Change is difficult at any age but can be particularly difficult when it concerns older adults. The choice to stay at home or move into an assisted living community can be difficult emotionally for both the older adult and their family. Weighing the potential options can be a tumultuous time for families, and it can drive divisions between parents and children and between siblings. There is potential for conflict at every stage of the discussion — conflict about what to do, how to do it and how to pay for it. However, through patient communication and creative problem solving, families can successfully navigate the decision-making process. Here are five common disagreements families face when considering assisted living, and how to avoid them.
- Disagreement about how much assistance a parent really needs
What might seem obvious to one person — mom should move into assisted living to get the care she needs — is not necessarily obvious to everyone in the family. Often, this disagreement stems from an underlying difference in perception about a parent’s ability to live independently. Conflict might stem form the fact that one sibling lives closer to, or sees a parent more often than others. It might also stem from a denial to acknowledge a parent is aging and needs more assistance. What’s needed in this case is information and equal access to it. In cases where a medical diagnosis has been made and a doctor has said that a loved one should no longer live alone, you should make sure that every family member is informed about that recommendation, the basis for it, and what that will look like in the future in terms of medical treatment needs and care needs. In cases where there is no acute diagnosis but a gradual decline in ability, it might be helpful to have a third-party expert, such as a visiting nurse, who can observe your loved one and offer an assessment of his or her care needs.
- Disagreement about what can be done
Even with an expert assessment of care needs, there might still be intense disagreements about what to do based on different opinions of what level of care the family is willing to — and capable of — providing on its own. These impasses are best solved by ensuring that everyone involved has a safe place to communicate their concerns. Care decisions for an aging parent are not black-and-white, so disagreements aren’t necessarily a bad thing, as long as the family can pull together to identify what is best for mom or dad. As mentioned in #1, make sure every family member has a thorough understanding of the condition your loved one is in and what caring for someone who is in that condition entails. Then, consider the ability of each family member to contribute to caregiving. How much time can they carve out? What will they be giving up to do so? Keep in mind that family caregiving is often a short-term solution, and other options should still be considered to ensure there is a long-term plan in place.
- Disagreement about process
Sometimes the disagreement isn’t about the decision itself but how the decision is being made. If one sibling is seen as pushy or secretive, it can cause others to feel left out, or like their opinion doesn’t matter. The key is to be patient and deliberate. Don’t assume that other family members think or feel the same as you. This applies to how you share information and how quickly you act on that information. While one sibling might wish to go visit assisted living communities first (without a parent), another may wish to involve mom or dad right from the beginning. There are pros and cons to both approach. Find the approach that is best for your family after discussing what the process might look like.
- Disagreement about roles
When adult siblings have to come together with their parents to make decisions as a family unit about long-term care, it can often resurface long-buried family conflicts and pull people back into ill-fitting family roles. Communication and an open mind is key to navigating these conflicts. By now everyone in the family should have a clear idea of the parent’s condition and his or her care needs and how much they are able to provide. This is where the open-mindedness comes in. Don’t assign roles based on your perceptions of others’ ability and interests. Discuss everyone’s desires together and find a fair distribution of labor, whether that’s in caregiving if it is decided that the parent is staying at home or in the search for the most suitable assisted-living community. Communication challenges, and navigating sibling relationships are the number one barriers that prevent families from making care decisions for aging parents. With patience and open-communication, keep in mind what is best for your parent, while ensuring everyone has the ability to feel heard.