As you anticipate caring for a frail elderly person—or seeking care yourself—it may be wise to ask (and answer) the simple question, “Who will be in charge?” It makes sense to address this matter as part of elder care conversations now. Events in my life over the past two decades have sharpened that question and broadened possible answers.
Consider this invitation to join in a two-part conversation: Today from the viewpoint of adult family members anticipating care for frail elderly parents; tomorrow we’ll look at this matter from the perspective of older adults helping younger family members with these questions.
How do we—the possible family caregivers—approach this matter in the first place?
With my parents, this seemingly small matter—delineating anticipated responsibilities–was included in the larger conversation about how best to provide care for them. That discussion was itself embedded in other end-of-life details that our parents had already prepared for.
This feels awkward.
Yes, it was that way for my parents and siblings, too. We may have waited too long–Our parents seemed highly capable of self-care well into their later years. When we eventually asked, “How could we assure Mom/Dad’s well-being when they can’t take care of themselves?”, the next question came to mind immediately, “Which of us will take primary responsibility?” Because of his proximity to and good relationship with our parents, one of my brothers stepped into that role.
What can stand in the way?
This is a difficult subject–large changes in lifestyles, challenges, anxieties, end-of-life details—and it’s not familiar territory. In our case, unwelcome emotions—e.g., shame, guilt, weariness, jealousy, sorrow, fear—may have clogged up our thinking.
How could this work?
Initial conversations lead to others. Questions yield to researched and reasoned answers. Emotional and intellectual honesty invite trust. Love emerges—for an elderly parent and for the other possible caregivers. Problems arise, but are carved down into manageable tasks. Each new answer/task/solution can include the question, “And which of us will be in charge here?” We can seek help from professional caregivers—medical staff, in-home aides and therapists, palliative care or hospice workers—who are available for those times where we get stuck. These professionals help expand our understanding of what’s involved.
What if we aren’t able to provide the care ourselves?
(This question includes this variation, “What if we don’t want to provide that care ourselves?”) If it’s financially feasible, one answer is to engage the services of in-home care providers and/or assisted living facilities. There’s no shame in turning over part of the day-to-day tasks of caregiving. It’s possible that asking others to share this part of our loving care could free us, physically and emotionally, to take responsibility for the spiritual, emotional and relational needs of our loved one.
What can change?
Our initial decisions may require re-negotiating. In our case, a medical emergency invited a change in the level of skilled medical care. Other changes—the personal situation of caregivers, the location of caregiving, finances, unanticipated problems—may necessitate new/better answers to the “Who’s in charge?” question.
This seems like a lot of work.
Yes, at the beginning. There’s promise and hope, though: When we have identified the necessary work that needs to be done and named the responsible person(s) for each phase or facet of the care, we can be assured that the work will get done. Because everyone doesn’t have to be responsible for everything, anxiety is not as likely to grip our spirits.
Answers to the “Who will be in charge?” question can lighten the workload, add efficiency and save energy. A blessing, for care givers and care-receivers….
Next entry: This same question from the viewpoint of older adults anticipating the caregiving they hope to receive.
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