When to Consider an Elder Care Consultant

by Linda Nastari, LCSW

As people reach their retirement years they are concerned about managing their affairs. This may be in the area of health care, such as decisions about continuing to live at home with help versus independent/assisted living, as well as decisions about estate planning, having a will versus trust and who will be the executor or trustee, having a health care directive, and appointment of a power of attorney over finances and health care. Many of these decisions are made with estate attorneys and financial planners. An elder care consultant can be beneficial when matters are complicated by financial hardship, divorce, strained parent/child or sibling/sibling relationships, mental illness, substance abuse or other family issues which impact trust, resources, and communication.

The benefits of an elder care consultant are:

• Understand the needs of the parent(s) and family members
• Meet with the parent and family members separately and/or together to diffuse tension
• Facilitate communication
• Help a family member or members with emotional issues that are impacting their ability to think clearly about the situation
• Reduce the emotional stress
• Resolve conflict so that the parent(s) are better cared for and family members can be more supportive of one another
• Develop a family care plan (more clearly define roles and expectations of family members), in order to carry out the wishes of the parent(s)

When a person becomes elderly and has greater needs there is additional stress placed on the family. The adult children are forced to interact with one another. Family member's views and their ideas of how the roles should be executed vary. Even family members who would otherwise get along may have difficulty, given the stress of the demands, change in roles, and grieving the loss of a parent. There may already exist strained relationships among the children who really do not want to cooperate. Also, each adult child will have different relationships and roles within the family and to each parent. They will also be at different stages in their own lives. Some will have more or less of time, finances, or emotional support to help an aging parent. Issues of equality and fairness become apparent. All of these factors can threaten family relations in the years to come. Conflict, disagreement, and poor communication can cause additional stress to the aging parent.

Although, each family is unique, here are some examples where a family consultant could be of benefit:

• A mother of 5 in her mid 80s who has suffered a broken hip and has the beginning stages of dementia. Decisions need to be made to move her to an assisted living community. Amidst these decisions are decisions about managing her finances, real estate property, and looking over her will. Among the 5 adult children there are disagreements about every aspect of her care. This occurred even though a will had been done and power of attorneys appointed.
   
• A mother in her late 70s with an adult daughter, age 50, living with her. There is one son who lives two hours away. The son is accusing his sister of mismanaging the mother's finances. He worries that his sister has a drinking problem, and that she is not adequately caring for the mother. The mother continues to allow her daughter to live with her, stating, "Where else would she live?" The mother is competent and does not allow the son to have any say regarding her affairs.
   
• A very successful business man in his early 90s suffering from dementia. He is married to his wife of 60 years. She has suffered a mild stroke 5 years earlier, but states she can continue to care for him. There are two adult children, one is single, working full time and the other is married living out of state. They both agree that more care is needed, but cannot agree on the type of care, nor how much to spend. The daughter who lives close by resents that the majority of the responsibility is falling on her. She feels that her sister does not fully understand the level of need of her parents, nor the time it demands from her.

In each of these three scenarios an elder care consultant would be helpful in talking with the various family members so that their parent's wishes would be honored, the elderly parent would be adequately cared for, and family relations would be preserved as much as is possible. Often times, when these underlying emotional/relational issues are addressed, the necessary decisions can be made with far less stress. An elder care consultant can make the difference to a family's emotional health by becoming another vital part of the team in an elder state plan.

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