As a care navigator, one of my responsibilities is to develop a care plan for my clients, many of whom are elderly. In simple terms, a care plan is a plan relative to daily activities, care in the home, medical care, and other activities that relate to well-being and maintenance or improvement of health.
Activities that some caregiving families see as normal for an elderly parent may, from an outside view of a care manager, appear to be a previous enabling activity that did not have positive results. For example, imagine a parent who frequently refused to attend medical appointments because dad said he wasn’t feeling well. Not feeling well. What better reason to see the doctor? Mom in this situation, rather than argue or battle with dad, simply acquiesced and did not take dad to the medical appointment.
What might then happen when dad is an elderly parent of 80 years old and mom has passed on, leaving dad’s care to his adult children. How successful will the adult children be in convincing dad to go to the doctor? Dad’s response to his daughter suggesting a medical appointment, “if mom didn’t make me go, neither will you.”
Enabling behavior may also be considered behavior that sets up a situation for future failure. This is no different than creating a spoiled child. When the child grows up, the behavior is ingrained and is extremely difficult to change. Why should I clean up after myself? Mom did my laundry. Mom cleaned my room. Mom folded my clothing. Heaven help the wife, unless she is an enabler, who marries this man.
What about an elderly parent who has been depressed since the death of a child, 20 years earlier? I remember my mom saying to me, “parent’s aren’t supposed to lose children” when my 29 year old sister suffered an accidental death by way of a tragic car accident.
Life in our family home changed for nearly 2 years. No holiday celebrations. The removal of my sister’s dog because the dog reminded my parents of my sister. These 2 years were not a pleasant time for a 17-year old who did not understand the grief process of my parents. I grieved the loss of my sister but in a very different way.
Is normal an elderly parent suffering from depression that began 20 years ago and still continues as the result of the loss of a family member? How many families would view this as normal? One would wonder why family members didn’t stage an intervention. Denial? Fear? Thinking it best to leave mom or dad to grieve? A 20-year depression is not normal.
Imagine a care manager coming into these two situations. Both families would be shocked that the care manager insists that dad see the doctor and that mom see a psychiatrist. Heaven forbid that the care manager upset the apple cart and start making changes to attempt to ensure that the parents receive care.
Protestations usually rise from some but not all of the parent’s adult children. I often hear, “thank heavens” someone has the courage to make a change” or “who gives you permission to take control and tell mom or dad what to do.” Family responses are a mixed bag of Abby Normal.
The responsibility of a care manager is to create and implement a care plan. The goal of a care plan is positive progress that usually requires intervention or change resulting from looking at a situation from an outside perspective.
Many times family members are too close to see the seriousness or decline of a situation. Too close to the forest to see the trees. How many of us lose perspective on our own lives and need a friend to take us aside and have a talk with us?
Care planning for elderly parents can be challenging especially when there is disagreement between adult children. Even more challenging is when there is a medical power of attorney making changes that are opposed by family members. This happens more than one might imagine and is normal in my experience..
Regardless of the person who is attempting to care plan for an aging parent, the situation may present a challenge. When in doubt, contact a care manager for assistance. When in doubt, check out my book, The Caregiving Trap: Solutions for Life’s Unexpected Changes for suggestions and ideas about caring for elderly parents.