FAMILY DISCUSSIONS ABOUT ELDER CARE
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1 FAMILY DISCUSSIONS ABOUT ELDER CARE T H O M C O R R I G A N, B S, M S W, C M C C E R T I F I E D G E R I A T R I C C A R E M A N A G E R E M O R Y F A C U L T Y S T A F F A S S I S T A N C E P R O G R A M A P R I L 1 8,
2 EXPLORING ISSUES THAT MAY REQUIRE FAMILY DISCUSSIONS Many Issues come up which may require one or more family members to feel the need for a discussion. (Examples) Individual members of a family unit may have varying or conflicting perspectives to consider and many factors affect the outcomes of having such a family discussion. Examples of these may include family dynamics, cultural & ethnic factors, level of education and level of knowledge persons involved have of the situation. 2
3 CONCURRENT FACTORS TO CONSIDER WHILE HAVING SUCH A DISCUSSION Traditional Family Structure Has Evolved & Changed The Need For Advanced Planning Is Crucial Current Economics May Preclude Affordable Options For Care There Is A Higher Incidence of Prolonged & Chronic Conditions Which Create Additional Caregiver Stress & Expectations 3
4 REASONS FOR HAVING SUCH A DISCUSSION Families Are More Spread Out & Mobile Due To Relocation The Increase In Elderly Population Is Disproportionate To Available Family Caregivers We No Longer Have A Sense Of Community With Informal Supports Available 4
5 SITUATIONS WHEN TALKING IS CRUCIAL A Change In The Person s Medical Condition or Prognosis A Need To Change Plan of Care or Caregiver Other Demands Preclude Your Being Able to Care for Person Emotionally or Physically Too Challenging Role Conflict, Role Reversal, Role Strain 5
6 WHEN IT S TIME TO TALK" Knowing When to Have Those Difficult Conversations. Facilitating A Family Meeting Dealing with the Elephant in the Middle of the Room. Creating An Atmosphere of Trust & Openness 6
7 WHEN & HOW Pick a time and a place that is comfortable for you and your loved one. Schedule ample time to meet so as not to feel rushed. Plan a time when you all are able to concentrate and focus and have a start and end time. Include the person being cared for in the discussion and invite them to express their concerns as well. 7
8 COMMUNICATION Talking honestly and openly about concerns Discuss a plan with loved ones Decide who will be designated as the decision maker Having to deal with really tough issues Let others know your specific wishes for the future 8
9 CONSEQUENCES OF NOT ADDRESSING Having To Deal With Tough Issues & Decision Making During A Crisis Lost Time At Work / Career Setback Strained Family Relations & Added Tension The Situation Has Escalated And Now Requires Even More Time & Energy To Stabilize 9
10 Increased Physical Illness & Somatization Compromised Health Emotional Anguish Financial Drain Unmet Expectations 10
11 WAITING TO DEAL WITH A CRISIS Being Forced To Put An Inadequate Plan into Place A Sometimes Permanent Setback In The Person s Health Status Inadequate Support System In Place Financial Toll of Now Having To Expend Additional Resources 11
12 LIKE PLAYING FOOTBALL WITHOUT A QUARTERBACK Multiple Professionals Working in an Uncoordinated Delivery System Our Health Care System Has Become More Complex & Fragmented There are More Specialists Providing Care to Seniors Each Year Having An Advocate to Oversee and Coordinate Ever Changing and Ongoing Needs May Be A Benefit 12
13 BRINGING IT ALL TOGETHER Taking a Holistic Approach to Problem Solving Today s Aging Issues Coordinating all the Resources Available Navigating Today s Complex Maze of Health Care Developing a Map, Plan of Care, Game Plan or Action Plan 13
14 PHYSICAL & EMOTIONAL IMPACT OF OF CAREGIVING More Than Half (57%) of Working Caregivers Say That, As A Result of Their Caregiving Responsibilities, They Have Had To Go in To Work Late, Leave Early or Take Time Off During The Day To Provide Care. Caregivers Experience A Higher Incidence of Physical Illness Than Their Non-Caregiving Peers Caregivers Also Report A Higher Incidence of Strained Relations With Other Family Members, Partners & Friends. 14
15 CURRENT DEMOGRAPHICS & TRENDS The number of people over 85 increased by 33.2% between Million Americans age 65 and older in 2005, up 9.4% since Of the 10.6 Million older people who live alone, 7.7 million of them are women. 15
16 PLANNING FOR SHIFT IN DEMOGRAPHICS Where Will The Care Be Provided? Who will make the health care decisions? How Will Our Method of Service Delivery Change In The Future? 16
17 LIVING OPTIONS Own Home Assisted Living Facility Home of a Family Member Independent Living Shared Housing Skilled Nursing Facility Personal Care Home Continuous Care Retirement Community 17
18 FINANCIAL PREPARATIONS Estate Planning Asset Protection Reverse Mortgage Long Term Care Life Settlements Medicare & Medicaid Insurance Irrevocable Trusts 18
19 LEGAL NEEDS OF OUR AGING LOVED ONES Advance Directives for Healthcare Durable Medical Power of Attorney Living Will Legal Wills Financial Power of Attorney (POA) Special Needs Trust 19
20 THE SANDWICH GENERATION Additional Caregiver Stress Parenting Our Parents A Society of Multi-Tasking Changing Roles & Expectations The Effect on Family Dynamics 20
21 OTHER CONSIDERATIONS Fragmented Health Care System Families are More Spread Out Demands are Changing as People Age Resources May be Limited Focus Remains on the Youth of Our Society 21
22 ENVIRONMENTAL Current Living Situation Safety Hazards & Structural Barriers Transportation In-Home Support Services Community Involvement Support Services 22
23 WHERE TO CAREGIVERS TURN FOR HELP? The Internet Physician/Nurse Social Worker / Clergy Senior Service Organizations Disease Specific Associations Government Agencies Friends Work Life Programs Service Organizations Other Caregivers 23
24 SUGGESTED COPING MECHANISMS Develop A Personal Support System Ask For Help From Family & Friends Keep Your Sense of Humor Develop New Interests & Hobbies Have Realistic & Agreed Upon Expectations 24
25 SUGGESTED COPING MECHANISMS Set Appropriate Boundaries & Priorities Consider Joining A Support Group Monitor Your Own Health & Wellness Adapt & Compromise Whenever Possible Seek Outside Professional Help When Needed 25
26 ADDITIONAL RESOURCES Geriatric Care Managers Rehabilitation Facilities Hospice Elder Law Attorneys Adult Protective Services Home Health 26
27 ADDITIONAL RESOURCES Adult Day Care Private Duty Care Medical Equipment Adult Congregate Meal sites Home Health Care Services Senior Service Agencies & Centers 27
28 ADDITIONAL RESOURCES Financial Planners Senior Move Specialists Mobile Dentists & Eye Specialists Visiting Physicians Other Home Based Services Senior Realtors 28
29 IN CLOSING. Americans are Living Longer Each Decade and We are Re-Defining The Aging Experience in the U.S. We Have Improved Health Care & Technology To Sustain Life, But to What Degree & At What Cost? It is Imperative That We Chart Our Own Course For The Future & Discuss Our Wishes With Those Who Will Be Involved In Our Care. As Spouses, Adult Children, Partners, Family Members and Loved Ones, We Must Advocate for The Care of Our Elderly By Facilitating A Necessary Discussion About How They Will Be Cared For. 29
30 THANK YOU FOR YOUR TIME TODAY Please feel free to contact Mr. Corrigan with any additional questions you may have about Elder Care. Thom Corrigan, BS, MSW, CMC Certified Geriatric Care Manager
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