Reluctant to make a plan? It’s not unusual. Posted February 7, 2012 in Our articles

Over lunch with a colleague recently we were commiserating on the worries she is facing with her aging parents. They are divorced and live in different states, adding to the challenge. Fortunately, she has the advantage of having a sister who has partnered with her in facing recent challenges, and together the sisters were able to create a plan to suggest to their parents. Over a period of weeks, Pam and her sister researched and investigated ideas for their parents and were quite pleased with the suggestions and resources they had researched, and believed to be reasonable options for concerns in the short term. They scheduled visits to each parent to ‘have a talk’. Not surprisingly, both Mother and Father expressed their appreciation for interest and effort made by their daughters, but said “I’m doing fine and don’t need any help now, thank you very much”. Sound familiar? Yes, it’s common for adult children and family members to gently suggest tweaks, arrangements, and services only to be thwarted by their elders whether the conversation is about the need for help at home, memory issues, driving safety, moving to a care community, or concerns of medication non-compliance or poly-pharmacy abuse. Do any of these scenarios sound familiar? Yes, and why so common?

As Americans, we are a fiercely independent culture that values autonomy and self sufficiency almost above other values.  The struggle to remain independent even in the face of frailty or illness is a deeply held value especially amongst post-WWII elders, dubbed The Greatest Generation by Tom Brokaw in his 1998 book highlighting the many achievements of that special generation. How many times we have heard of a revered community member and elder who takes pride in their ability to live alone, drive and carry on without the support of others. The local news recently highlighted a nonagenarian who continued to play tennis three times per week as she had for the last many decades, that’s great, I wondered, how incredible is she, was she able to drive herself to the courts as well? Conversely, one rarely hears an elder boast of their need to consider and accept support and assistance from others, and that it has brought them peace of mind and comfort to know they have planned for that possibility. Rarely do we acknowledge the sensibilities and acknowledgement that it takes to takes to consider one’s needs, create a plan and then implement it.

Addressing this challenge takes finesse and planning. First, engage your elder or community member in a dialogue, at a time that is appropriate for everyone involved.  Be an active listener, sensitive to their perspectives and concerns. Enlist the support of a family member, trusted friend or a geriatric care manager who may be able to be more objective.  Underscore the importance of being proactive, planning preserves independence. As we all know, reacting to a crisis inevitably results in fewer choices and less desirable options. Consider and discuss necessary and short term interventions vs. long term plans, considering changes one step at a time may make the process more palatable.

Pam and her sister plan to reengage their parents, at which time I will join the conversation. We will impress upon the folks our wish to avoid reacting to a crisis resulting in plans created for them, not with them, not proactive but reactive.   Additionally, planning liberates families, and caregivers are relieved that the situation hanging by a thread will not land in their laps without consideration.