Start the conversation early

Don’t wait for a crisis—talk about the possibility of increased care before your loved one needs it. In an urgent situation, decisions may need to be made quickly and with limited choices, which will cause more stress.

Ideally, you’d want to have these discussions when everyone involved with decision-making is calm and not under emotional distress. You’ll all be able to think more clearly and make better decisions when there isn’t a crisis. It‘ll also be important to keep other family members informed of your discussions—and involved as much as possible—so everyone is aware of how future needs will be met. Should your loved one need more care, the plan will be clear.

Get other family members involved

As a caregiver, it’s important to reflect on how much you can do—realistically—and to ask for help when you need it. Getting others involved can decrease the burden on you, take away some stress, and reduce the number of surprises. If you have siblings or other relatives who are involved, ask for their advice and support. It's also worthwhile to ask them to become involved so they can develop a sense of your loved one’s care needs.

Write down your thoughts

Thinking about what you’ll say before speaking with your loved one can help you organize your thoughts. That way, you’ll be clear and to the point when the time comes to have this conversation. Consider sharing your thoughts with a trusted relative or friend beforehand to get their input, even practicing the conversation with them first.

Enter the conversation with options

Start off the discussion with options rather than with decisions that have already been made. This will help your loved one feel involved in the process. This approach can soften the blow if your loved one is going to lose some independence.

Be empathetic

If your loved one feels sad or frustrated about the situation, let them know you care about how they feel. You may not be able to put yourself in their shoes, but you can tell your loved one you know it’s hard for them and—importantly—that their feelings matter.

Be inquisitive

If your loved one resists help and doesn’t want more care, find out why. Asking questions lets your loved one have time and space to talk about how they feel about this change. Acknowledge their feelings. Tell them that support is available to help them be as independent as possible.  

Let them know your first priority is their safety

Safety is paramount. When your loved one’s environment is safe, it significantly reduces their risk of injury, which helps them stay out of the hospital or a skilled nursing facility. One thing you can do is take a look at your loved one’s home to see what changes you can make to prevent falls. Being as healthy and mobile as possible will help your loved one stay as independent as possible for as long as possible.

Emphasize that no decision is permanent

If a new care situation is not working out, the family can discuss it and find alternatives. Let your loved one know that there are other choices, and that your family is willing to consider alternatives to the plan as his or her health improves or declines.

Don’t promise your loved one that nothing will change. It’s impossible to predict what tomorrow will bring. Having to break your promise can easily result in hurt feelings, mistrust, and anger if your loved one feels betrayed or let down. And you may feel guilty if you have to go back on your word.

Prioritize what needs to be done

Decide which tasks are urgent and which can wait. Ask family and friends, or find outside resources, to help take care of critical needs first. Then, the non-urgent tasks will be easier to manage.

Even though you’re trying to keep your loved one as independent as possible, they may feel overwhelmed, frustrated, or scared. As a result, they may even refuse aspects of important care needs.

Keep the conversation going. Have discussions with your loved one, depending on their cognitive ability, about what’s important in the moment. Do your best to encourage them to get through those important things now. Then take a break. You can go back to the less urgent responsibilities later when the frustration level is lower.

Let your loved be as independent as possible

Support your loved one in doing what they can on their own, such as completing a chore, getting ready in the morning, or making something for lunch. Being as independent as possible benefits their overall health and happiness. 

For example, doing daily tasks themselves will give them a feeling of accomplishment, boosting confidence and self-esteem. It will also promote being active, which supports strength and mobility. 

Supporting their ability to make decisions for themselves is also important. When your loved one can make their own choices, it’s empowering. It helps them keep their sense of self and value, which can counteract feelings of depression. It can also encourage them to continue taking part in activities they enjoy as well as keep up with important relationships. All are vital to emotional well-being. 

Diane Paseos, MSW, LICSW, CDP, is a behavioral health case manager for Fallon Health’s NaviCare program.

 

Originally posted: April 2019
Last updated: September 2024

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Assistance/support  Coordinating care  Planning  Relationships