EagleTribune.com, North Andover, MA

March 18, 2013

Siblings can't decide on care for parents

Roseanne DiStefano
Elder Q&A

---- — :Q: My mother age 87 and stepfather age 91 are still living in their own home. They recently hired a housekeeper to come in once a week so concerns about the condition of the house have been resolved. Unfortunately other issues regarding nutrition, driving and health remain. My step-siblings and I are not in agreement as to whether they can continue to live independently. How do we find a solution if we perceive things so differently?

:A: If there was a clear cut, definitive answer to your question, families in similar situations would take a huge sigh of relief. Although you and your siblings may not see eye to eye on what changes should be made you all are invested in the well being of your loved ones.

There are circumstances that have an impact on whether the situation allows for time to consider alternatives, or if this is a time to act promptly. If an older adult’s actions could directly result in putting themselves or others in danger, they could conceivably be viewed as an elder at risk. The individual could be making poor decisions, wandering/getting lost, leaving the stove on, smoking carelessly or displaying a number of other unsafe behaviors. Families should not overlook situations such as these and seek professional advice and intervention as soon as possible. Placement in a structured environment may be necessary to provide adequate and appropriate care.

There are other times when it becomes apparent the home life and or health of the older adult is beginning to deteriorate but may not indicate an immediate crisis. The changes take place gradually but clearly point out some action may need to be taken in the near future. Red flags could include difficulty in bathing, dressing and handling other activities of daily living. Taking medications on time and the correct dosage could be a concern. The elder may be showing signs of forgetfulness, confusion or depression.

While the above changes don’t necessarily indicate an emergency they are an advance warning other options may need to be considered. This is a scenario which could be easily resolved by introducing community based services to compliment services already being provided by family, friends or neighbors. The elder may be safely maintained in the community with homemaker services, personal care assistance, meal preparation, and transportation.

Please understand it is always preferable to include your older relatives in any conversation regarding their care. Unless they have been deemed incompetent by a court of law they have the right to be a major part of the decision making process. For the most part families have the best of intentions but they have to remember and accept whose life it is. As in any successful communication it is vital to be up-front and honest with your relatives. Do not turn this into an issue about their ability to function on their own but more about your love and concern for their well-being. This is a time when it would be advisable to seek the assistance of an elder care professional to facilitate family discussions.

Sometimes it all comes down to a judgment call to determine when the decision must be made to seek other living arrangements and a more formal service plan.

Do you have a question? We encourage inquiries and comments from our readers. Direct correspondence to ro@esmv.org or Elder Services of the Merrimack Valley, Inc. 360 Merrimack Street B#5, Lawrence, MA 01843. Rosanne DiStefano is the Executive Director of Elder Services of the Merrimack Valley, Inc.