Exploring the developing “forward to the past” revival of the family home as the late-life residence of choice, often preferably with the children and grandchildren, the experts advise us to consider some decision factors thoroughly:
Is Mom or Dad likely to be OK there, even with adequate caregiver assistance?
Some worsening physical disorders won’t be manageable at home later. For example, we know that it’s beyond practicality, both technically and financially, to do at-home kidney dialysis, cardio-pulmonary mechanical support, or chemotherapy monitoring, therapies that require massive high-tech equipment and constant professional oversight.
The doctors tell us that many forms of dementia, especially Alzheimer’s, are the most prevalent self-reliance destroyers. Yet, in early stages they also can be the most elusive to recognize and to accept. Lack of awareness and psychological defense mechanisms nurture denial, rationalizing, even confabulation, resulting in the familiar, but dangerous “I don’t need help!”. And, of course, in advanced stages, the necessity for non-stop supervision can make at-home care unaffordable, unless several family members sacrifice their own entire universes of living in order to become skilled full-time caregivers. Communicating amicably and effectively with the demented, as well as the personality-disordered, even borderline ones (BPD’s), is a highly critical challenge.
Opting for the emotionally warm-cozy idea of “living out our time comfortably and in peace at home”, are the folks and the family failing to give enough importance -- and regretting it later -- to the need for social interaction and the isolation that at-home might impose?
Similarly, will the family members likely be OK there?
Will the “warm-cozy” eventually evolve into “cold-ugly”? Similarly under-importanced, and likely regretted later: Will housemate family members always be compatible with Mom and Dad’s special requirements and their quirks over the long-run?
Will everyone accept and adapt to the need for family caregivers to take periodic respite time off? And will respite care be available affordable, and acceptable, either at home or in short-stay institutions?
Can everyone happily, comfortably and lovingly accept and commit to the necessary life-style compromises? Will the de facto boss of the household, whether it’s Mom, Dad, son, daughter, or in-law, be OK with yielding or sharing the power and control?
Will housemates’ own physical and emotional needs be trampled? So many, especially the young, not yet adept at dealing with intrusions, can feel demeaned, disregarded, resentful. Will all family members be “with it”, physically, intellectually, and financially, or will some boycott or be excluded, fueling resentment?
How do we know that it’s time to get help?
A silly question? Sure, we all know about frequent falls, constantly short-term memory blackouts, forgetting of phone numbers and pill-taking, persistent bathroom odors and stains throughout the house, overwhelming fatigue and shaky muscle control, unwholesome eating, emotional blahs, and all the rest.
But, how to discover them? Of course, the obvious is to get there, genuinely joyful family togetherness mini-vacations. Just bring your sharp eyes and ears with you.
When you aren’t there to observe? When phoning, talk less and listen more, for clues -- changes in habitual conversation, vague or smoothed-over answers to questions, statements that just don’t make sense or seem right. And it’s perfectly OK to ask Mom and Dad’s neighbors, friends, church group, even health care providers, for observations.
The big challenge comes when fear, denial, pride, confusion, or whatever motivator brings rejection. That’s when delicate, carefully structured conversation becomes vital. Marketing consultants teach that “third-party influence” is a powerful motivator. A trusted and respected friend, churchman, health care provider, or club-mate can achieve successful results, even when family members are resisted. Real-life observation -- allowing Mom or Dad to perceive the results of loved ones’ disasters -- sounds mean, but certainly justifiable.
Basically, successful communication requires gentle, compassionate, patient, non-threatening, responses to Mom and Dad’s thoughts, helping them to guide themselves into accepting the idea. From Right At Home’s “Right Conversations”, an awesome step-by-step guide about this: “The subject can be difficult to broach, and you may not feel comfortable initiating a conversation about it. You are not alone…. Communication barriers are a real challenge for family caregivers. Conflicts within the family…can lead to frustration and stress in the caregiving cycle”.
All of this is only a glimpse at the needed wisdom. Some brilliant resources do enlighten us about how to master that successfully, hopefully before a disaster forces urgent maxi-care decisions. Libraries of information and guidance are at our fingertips, free of charge, at that. We’ve mentioned some sources, such as the National Institutes of Aging’s on-line library, A Place for Mom’s “Senior Living Blog”, and Right At Home’s literature. More: The Internet, Horry County Council on the Aging’s seminars and counselors, social services agencies, AARP, and health-care providers’ community outreach programs.
Next time we’ll look into the practical dynamics and the world of the home-care-assistance industry.
Do keep your ideas, stories, and comments coming!
Contact Gary Newman at email@example.com. Your ideas and comments are always welcome.