Disagreement Over Care Of Aging Parent

[ photo by Ketut Subiyanto ]

As we move through January, we have all been inundated with more grim news on COVID-19 and yet another wave that is affecting the nation. We saw the writing on the wall heading into the Holidays that this wave was going to come. So here we are again. Hospitals are filled beyond capacity due to this latest wave.

This one feels different, though. It’s angrier. By angrier, I am not talking about the virus itself; I am talking about people. It seems to me that at this point, two years into the pandemic, we have drawn a line in the sand and have picked a side. Sure, there are some people who are straddling the line somewhat, but for the most part, those of us that can make decisions for ourselves have picked our side.

This imaginary line in the sand is causing real-life fractures among family and friend groups. These fractures become even more pronounced in the families who do not see eye to eye with the handling of COVID-19 and how to manage an aging loved one.

So what do we do if the family disagrees with how to manage an aging loved one. Do we get her vaccinated? Do we test ourselves before we are with him if we are not feeling well? These are questions that are strongly impacting family dynamics, even families that got along harmoniously prior to this wretched pandemic.  

Please, keep reading. I promise this post  is not meant to cause further division. Instead, it has got me thinking about disagreements between loved ones in providing care for their family members. It seems to not matter where I turn, I hear about disagreements among families surrounding COVID-19. I must say, however, that disagreements were happening long before COVID-19 came about.

When it comes to caring for our aging loved ones, we all have our own opinions. For the sake of simplicity, I am going to write this post from the standpoint of siblings in disagreement in the care of their aging parent. I know it’s not always siblings making decisions in the care of a loved one. This post applies to any two or more people who are working together to make decisions in the care of a loved one. 

As a physical medicine and rehabilitation physician, I have been in the middle of family disagreements more times than I can count.

For the most part, despite the children of my patients disagreeing, they each have the common ground of loving the parent and wanting what is best for their loved one even though the idea of what is best differs from each other. These are tough situations and often pretty difficult to navigate.

In these cases, I like to go through the options available and work through it with the feuding caregivers and the patient. The most common disagreement I encounter is the living situation of the parent. The patient was living on his own prior to his hospitalization. One child wants Dad to be able to return back to his home, one says it’s time for Dad to move into assisted living, and one is stuck in the middle, unable to really decide what is best.

(Related blog posts: Moving Elderly Parent, Memory Care For Dad, From Independent Living To Senior Assisted Living Facility)

So how do I go about managing these situations? 

First, I speak with my patient. What does she want? If she is capable of making her own decisions, then she will ultimately get the final say. I have had many patients who can make their own decisions, and just because they are able to make their own decisions does not mean it is always the best decision.

Well, don’t we all make bad decisions at some point in our lives? Sometimes it is best to allow someone to follow through with their choice. Oftentimes they will fail. Can the failure be life-altering? Sure. It is not always, however. When a bad choice becomes apparent to the one making the decision, then that’s when the caregivers step back in, not to say “I told you so” but to help right the decision and get the loved one to a better spot. So when someone who can make his own decision chooses the less safe option, the best thing to do is to equip that person with the tools and help he needs to make an unsafe decision less risky. 

Once I have met with the patient to discuss what she wants, I then bring the family in to meet all together. If the patient is capable of making her own decision, we then all discuss as a group what steps can be done to make the decision a more safe option.

In previous posts, I have discussed many ways to help an aging loved one be safer on his or her own. We then work to have as many of these safeguards in place prior to the patient discharging from the hospital to make this sometimes ill-advised decision a bit less dangerous. 

(Related blog posts: Elderly Home Modifications, Home Medical Equipment, Mobility Assistive Equipment)

What about those without decision making capacity?

In the case of a loved one who is unable to make his own decisions or just does not want to make the decision, I bring the family members together to discuss the options. I give each of the children a chance to voice what they want for their parent.

(Related blog post: Caring For Dementia Caregivers)

It is important that the other sibling(s) give that person a chance to speak without interruption, as hard as that might be. Once each person has had a chance to state the desires of what they want for their parent, I then talk through each option, giving the pros and the cons. The goal of these meetings is to allow each person to be heard in expressing their wishes for their parent.

Sometimes, just hearing a brother or sister state the reasons for why he or she wants Mom or Dad to have a specific treatment or live in a particular place is enough for the listening siblings to see where the sibling is coming from. We often get stuck in our heads that our way is the right way, and anything that doesn’t match our way of thinking is just wrong. Oftentimes, there really is not a wrong or right option. In many cases, the finances/ability to pay for certain options is what makes the final decision. I hate that it is that way, but often that’s just the way it is. 

For those of you reading this that have not yet done so, let this be a reminder of the importance of making your wishes for your care and where you live known to your loved ones while you are of sound mind. In addition, if you fear your spouse or children might have issues with coming to the same conclusion on your care, remember the importance of completing your living will and medical and financial powers of attorney.

(Related blog post: Why You Need Medical Power Of Attorney And Living Will)

As I said earlier in this post, there is a very high likelihood you all want what you believe is best for your parent. You are each coming to your decisions out of love. There is a very high likelihood that you and your siblings will outlive the loved one in which you are having a disagreement about. Especially in the cases where the decisions are not black and white, put your pride aside and work with your sibling in making the decisions for your aging parent. Please don’t let these disagreements cause division among yourselves. This is important to remember in these present times, dealing with COVID-19 and in the long-term decisions in the care of our loved ones. 

Feeling overwhelmed with the process?

Afraid you may not make the right decision at the right time? This stage of life for you and your aging parent often brings more questions than answers. Reading information from a trusted source like me can help guide you in the process. However, if you still feel overwhelmed, don’t hesitate to reach out to me. I am happy to help with a personalized plan for your unique situation.

© 2021 Jessica Kluetz, DO