Making Care Decisions for Aging Loved Ones

As parents grow older, age related declines—or in worst cases a health crisis often highlight the need for family members to become involved in making elder care decisions for a loved one. According to the Caregiving in the U.S. Report, 66% of family caregivers report having significant decision-making authority on behalf of their care recipient. For elderly parents to receive the care they need a number of factors need to be considered, starting with establishing an accurate picture of their care needs.

Aging loved ones often do an excellent job of "hiding" their declining physical or cognitive abilities from their families—especially from those who live far away. They do this for a range of reasons; from not wanting their family "in their business," to an outright denial that there is a decline. They may even lack the cognitive ability to recognize that they have a problem.

Making Care Decisions for Elderly Parents

Family members who have observed a need for intervention should take the following steps when making care decisions to ensure an elderly loved one's continued safety and well-being:

Assess the situation 

Do you have a crisis on your hands? An urgent situation? Or an ongoing chronic decline? Your answer to this very important question will determine how quickly you must act and make decisions, and how much collaboration with other family members you can afford to engage in. The more urgent the situation, the less time you will have to seek a lot of input. If you find yourself in this place, make sure that you are, in fact, the person with the legal authority and responsibility to be making decisions. If you aren't power of attorney, then it is imperative that you immediately get the person who has this authority involved. If no such person has been named, your loved one should formally select someone right away, if they still have the cognitive capacity to do so.

Establish care needs 

If your parent can participate in the conversation, discuss your observations with them. Without being confrontational or shaming, enlisting your parent and other family members in discussions of their needs may help in getting alignment when deciding next steps.
Make a list of everything you can think of that needs to be done, fixed, solved or otherwise handled. Recognize that sweeping changes usually do not need to take place immediately. Prioritize this list according to what needs to be accomplished right now and what can wait (it is essential to distinguish between wants and needs). Determine if any of these things can be handled from afar.

Remember that safety must come first 

As you are prioritizing, don't forget that your job is to make sure that your loved one stays safe. When making care decisions, it may be necessary to be more direct or even act against a parent's wishes if they are no longer in a safe environment.

Prioritize your parent's independence 

Involve your parent in elder care decisions as much as possible and make choices or recommendations that prioritize their independence. The most difficult aspect of aging for many older adults is the real (or perceived) loss of independence, so if you can keep your loved one safe and as independent as possible it is almost always the better choice.

Match care needs with available resources 

Compare your list of needs to the resources you know your family has. For example, if the issue is grocery shopping and your loved one already has a family member who comes once a week, maybe you can ask that person to take your loved one shopping or do it for them. If the issue is how to pay for care, you might write down that your parent is a veteran and may be eligible for veteran's benefits that could help cover costs. If you are not sure what resources your family has to deal with a particular need, leave it blank.

Decide who will provide care 

If there are a lot of blanks in your plan, your first step is to identify family, friends, neighbors and volunteers who you can count on to consistently provide care. With one caveat: be realistic. As long as these efforts have resulted in a comprehensive care plan, make a list with names, contact information and notes regarding who is available to do what and enact your plan.

Enlist elder care professionals

Don't be afraid to ask for help. If the burden of care is too great, or someone believes a change in the level of care is necessary, there are a number of resources available to help coordinate care. Whether professional caregivers are needed or a move to assisted living is required, advisory services can help family members choose care based on individual needs and budget. Doctors, social workers, therapists as well as hospital or rehabilitation centers can provide guidance and referrals to appropriate levels of care.

Revisit your care decisions  

Remember that any plans you make and implement will need to be revisited from time to time as your loved one's needs or resources change.