LLC, a Baltimore-based consulting firm specializing in issues that affect the quality of life of older adults. She can be reached at (410) 935-7809 or through www.schaeferassoc.com.

By Diane E. Schaefer, MA, CSA

Although we might competently manage our own lives or businesses, more and more of us are facing the challenge of caring for aging parents or other relatives. These problems are difficult to get under control because we are dealing with emotionally charged situations rather than objective issues that can be resolved logically.

It is difficult to see our parents lose their independence and sometimes harder still to get them to acknowledge that the situation requires a change in their lifestyle. If you can have discussions in a loving manner and relaxed atmosphere before a crisis occurs, you can later act with the assurance that you are doing what your parent wants.

In conversations with my clients, I frequently find they are willing to discuss aging and death, but their children cut them off with comments like, "We don't need to talk about this now."

Two rules apply to the discussions:

This is not about your view of your parent's lives.
Chronological age is not the determining factor. Physical and mental health are relevant.

You are embarking on a journey. Have patience and realize it probably will take several discussions to achieve understanding. You are dealing with someone's life and making decisions that might have significant impact on the quality of that life.

It is important to choose comfortable situations when introducing these subjects. Trying to initiate such a dialogue at a large family gathering or holiday celebration is not a good idea; nine times out of 10 it will backfire, making it even more difficult to raise the subject later.

Instead, find a quiet time without distractions. Perhaps a medical emergency or unexpected death of someone close to you will provide the opening. It can be as simple as asking a parent what he or she thinks the spouse of the affected person should do. This approach will give you insight into your parent(s)' beliefs. Without offering any judgment, try to get her or him to talk about how he or she would feel in the same situation.

If the situation above does not occur or if you are unsuccessful in getting the conversation started, you can talk about how you are planning for your own old age. You might have recently revised your will, created a durable power of attorney or advance health care directives, or named a health care agent. If your parent(s) have not made these decisions for themselves, you can discuss what the documents do to ease your mind and how they work. If they have created them, you can each share information about your decisions.

One of the hot buttons that frequently is pushed in a family involves who is named as the health care agent or given the power of attorney. The important factors in these appointments are the following:

Is there trust between the parties?
Have the parent(s) and child really reached an understanding about the parent(s)' wishes?
Most important, will the agent do what the parent wants?

Although sibling rivalry sometimes enters into these situations, you should try to focus on the actions that will need to be taken.

As an example: It is a bad match if the parent chooses to forego all life support mechanisms in her Advance Health Directives and then wants to name as her health care agent a child who believes that life should be prolonged at any cost. Likewise, giving the financial power of attorney to the oldest child, even thought that child might have no head for numbers, is an equally bad decision.

In most cases, several discussions are required to reach an understanding about what parents want and need as well as when they are unable to care for or decide for themselves. The next step is to put the wishes in a written legal form. By initiating these discussions before an emergency arises, it is possible for your parent(s) to remain in control of the situation. This also will avoid the inevitable guilt or second-guessing that occurs if the children do not know what their parents would have chosen.

In summary:

have the discussions,
make the decisions,
formalize those decisions in proper legal form,
select the right person to act as agent, and
relax and live your life!

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