Hold Family Meetings about Your Long Term Care

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Planning for long-term care is not a decision that you should make alone, whether the plan is for you or for a parent or other relative.

Perhaps you have held family meetings throughout the years to discuss job changes, divorce, moves, problems in school, budgets, and other family matters. Or perhaps yours is a family where the very idea of sitting down together to talk about a major life change would be a totally new and probably anxiety-producing experience. If so, don't be put off by the novelty of the idea.

Who should be included in the family meeting ?

Make a list of your close family members and friends. Review it and see if you want to add anyone or take anyone off the list. This list gives you a starting point for people to include in your plan. But not all of them need to be part of every aspect of your decision making.

Limit your initial discussions to the people most directly involved in your life, or the life of your parent or other relative. This is your inner circle, or core group. People who you believe would want to be involved but can only do so on a limited basis form an outer circle. People can move from one category to another as the discussions proceed and as needs arise.

When making plans, involving the person who is at the heart of the long-term care is essential. If it is you, then you are already the center. But if it is a parent or other relative, he or she should be the primary person in every discussion.

In some situations, that may not be possible — because of advanced dementia, for example — but for most situations the person himself is the critical factor. That doesn't mean that everything this person says or wants should be accepted at face value; it just means that the discussion should be with the person, not just about him or her.

If you have a spouse or partner, of course this person should also be involved. If you have adult children who may provide assistance to you or a grandparent, they should be included as well.

Sometimes people who are more distantly related — cousins, nieces, and nephews, for example — are important members of the group. If the person you are planning for is your parent and you have siblings, count them in (even if the relationships between you and them or between them and your parent are not ideal).

Try to keep the inner circle to a manageable number — perhaps five or six. But don't leave out anyone who really should be involved. If you have a large number of children or siblings, they should be included. They may not accept your invitation to participate and you may need to deal with that later on, but the invitation should be open.

When should you get together?

In some families holidays are particularly stressful times when past jealousies and slights come alive again. If alcohol is on the menu, it may be a disinhibiting and unhelpful factor. Instead of burdening a holiday with this discussion, set aside a specific time for a serious and thoughtful discussion about long-term care, without any distractions.

With Skype and other technology, it is possible to have a meeting without everyone being in the same room. Businesses do it all the time, and it can work for families too.

If you anticipate disagreements and personality conflicts, consider inviting a neutral observer, such as a clergy member, social worker, or family friend who understands the family dynamics. This person is not a decision maker but can try to make sure that all points of view are heard in a respectful way. He or she can also keep the discussion on target and not let it get into a rehearsal of old family history or perceived injustices.

This is not an occasion to debate whether “Mom always loved you best.” The goal is not to arrive at a quick decision or to settle old disputes but to reach a consensus about long-term care, even if that consensus is only an agreement to keep talking.

You also need to consider where to hold the meeting. It may be your home or your parent's, someone else's home, or a different place altogether. Whoever is host should supply plenty of snacks. Alcohol is not a good idea. It does loosen the tongue, but with unpredictable results.

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