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Planning
How many of us have had the time to sit down and figure what you want to be when you grow up? I don’t mean a teenager deciding on a first career, I’m talking all grown up and trying to decide what your life will look like when you are no longer working. Where will all those hours go? As we plan, we decide upon the most idealistic version of ourselves.
Reality
We can ignore it, or we can spend hours every year refining our plans. No matter how much time we spend, most people leave out an important piece of the pie - health. As positive people, it is not in our nature to say this or that could happen to our health, so we see ourselves in the light we are already in as we envision our health as it is now. There is not a lot we can do about that - except get someone to project average costs of care for us in the future. However, many of us have a more stark reminder of our fragile reality as we simultaneously plan our own retirements and take care of Mom.
Family Make-Up
Somethings not right. Maybe on a phone call you realize she is not as sharp as she usually is. You visit, and find some of her medication on the floor next to her dresser and wonder if she thought she took those pills. You open the refrigerator and find 4 pounds of butter, an unrecognizable dinner from the good old days, and milk that is...no longer milk. Oh, oh, this is going to take some sort of action.
The Natural Caretaker
Time for the family meeting. As your siblings and greater family learns of the situation, you begin to hear various versions of denial, fear, and quick opinions about exactly what to do. This is a difficult time for the family and you will quickly see everyone's true personalities come out. If you are lucky, a natural caretaker emerges. Someone who has the fortitude to deal with the medical issues, relationship to introduce them with love and care, and the willingness to do so.
Geographic Issues
The world has to align with the stars for that to happen right off the bat. One of the most difficult items is where mom is right now. Is it reasonable to expect Sis to drive 2 hours each way every day to see her? Is she close to the doctors she regularly sees? Is the hospital convenient in case of emergencies? The chosen sibling will have a lot to deal with. They may just find it necessary to love mom. This is tough. Giving up the memories of a home, friends in the area, or favorite activities like a social club or house of worship.
The Financial Realities
Taking on this job is just that, a job. Many see it as a responsibility though. And for those people it's hard to recognize that many people do not. Years ago, there would not even be a consideration for any alternative care options. Family is family after all. But now a days despite all desire or effort, there may simply not be the financial means for a caretaker to quit work to spend the needed time. This reality has evolved more in recent years where two household earners are needed to make ends meet. Years ago this was not the case. Different cultures also have different feelings about how to care for our loved ones. Maybe there needs to be an agreement that Mom will cover some expenses if she has the means. The financial realities of the situation will appear in many ways from care options to estate planning. You will be faced with how to pay the bills, who can legally make medical decisions, and how to execute powers of attorney for her financial well being.
Are You a Long-Timer?
Before you take it on, make sure you are realistic as to how long this could last. After all, we live in a time where medications and care performs miracles. Mom could live many many good years with the right attention. As caretakers, we have to think about our own relationships, kids, career, and even retirement. It's your dual responsibility not to let your life fall apart, or miss all the milestones along the way. You may need help and you can’t just command it from others. Instead understand others limitations, or life choices and act as a leader with a realistic expectation of how the whole plan comes together. A realistic balance will come if you don’t jump on instant answers. This is where it's important to keep an open channel with your siblings or other care providers. Frustration will build. Patience will run thin. You will relate more to the sentence, “it takes a special person to be a care provider.”
Medical Intervention
It will not be unlikely that eventually there are things that you just can't do. Doctors appointments will multiply, skilled care will be required, emotional concerns will arise. Here again you are charged with seeing and understanding these concerns. But you are also faced with your own limitations. Building a muscle that allows you to deal with mom in her new reality is one thing, training to become a triage nurse, a whole other thing. You are who you are along with all your limitations emotionally and intellectually.
What are her Realities?
So what is she actually dealing with? Probably fear. She knows in her heart something isn’t right. She faces pain, loneliness, loss of her natural place in the family, and the loss of independence that we all find so dear-just to name a few. Identifying these areas one by one will give you a healthy perspective and allow you to help fill those gaps. Maybe you can “divide and conquer”. You may have family members who are unable or unwilling to help. That doesn't mean you can’t come up with smaller roles they would be willing to take on. Can someone prepare meals? Transport to doctors? Spend some time playing a board game? It's possible they just don’t know how to help with something in their wheelhouse. Just keep asking and try not to get angry or get them on the defense. You are all on the same side.
Independent, Assisted, Memory, Nursing, Hospice
Many times, outside help is needed. The first in the progression can be needing help around the house, maybe she is already in a 55 plus community where outdoor tasks are covered. Next will come something known as independent living. This is usually attached to a long term care facility. Here you have a group of people ready to prepare a meal or change a lightbulb. You just have to ask. Moving on to an assisted living facility where often happy and vibrant residents have their meals and activities provided. Additionally help will be needed with medications, dressing, bathing, etc. this type of facility can at least feel like a home instead of a hospital. As care needs progress beyond the tasks that is this type of care-taking, you may find need of memory care (constant watching for fear of harm) or a skilled nursing home (medical interventions).
It's no easy task to think of your whole family unit in terms of care needed and care abilities. We often spend years trying not to really see it. Should you find yourselves in this situation the most important aspect is leadership. Someone has to rally the troops.
