together everyone to better understand where things are going.
Helps create buy-in and a sense of responsibility.
Develops a clear focus to produce more efficient, effective solutions.
Ensures effective resource use.
Leads to wiser decision-making.
Measures success (and failure) so you can make even better choices next time.
Results in better outcomes and peace-of-mind.
Keys to Successful Planning
Successful planning depends on cooperation and participation by all parties involved in the caregiving process. Discussions can be held over the phone, via email, or by the exchange of traditional letters. You may wish to have a meeting in which all parties come together (a family meeting). Regardless, the following key issues are likely to be of concern:
The guiding purpose of the planning is to maintain the quality-of-life, independence, and dignity of both the family caregiver and the person receiving care. Each goal and stated outcome of the Plan must support that guiding purpose.
Decide how to proceed. Deciding when to start and who is involved is critical. Delaying starting or avoiding starting altogether assures that nothing will be done before a crisis (or another crisis) arises. Do not think you have unlimited time because nothing critical is happening or it is “early days yet.” You cannot determine a turn in the health of your loved one any more than you can be assured you will not have a car accident or a debilitating slip and fall off the “diving board” of life. Family and financial circumstances can change rapidly, and the System is constantly changing, so you need to be ready.
Successful planning depends on cooperation and participation by all parties involved.
Planning now is better than planning later or waiting for a crisis to occur. Planning during a crisis is likely to lead to disaster. The Plan is the key to calmer decision-making and the greater likelihood of success.
Do a resource inventory so you can look at available resources (e.g., people, dollars, time, housing). If you do not understand your resources (financial, emotional, and practical), you cannot make good decisions. You must base every decision on what you have to work with. For example, it does no good to plan for your disabled sister who is in a wheelchair to live with you if you live on the fifth floor of a building with no elevator. Even front steps can be a barrier. And you have to consider whether the wheelchair can make all the turns in your older home and get through the bathroom door.
Identify key choices and issues that will have to be considered in planning. If you do not have a full understanding of important issues and options for addressing them, it is likely the decisions you make will not work. For example, you need to decide whether your disabled aunt can continue to live at home, but her house is in poor repair and may not be safe, especially when you consider her disability. You must ask: Can the roof be repaired? Can the electricity be rewired? What do you do about grab bars and ramps and other things that will make the house livable? Is money available from existing resources for repairs and modifications? If not, how can you pay for what has to be done to make the house usable? And, finally, if the changes cannot be paid for, what are the other options? Moving your aunt into a safe and comfortable facility may be the best choice.
Develop a shared vision as a family.
Be clear about whom the Plan is for and what needs the Plan has to meet. If goals meet only your personal needs, the needs of the person you are caring for may not be met. If the steps that are to be taken do not meet the situation’s needs, the results are not likely to fulfill the desired outcomes. In family caregiving, understanding and addressing real needs is one of the most challenging tasks. For example, everyone, including Dad, needs to agree that rather than keep the family home as an inheritance, it is better to sell Dad’s home to pay for nursing care that is essential to his safety and well-being.
Develop a shared vision as a family, perhaps during a family meeting (or more than one meeting, if needed). Families come in all shapes and sizes (and are not necessarily made up of blood relatives). In planning for family caregiving, everyone should have a shared purpose or vision, but reaching that shared vision can be challenging. There may be ten family members who need to agree on whether Dad, who has vascular dementia and is acting out violently against Mom, should be institutionalized. If Mom or one sibling resists moving Dad out, the delay could result in Mom being badly injured. When there is disagreement, at least one family caregiver has to take a leadership role and create a consensus.
Consider whether you need the help of a neutral facilitator during a family meeting. Some family issues are difficult to plan for and quantify. Family members may disagree because of historical differences (e.g., a brother and sister fought as children and are fighting now to see who wins); the nature of personal relationships (e.g., a sister perceives a brother as being egotistical and uncaring about a parent); or because of a personality clash (e.g., Dad’s brother, who thinks he is the “boss of everything,” versus Dad’s protective second wife who does the actual caregiving).
A neutral party may be able to facilitate the meeting, reframe issues, make objective observations, and get decision makers back on common ground. Your community may offer a number of professionally certified mediators, such as an elder care mediator or a family issues mediator.
