This issue of the Voice was written by SNA member Twyla Sketchley, B.C.S. of the Sketchley Law Firm, P.A. in Tallahassee, Florida. She specializes in guardianship, elder law, fiduciary representation, estate planning, and the prevention and maltreatment of elders and people with disabilities.
Caring for elderly or infirm loved ones is difficult. It can bring families closer together to work as a team. However, it can also create serious conflict. Differences in opinions, stress from responsibilities, and emotional strain all contribute to tension between family members. Fortunately, there are five simple strategies families can implement to foster cooperation, reduce stress, and minimize disagreements.
Communicate Openly and Regularly
Most conflicts arise due to a lack of communication. Lack of communication leads to misunderstandings, incorrect assumptions, and even hostility. If the loved one is unable to provide accurate information, or some family members live at a distance and do not participate in the daily care of the loved one, a lack of communication makes conflict even more likely.
The first way to reduce stress, eliminate assumptions, and quell hostility is to create a regular communication plan. This should include periodic formal family meetings, either in person or virtually, to discuss caregiving plans, updates on the loved one’s condition and financial needs, and any other concerns or changes. All family members should be encouraged to share their thoughts and feelings honestly, and to practice active listening to help ensure all voices are heard.
In addition to periodic family meetings, there should be regular written updates provided to all family members. This should be done via email. Regardless of disagreements, these emails should be friendly, factual, and helpful. They should include a short update about the loved one, a brief description of any changes, a list of current medications, a list of medical providers, any relevant financial information or updates, confirmation of plans, requests for assistance, and encouragement for all family members to communicate with the loved one. These emails not only create a record of the loved one’s activities, finances, and conditions, but also a record that can be referenced by the family members if a caregiver has an emergency or can no longer provide care to the loved one for some other reason.
Below is an example of a caregiver update for a family that has been communicating. If a caregiver is just starting the updates, they should provide the basic information listed above.
Just wanted to give you the weekly update for Mom. Please let me know if you have any questions.
Mom saw Dr. Angel this week for her checkup. She is still doing pretty well. She lost a pound since her checkup last quarter. Her blood pressure is still under control, so Dr. Angel did not adjust her blood pressure meds at this time.
She is still taking the same meds that were listed in my last email. She is doing better walking on her walker, although she is still mad that she has one. She has told me every day for the last month that “only old people use walkers.”
Mom returned to Elder Day Stay three times a week now that she is over her cold. She seemed happy to be back. Rita, the caregiver assigned to EDS, said that she can tell Mom is physically slower since she was last there. She is going to try to get Mom to participate in the seated yoga program. I pick her up after work.
EDS is now $126 a day, and that includes breakfast, lunch, and medication administration during the day. They are sending the bill to Bobby for him to pay from Mom’s account. They still have Bobby’s email on file, so there shouldn’t be any changes. Bobby, let me know if you don’t get the bill in the next week or so.
Next week is Freda’s birthday. Mom will be sending you a card that she made with Annie and Joey. She was pretty excited about how it turned out. Freda, please call her when you get it so that she doesn’t worry that it got lost in the mail. There have been a couple of news stories about the mail in our area, and she is overly worried about it.
Robert and I are taking Annie and Joey to Epcot and Disney World for vacation from February 1 through February 7. Bobby and his wife are planning on staying at our house with Mom while we are gone. Please let me know if that still works and whether you want me to make reservations at The Lodge at Wakulla Springs for you all and Mom. She loves to go there, and the manatees will be in the springs then.
Be sure to call Mom this week; she is probably bored with us and needs to hear some fresh stories. If you want to Facetime her, text me, and I will set it up. I’m done working by 6 when I work from home. And, if you want to send her mail, please do. As you know, she loves cards for any reason, and getting mail will help her stop worrying that her mail is being lost.
Hope you all have a great week.
Twyla
Define Roles and Responsibilities
Next, define the role of each person on the caregiving team. Ambiguity about each team member’s responsibilities can lead to frustration, miscommunication, and resentment. Create a written caregiving plan that clearly assigns tasks such as medical appointments, daily care, grocery shopping, communication, or financial management. Ensure that assigned roles match each family member’s strengths and , and be open to revisiting these assignments as circumstances change. Even family members at a distance who have busy lives can be given meaningful tasks such as scheduled communication with the loved one, researching and resolving issues that arise, or visiting the loved one to provide respite for the primary caregiver.
If there are roles assigned to certain family members or caregivers under legal documents such as durable powers of attorney, health care advance directives, trusts, or caregiver contracts, share those documents with all family members. This allows all family members to understand who has assumed these specific legal roles, as well as the responsibilities and limitations attendant to the roles. This also helps minimize the risk of faulty assumptions regarding what these roles entail in terms of providing care for a loved one.
Respect Each Other’s Perspectives
Family members may have different ideas about the loved one’s care, influenced by personal experiences or cultural backgrounds. Respect these differences by acknowledging (if not agreeing with) each person’s viewpoint. When disagreements arise, focus on the shared goal of the loved one’s well-being, rather than on trying to win an argument. Explore what is at the root of the disagreement. For example, is there an assumption being made by one of the parties about the situation that can be clarified? A common assumption is that one or more family members should provide significant care without compensation or reimbursement. This assumption can often be resolved by confirming and acknowledging the actual out-of-pocket costs incurred by those who are rendering care to the loved one. These types of disagreements are nearly always resolved if each member of the care team is willing to provide and evaluate information and to define the role that each member of the team is willing to fulfill.
Seek Outside Support When Needed
Conflict sometimes escalates beyond what the family can resolve alone. When needed, the caregiving team should seek help from professionals such as social workers, counselors, attorneys, or eldercare mediators. Support groups for caregivers can also offer valuable advice and emotional support, helping family members navigate complex situations constructively.
These professionals are often able to provide knowledge and information that is unavailable to family members, and which often needs to be analyzed by a third party. Professionals can also help caregivers and family members set up the communication plans, agree on the duties and roles that are necessary to resolve current disagreements, and prevent future conflicts.
Prioritize Self-Care and Compassion
Caring for a loved one is demanding and stressful. Caregiving leads to negative physical, emotional, social, and financial impacts on caregivers, who often neglect their own health and well-being when caring for their loved one. This leads to burnout, irritability, illness, and financial losses. Family members should understand that no single person can provide full-time care without a break. Every family member should make time for self-care, including exercising, pursuing hobbies, or simply taking a break. It is essential to show compassion to each member of the caregiving team and to recognize that everyone is doing their best under challenging circumstances. Family members who do not serve as primary caregivers can help by offering respite care, taking on tasks such as delivering groceries or supplies, or just being a supportive sounding board for the primary caregivers.
Family caregiving can be deeply rewarding and provide loved ones with dignity, improved safety, and autonomy. By applying these five strategies, families can work together more effectively, reduce conflict, and ensure their loved one receives the best possible care from those who best know and love them.
About this Article: We hope you find this article informative, but it is not legal advice. You should consult your own attorney, who can review your specific situation and account for variations in state law and local practices. Laws and regulations are constantly changing, so the longer it has been since an article was written, the greater the likelihood that the article might be out of date. SNA members focus on this complex, evolving area of law. To locate a member in your state, visit Find an Attorney.
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