Resolving the Elder Care Safety Tug-of-War

It is an age-old tug-of-war. Adult children worry about their older parents because they care. They worry about Mom eating or Dad taking his medications, or fill in the blank __________ – driving, falling, socializing, getting enough exercise, taking care of themselves, etc. It is the quintessential elder care concern, and often prompts the search for home care and other elder care services.

But older adults have a different perspective: They want their autonomy. Physician and best-selling author Atul Gawande captured it best: We all want autonomy for ourselves but safety for those we love (no matter what their age).

And so we have this natural tension as we age, one that Lifesprk Life Care Managers (LCMs) who are nurses working in home care or senior living campuses, encounter on a regular basis.

In fact, says LCM Mary Claire O’Brien, RN, one of the main things she does is to keep the lines of communication open for both the client and family to share their concerns and perspectives. It all starts with building trust. “Our goal as Life Care Managers is to encourage open, candid, honest communication. People see it is a gift to have someone – like an LCM – with whom they can share their frustrations, concerns, hopes, fears, and that creates peace of mind,” she adds.

“The deeper the relationship and the longer we know our clients and families,” she continues, “the more we are able to take the stress off them, enabling them to talk openly and ask the questions they may be reluctant to bring up on their own.”

As Kathy Christians, RN, Director of Life Care Integration, explains, seniors may not want to worry their children so they stop sharing concerns. Having a third-party professional such as an LCM to facilitate these discussions can be so beneficial. The LCM can ask questions to prompt considerations that the family hasn’t thought of or experienced. She can also identify resources and options they may not even have realized were available,” says Kathy.

“By listening and communicating reflectively on what we have heard from the client and the family, we as LCMs are then able to focus holistically on the client’s needs AND wishes,” says Julie Flanagan, RN, Campus Director of Life Care. “Clients and families are reassured when they know the LCM understands the client’s wishes because they then know the LCM will focus on what is best for the client.”

Seniors want to be seen for whom they are – not their diagnosis, their condition, or their limitations. “I tell my clients ‘you are not defined by your diagnosis,’” stresses Mary Claire. “That only tells me one part of your health story, not your whole life story and what you want. We have to have that fuller picture to help people make good choices for themselves.”

Lifesprk LCMs share these tips for clients and families facing these safety concerns:

  • Engage a professional in the dialogue – Identify a professional, preferably with elder home care expertise, to help facilitate safety discussions. Helping clients and families broach these discussions is one of the main benefits of the Lifesprk service which helps, as Mary Claire explains, to “broaden the safety net for the client and family. You are not in this alone.”
  • Ensure everyone understands the client’s goals AND wishes – Do you know your older loved one’s wishes and goals? Avoid assumptions which can lead to tensions later. Be sure any elder care service begins with discovering your parent’s goals, not just their needs which may be very different. “At Lifesprk, our Discovery process covers all 7 elements of wellbeing to help everyone know the client’s preferred lifestyle choices so we can work together as a team to identify options that reflect those values,” adds Julie.
  • One conversation is not enough – Growing older involves ongoing changes and so clients and families continue to face different issues over time that will need to be addressed.
  • Create a safe place for expressing concerns – These tensions can become fractious and create real family rifts, says Mary Claire. That’s why everyone needs the opportunity to vent without guilt or ramifications, to feel heard, and relieve some pressure.
  • Don’t fear the conversation – Far from seizing control from anyone, these conversations are really about ensuring all sides feel heard in the context of wanting what is best for the client based on his or her wishes.

So what does this support look like in action with a real-world example?

One Family’s Experience

Bob & Mildred* were living on a senior campus to maintain their freedom and independence but faced challenges due to Bob’s tendency to wander. The family very much wanted to honor their parents’ wishes to maintain their freedom and did not want to move them to memory care because they felt their parents would feel ‘locked up.’

Through much discussion, the family realized how intrusive and restraining the current situation already was due to frequent checks and one-to-one care to promote safety but which was also causing distress for Bob & Mildred. The family was shocked to learn how much of their parents’ independence had actually eroded already.

By having an LCM as an objective seasoned professional working side-by-side with them, the family learned how much independence and freedom the couple could have by moving to a secure specialized environment with oversight 24/7 from afar. The family and couple made the decision to move to memory care and had a successful transition. Today the couple is able to live as they want, and the family is relieved knowing their parents are safe, while still able to live independently and freely, with less anxiety and fear about safety.

* Not their real names

What are elder care safety concerns your family is facing? Share your concerns and help others learn. Need help connecting to resources to balance safety and independence? Call Lifesprk Navigation: 952-345-0919.

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