With Thanksgiving coming up and the December holidays right afterward, this is a time when the family visits with our elder loved ones and finds -- often to our surprise and consternation -- that things have changed since they last time we were together.  Mom or dad might have deteriorated in ways the family hadn't understood until we were gathered in person.

When should you be alarmed? Jewish Family Service of Greater Boston makes this recommendation about things to look for when we visit our elders in their homes -- all of which are signs that their safety and well being may be at risk:

  • Spoiled or outdated food in the refrigerator
  • Multiple pill bottles, with both new and outdated prescriptions mixed together
  • Mail and bills piling up, unopened or unpaid
  • New dents or scrapes in the car
  • Neediness, irritability, and/or confusion

When we see these alarming signs, we relatives often blame ourselves, feeling terribly guilty.  In some cases, yes, we could have been more attentive and connected.  But in other cases, there may have been a cover-up going on -- one that we just didn't penetrate until we laid eyeballs on our folks. For example, the stronger spouse may cover up for the ailing one, not letting anyone in on what is really going on. We may not have noticed how conversations were steered away from sensitive topics, or the little fibs that were told ("Oh, Mom is in the bathroom [taking a nap, at a neighbor's]") so we couldn't hear for ourselves that Mom was experiencing problems on an especially bad day.

So, now the family is all assembled and the cat's out of the bag. What to do next? A lot will depend upon the cast of characters and how the family operates typically. There are four things I recommend, however, to create productive movement toward addressing the problems:

1) Everyone's together -- start talking. Do not be surprised if you find there unequal amount of engagement among all family members. Or that family members don't agree on the need for change, or that there even IS a problem. Consider whether or not you are reacting out of guilt and surprise, over-magnifying the urgency of the problem -- over-magnification being a not uncommon reaction of the most geographically distant or most absent family member.  Be sure to give great weight to the most regularly-involved family member(s).

2) Be gentle. Head-on confrontation followed by demands for change around what is likely a very fraught and complex topic may end up being counter-productive. Consider this the start of the process. If the elders involved are in danger for their safety, however, help and change may be needed quickly, therefore...

3) Involve professionals. The family doesn't need to go this journey alone. In fact, I recommend involving helping professionals in the process as soon as possible.  In Massachusetts, each city and town has a Council on Aging, and they often get calls following holidays asking "What do we do next?" The local policy department usually has an officer who is a special liaison to the community's elders, and knows the ropes very well.  If the elder is in danger, Protective Services can be very helpful -- you can reach them directly through your local Aging Services Access Point (ASAP), or through the Executive Office of Elder Affairs (EOEA). The latter has a 24/7 hotline for abuse and neglect (and this includes self-neglect) at 800-922-2275.  A professional Geriactriac Care Manager (GCM) is also a blessing where family members either can't agree, or are afraid of damaging their relationship with the elder by speaking unwanted truths. A GCM will do an assessment devoid of personal involvement, giving some solidity and shape to the problems. Also, when family lives at a distance and can't be present to help sort out and carry through solutions, a GCM is a personal agent who can be present.

4. Remember to enjoy each other, too. It's important to not turn these unexpected discoveries into an unending nightmare visit. Have a slice of pie and a cup of tea together. Share some warm memories, and affirm your bonds.  Look at old photos, and talk about the things that bring strength to your family.  The concern we feel out of our love and caring for our elders will come through much more clearly if we spend some sweet, uncomplicated time together.

Trackback URL: