As your parents age, making health care decisions together can be both complex and emotional.
Maybe you and your parents have always had great relationships, but watching them age worries you, and this anxiety causes you to be more controlling than caring. Or perhaps you and your parents have had a tumultuous relationship, or you’re not just cut out to be a caregiver.
Similarly, for some families, having adult siblings to team up with can be a great comfort. For others, it can be a serious source of stress.
No two families are ever alike. Research suggests that there are not only fundamental differences in the way women process and work toward solving a problem compared to men, but the way you make decisions also changes at every stage of life.
So whether you’re deciding if it’s time for driving retirement, whether to buy a house with an in-law suite, or between home care and assisted living, understanding these differences can help you understand why your brother might all of a sudden want to be very hands-on with care decisions about your father and might ask you to give him one more year of living at home.
Here are nine tips, based on research, for making important health care decisions with aging parents and siblings.
1. Start Talking Early
Oftentimes, families wait until they’re in the midst of a crisis to decide who will care for Mom and Dad. This can make conversations more emotionally charged and make the decision-making process feel rushed. Keep in mind that different family members will have had different exposure to the amount of help a parent may need. For those providing less direct care in the family, this can take time to understand.
Instead of waiting until you have to consider other options, initiate regular family meetings as soon as your parent begins to have noticeable changes in health or struggle with activities of daily living.
2. Flip the Familiar Scripts
Many family members, especially aging parents, may have fixed beliefs — that a daughter should take them to medical appointments, for example, while a son fixes the house and pays their bills. If these arrangements don’t suit your siblings’ availability, willingness, or talents, devise an alternative division of the caregiving labors.
Men and women may also have different expectations of their spouse and what that means for caregiving as one spouse needs more support. For example, if you know that your father expects your mother or a daughter to care for him as he ages, you’ll be less likely to assume he’s just “being difficult” or even fickle. Have conversations that set realistic expectations and discuss a plan for the future should caregiving be too difficult for just one person to handle.
3. Help Your Parents Feel in Control
Do your best to make your aging parent feel they are in control of their life and this decision — because they are. For example, you might say something like: “Mom, I want what’s best for you, but I also respect that it’s your decision. Do you mind if I share my thoughts with you and we can talk about possible solutions together?”
4. Focus on Overall Well-being
Discussing long-term care decisions is rarely easy. Understanding that overall well-being — happiness, not just good health — is the goal is important for helping a parent understand the benefits of making a change. Remember that older adults are typically risk-averse and the thought of such a big change can be quite scary.
6. Talk About Interests, Not Solutions
In Deborah Tannen’s book about male-female differences in the business world, Talking From 9 to 5, she writes: “Often women want to talk about problems and get annoyed with men who want to solve them. … Men tend to take complaints as requests for solutions.” So when it comes to shared decision-making, rather than jumping to what you think should happen, talk about what’s important to you about any decision that’s made.
7. Listen with Genuine Curiosity
Understanding differences in how each person in your family makes decisions is the key to working out any differences you may have. By knowing that women and men sometimes see things through different filters, you can begin to share with one another the distortions you experience and find your way to clarity.
Why does Dad expect you to care for him, and how does he see that changing your relationship? Why does Mom feel it is best to stay at home to care for your dad, and what kind of an effect has this had on her health and well-being?
Sometimes the best conversations are had by starting with curious questions to understand why a loved one feels the way they do.
8. Make Information Personally Relevant
When starting a conversation with an aging loved one about care, caregiving, or senior living, talk about family or friends who have encountered their own difficult situations and who didn’t have a plan in place. You might say something like: “Mom, I was thinking about what happened to Karen, and it made me realize we never talk about these things. I don’t want to pry, but it would give me peace of mind to know there’s a plan if we need it.” Or you could also focus on what has changed: “Dad, do you remember how active you and Mom used to be with church or your cribbage club?”
9. Be Patient
Give your aging loved one time to reflect on their current situation, how their health or happiness may change in the coming years, and the information they’ve received from you. Tours of prospective communities or day programs might be a great way to give your loved one time to process.
Unless you consider your loved one’s need to be an emergency, try not to push. It’s hard to wait, but you will likely need to take more time to work through the process than you’d like, so being proactive is key.
If you want to broach the subject again, try waiting for an opportunity to offer an alternative living arrangement, a day program, home care, or assisted living as a solution to a problem your parent has brought to you. For example, you might wait to say anything further until a very lonely day when Dad is bored and complaining about how he never sees his friends anymore to talk about all of the activities and opportunities he would have in a community setting.
Decision-making Styles and Why It Matters in Caregiving
The senior living decision is not one that can be taken lightly. Families often struggle with this, and it’s easy to see why: Not only do family dynamics play a very big role in the senior living decision, but there are also age and gender differences in decision-making styles.
Of course, when we talk about age and gender differences in decision-making styles, we are talking about tendencies, not absolutes. But these observations go beyond simple stereotyping in that they have been well-verified through research.
To learn more, download our eBook The Role Age and Gender Play in Making Health Care Decisions for Aging Parents.