Tough Conversations

Solutions Through Compassionate Communication.

Trading Places

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Changing roles is an inescapable byproduct of time. From your baby’s first step, to his first day at school — from the day she gets her driver’s license until her college dorm is in your rear view mirror — your role is changing. And your relationship evolves from all-knowing protector and teacher to “out to lunch” parent of a teen, to bankroller with a good idea once in a while, surprising your nearly grown college freshman.

Then, for several decades, the parent-child relationship becomes adult-adult. This period can be very pleasant. Like good friends, you help each other in a pinch, but live your own lives and make your own decisions.

Role reversal begins when the child assumes control of some aspect of a parent’s life. It may begin at the parent’s request and be relatively minor, such as taking care of Dad’s car maintenance, or driving Mom to medical appointments, doing income taxes or balancing checkbooks. This control shift is limited and non-intrusive. Inconvenience to the child is minimal and the parent is grateful. [Read more…]

Is Lack of Transparency the Same as Lying?

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What if we neglect to tell a family member something that we feel is unimportant or even trivial, but they think IS important and not trivial? Is that lying? Or behaving falsely?

For example……

What if a family member, a care-giving sibling (CGS), uses her parents’ money to purchase a first-alert device or a home security system so she knows whether the parent has been in an accident or has a medical emergency? The other siblings live a several hundred miles away. Why bother? They’re not involved, right?

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Who’d Have Thought?

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As elder and adult family mediators, we keep learning about (not-so-new) legislation, court settlements, and resources that may pleasantly surprise Whp'd Have Thought by Sig Cohenmany elders and their family members. Here are three that may benefit you, a loved one, or someone you support.

  1. Medicaid is Not a Single Program

    2.  
    Many, including myself, thought that Medicaid covers only nursing home care for low- and no-income individuals who financially qualify for the benefit. Not so. [Read more…]

An Alternative to Guardianship Made for Mediation

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An Alternative to Guardianship Made for MediationWell, if you die before she does, then she’ll need a guardian,” an attorney recently told a friend of mine. He was referring to my friend’s sister who relies largely on him to handle her financial, healthcare, and other concerns. The attorney’s remark was like the snap of a wet towel across his thigh. [Read more…]

When Is It Time?

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Tough Conversations is pleased to feature an article by Guest Blogger Susy Murphy who is a respected Aging Life Care Manager and Owner of Debra Levy Eldercare Associates in Maryland.

Making The Difficult Decision to Move a Family Member to Assisted Living or Memory Care
(reprinted with permission)

When is it timeOne of the most difficult decisions that any family faces is making the decision about when, or if, moving a family member to assisted living is the right thing to do. As Aging Life Care™ Managers, this is often when we are called on, whether to schedule an office consult with concerned adult children to discuss options or to meet with a spouse in their home and assess whether or not their husband or wife can still be safely cared for there. It is nearly always an emotionally fraught decision. Sometimes adult children promised their parents that they would “never put them in a home,” whatever that may mean in today’s world where some skilled nursing facilities actually more closely resemble a Hilton Garden Inn with nurses, and long before being faced with the realities of a difficult diagnosis, such as Lewy Body Dementia. [Read more…]

Talking to Grief – Part 2

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“What can we do to help?” friends asked me as my husband lay dying and soon after he passed. At first I didn’t know how to answer.Talking to Grief - Part 2

I was still feeling my way through early-stage grief, from the inside out. At first I didn’t know what I needed, but others sometimes recognized a need and offered specific help. Or just showed up with it. Sometimes my head was clear enough to ask. Sometimes not.

I previously wrote about helpful things to say to a person going through a loss (Talking to Grief). But it’s not all about words. Support comes in words and actions.

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Talking to Grief

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by Carolyn Miller Parr

Talking to GriefWhat can you say to the parent of a 17-year-old son who dove into a wave this summer and came up paraplegic? Or your 53-year-old family member who suddenly discovers he is riddled with cancer? Or “Sarah,” a church friend, who will soon celebrate her 56th wedding anniversary, holding her husband’s hand and watching his slow but unstoppable surrender to dementia and death?

Recently I have felt surrounded by grief. It knocks at my own door and I see it everywhere. I can smell it, touch it. Anyone who watched the Pope’s visit on TV saw plenty of it. He waded into it: immigrants, homeless people, prisoners, babies attached to oxygen. Francis knows how to speak to pain.
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Conversations That Will Never Take Place

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Some conversations, in the name of human decency, simply cannot take place: for instance, certain ones between a caregiver and a cared-for person. What can you possibly say to a mentally handicapped brother in law whose movements – through no fault of his own – are glacial or who fails to take his meds on schedule?

