With every passing month, our loved ones have ups and downs in their health profile.  During the down times, we think about how the future can be managed when those we care for cannot provide any input.  The questions and concerns stick to the roof of our mouths, unsaid. 

Approaching the subject may have been tried time and again, with your parent or spouse changing the subject or outright refusing to discuss it.  We may be in the next millennium, but the concepts of “breadwinner” or “head of the house” continue in our society.  The need for one partner to retain the role while being ill creates enough of a power struggle within the individual, let alone the partnership of caregiver to family member. 

The best way to begin the subject is by doing your own research.  There are a number of resources online that will help you compile enough information to have answers and options.  The Alzheimer’s Association has a 24/7 helpline to assist caregivers with any questions they may have, ranging from service referrals to finding the appropriate legal professional.  However, your family member may not be experiencing dementia or a related condition, and a 1 a.m. phone call to any crisis line is not the way to start planning. 

The goal of planning ahead is allowing you and your loved one to share and live your lives fully, without the fears that come with thinking about the future.  Real or imagined, these “what ifs” create anxiety.  Stress clouds problem solving ability, and partial or total caregiving generates enough stress.

You may want to seek a referral to a legal professional to make an appointment on your own, to be guided to the possible avenues that must be addressed in this planning.  You can feel free to ask questions in any manner, without your loved one being affected.  Be blunt, express your fears, and have complete information with you.  This allows you to focus on the complete picture.

Once you’ve compiled information, sketch out a plan for yourself.  The best way to begin a conversation about planning for the future is by showing your family member that you have concerns for your own possible needs.  You won’t have the same prognosis, but the willingness to acknowledge that planning is for everyone, regardless of health, is a door opener.

It’s hard to do the homework alone.  You may find help through friends or family members who can be trusted to keep the research project quiet, until you can bring up the subject.  When parents are involved, one spouse may be able to develop a plan for their partner to discuss with Mom and Dad.  An interested, compassionate mate usually has the ability to provide suggestions you may not feel comfortable entertaining.

Elderly parents can often feel pressure if you “make a date” to discuss planning.  Annette F. has found that each conversation can add pieces to the “what to do” puzzle.  However, when her father is approached with specifics, he becomes resistant to discussion.  You may find the same thing happening, and this is where turning the situation to your eventual needs can break the ice.  The time to have the puzzle completed isn’t at the last minute, when social services must be called to make arrangements.

Banking centers vary in their ability to guide an individual beyond the eventual “In Trust For” designations on account.  Private banks that focus on developing close relationships with depositors may have more programs available.  No one wants to lose control over their financial resources, and a discussion of escrow accounts, eldercare and investment options provide useful alternatives.

Keep the talks short, informative, and offhand.  “I was thinking about this as a plan in case I have any problems” is a great opener, especially when followed by “What do you think?”  Letting a family member help you decide about your future needs shows them you trust their decisions and advice, too.  After some discussion about your needs, ask “What do you want to do?”  It’s possible you’ll get some evasion, but gently persisting at this interval might make a difference.

A caregiver’s world is sometimes closed off to interactions with others.  Unless you are in a support group, you may not have friends who have been down this road.  The ability to bring up a situation that a social acquaintance has experienced with planning may not be available.  It’s not totally closed off, however.  There are articles in the paper and magazines that point out situations people have experienced when they plan with positive intent. 

Instead of focusing on the negative things that can happen when planning isn’t done with timely direction, bring your attention to what can happen.  “You know, if we took care of planning our care needs right now, we’d have a few extra dollars by the end of the year to take that trip” is positively focused.  It allows your loved one to address the issue as mutual (“our”), gives them an ability to decide with you, and most importantly, offers a future option for a welcome event. 

We all have a fear of naming our illnesses and problems.  Some lawyers still haven’t made funeral arrangements, even though they encourage their clients to do so before family must do it for them.  This is all part of being human and the hidden superstitions we carry about the Murphy’s Law of mentioning something negative, and it happening right after.

In spite of mortality statistics for given diseases, as caregivers, we may be the ones who fall ill first.  Blindsided by your own problems, there is a need for you to think of yourself, too.

When multiple family members are involved, everyone has an opinion on how the issue should be approached.  Since more than one opinion can help or hurt a discussion, consider having one family member be the spokesperson, keeping the same considerations for the person’s ability to tolerate an intense talk. 

Be sure everyone is on the same wavelength before having a discussion, to avoid not only misunderstandings, but the later need to have another discussion once everything is settled.  You may be the primary caregiver, but circumstances may need to be changed if unforeseen events happen.  Even reticent family can be asked for input, which will bring them closer to your circle.

Focus on the positive aspects of planning, briefly addressing extremes that may happen.  Without advance planning the court may have to be called in, and the family may have limited decision making power, let alone the patient.  Planning is a method of preventing last minute interventions.

Caregivers have to look within and assess how they feel about planning before they can sit down to have a productive chat.  Information, research, and support systems provide the means to get things done.  They are only partially useful if you haven’t come to peace with that portion of caregiving. 

You and your family member are caring for one another by making these decisions together. They are protecting you as much as you are looking out for them. One way to start the conversation is by saying, “I need your help with something.”

American Bar Association’s printable kit to assist with planning care.
www.abanet.org/aging/toolkit/ 

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