Or to a parent whose medical expenses are through the roof and whose resources are limited if not nonexistent?

Or to a spouse with dementia who keeps asking the same question over and over and over?

Instead, perhaps all you can do is …..scream?

November is National Caregivers Month. I know this is small consolation to the tens of thousands of family members who provide invaluable services and supports to their infirm parents, siblings, or other family members.

Did you know that in America caregivers provide free an estimated $450 billion annually in services to other family members? Or that family caregivers spend an average of 20 hours per week providing care? I knew it was high, but not to that extent.

In observance of Caregivers’ Month, AARP and the Ad Council created a youtube video: “Silent Scream.” Find it by searching: “Care giving: Ad Council PSA – Silent Scream.”
According to Washington Post Business Columnist Michelle Singletary, “the 32-second video captures caregivers silently screaming from the frustrations, paperwork, and money issues that come with the job of care giving.”

Oh, and check out the National Family Caregivers Association (www.nfcacares.org). It’s a goldmine of information and resources designed to make caregivers’ lives a little easier.

Sig

“What is it about money…”

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that so often brings out the absolute worst in people, especially when that money travels from one generation to the next.?

My friend Sam told me about his grandmother’s case: Instead of apportioning her legacy equally among her three children, she gave more to her son Phil than to her other children, Jane and Alice. Alice didn’t blink an eye. But Jane, who ‘married rich’ as the saying goes and didn’t need any help, was furious. Phil, on the other hand, was struggling. After trying to keep the family dry cleaning business afloat, he went from job to job barely scratching a living.

Once the will was read and Jane learned of the unequal distribution, things were never the same between Phil and Jane. Mind you, Phil had nothing to do with it. It was their mother’s decision, pure and simple. But Jane couldn’t get it out of her head that Phil had to be ‘the favored child’ because he got a larger inheritance. Go figure.

Carolyn and I hear story after story similar to this. For example, the adult child who has assumed the lion’s share of caring for his or her parents, can’t shake a dime loose from the other siblings. Why? A hundred reasons: Will the money pay for their parents’ care or end up in the pockets of the care-giving sibling? Or, the care-giving sibling has plenty of money. Why come to me for a ‘hand-out?’ And so on.

The money issue isn’t easy to resolve. It can impact relationships for years. Have you had a similar experience? If so, let us know how it was resolved. Or. was it ever resolved? Add a comment or drop us a line.
Sig

The Moment of Change

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Every time I talk about my work in Tough Conversations I hear a story. And most aren’t very happy.
Recently a friend told me about her parents who live in Buffalo. Her Dad has early Alzheimers; Mom has been his caregiver. My friend and her brother both live in Washington. Mom was doing fine as caregiver until the day she fell on a freezing sidewalk and broke her right wrist. Unfortunately she could not stand up using only her left arm. And she had neither a cell phone nor wore a Lifeline emergency call necklace. The streets in her neighborhood were deserted, and there was no one to whom she could shout for help.
My friend told me that her mother had to drag herself through the snow some 50 yards to the door of a neighbor who thankfully was home and could call 911.
That day life changed radically for my friend and her brother. Since her mother could no longer cook, perform housekeeping chores, or care for her husband, she and her brother would now have to fly to Buffalo on alternate weeks to care for her Mom and Dad.
In retrospect it was only a matter of time before such an event would alter the delicate balance of care and support that she, her brother, and their mother had created around the deteriorating state of her Dad. What could this family have done to save her mother the indignity and discomfort of dragging her exhausted body through the snow to her neighbor’s front door? As important, what steps could they have taken to ensure that the adult children’s lives wouldn’t have to change so drastically?
1. Provide her mother (and every caregiver for that matter) a Lifeline or other kind of emergency call system.
2. Ditto for a cell phone.
3. Compile a resources folder with a list of local caregiver agencies, doctors and their phone numbers and addresses, as well as a run-down of emergency facilities and police.
4. Develop a contingency plan for the day when Mom might not be able to fulfill her caregiver responsibilities. This includes a move to Washington or wherever the adult children live.
The list goes on. But the most fundamental question remains: When should contingency planning begin?
The answer is: NOW.

Sig Cohen, Tough Conversations, a Division of Beyond Dispute Associates.