Tag: eldercare

Navigating Family Dynamics: A Compassionate Guide for Caregiving Together

August 16, 2023 / David Russell

The journey of caregiving is often a complex, emotional, and deeply rewarding experience. As we reach a certain stage in life, the roles begin to shift, and we find ourselves faced with the responsibilities of caring for our aging loved ones. This transitional phase, though born out of love and concern, can also lead to tensions and challenges, especially when navigating the intricate web of family dynamics. For those in the caregiving age demographic, finding ways to work together harmoniously as a family becomes paramount in ensuring that our caregiving efforts are rooted in respect, empathy, and collaboration.

Tip 1: Foster Open Communication

Communication is the cornerstone of any successful endeavor, and caregiving is no exception. Initiate open dialogues where family members can express their thoughts, concerns, and wishes. Encourage active listening, allowing each voice to be heard, and validate emotions. As Dr. Maya Angelou once wisely said, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

Tip 2: Embrace Each Other's Strengths

Every family member brings unique strengths and abilities to the caregiving journey. Embrace these strengths and divide tasks accordingly. By recognizing and valuing each person’s contribution, you create an atmosphere of shared purpose and cooperation.

Tip 3: Seek Professional Guidance

Sometimes, external advice can ease the strain of family dynamics. Engage a professional mediator, counselor, or geriatric care manager to provide a neutral perspective and guide your discussions. Their expertise can offer insights that help in making difficult decisions while preserving family bonds.

Tip 4: Establish Boundaries with Respect

Caregiving often involves intimate aspects of an individual’s life. Set clear boundaries and respect each other’s personal space and autonomy. Dr. Jane Nelsen reminds us, “Respect is a two-way street; if you want to get it, you’ve got to give it.”

Tip 5: Maintain Flexibility

The caregiving journey is filled with unexpected twists and turns. Flexibility is key in adapting to changing circumstances. Remember that everyone is doing their best, and sometimes, the ability to adapt gracefully is the most valuable skill of all.

Tip 6: Celebrate Small Victories

Amid the challenges, don’t forget to celebrate the small victories. Whether it’s a successful medical appointment or a cherished moment shared, acknowledging these moments can uplift spirits and foster a positive atmosphere.

Tip 7: Preserve Family Traditions

As caregiving becomes a central focus, it’s essential to preserve and cherish family traditions. Engaging in shared activities and celebrating milestones can help maintain a sense of continuity and connection.

Research conducted by the National Institute on Aging underscores the importance of a united family front in caregiving, noting that strong family support positively impacts both the caregiver’s well-being and the care recipient’s overall quality of life. Dr. John Gottman, renowned for his work on relationships, emphasizes the significance of emotional bids and responding positively to them. This principle can be applied to caregiving, where acknowledging and reciprocating efforts can strengthen familial bonds.

In the realm of caregiving, family dynamics are an integral part of the equation. By fostering open communication, embracing each other’s strengths, seeking professional guidance, establishing respectful boundaries, maintaining flexibility, celebrating small victories, and preserving family traditions, families can navigate this challenging yet meaningful path with grace, compassion, and togetherness. As we embark on this journey, let us remember that by supporting one another, we create a legacy of care, respect, and love that will continue to resonate through generations.

How a lawyer can respond to diminished capacity.

August 14, 2023 / David Russell

Confidentiality is one of the hallmarks of the attorney-client relationship. Clients expect their attorney to uphold the confidential nature of their discussions, and attorneys must adhere to a strict code of conduct to protect the public they represent. But what happens if the attorney questions the capacity of their client?

Capacity can be a complex legal doctrine, but legal capacity is required by parties of a valid contract. Moreover, standards of capacity can also vary by they type of contract entered into as well as by different states in which the contract is governed. For example, capacity to create a valid Last Will and Testament requires the one creating the will to know the general nature of their possessions and who their legal heirs are. Another standard may be applied to a more complex legal transaction.

Attorney Mark C. Palmer, Chief Counsel at the Illinois Supreme Court Commission on Professionalism, addresses how attorneys can work with clients that are demonstrating cognitive decline. In his article,
Diminished Capacity of a Client: How Should a Lawyer Respond? | Q&A, Palmer discusses three questions an attorney needs to consider:

How does a lawyer know if the client has diminished capacity?
How might this change how a lawyer represents a client?
What protective measures can the lawyer take while meeting ethical obligations?

If you have concerns about the capacity of your aging loved one to execute a valid legal contract, consult with a qualified legal professional, preferably a Certified Elder Law Attorney (CELA) as well as your loved one’s medical provider. It is these professionals’ responsibility to independently determine whether your loved ones have the required capacity to act in their best interests.

MARK C. PALMER

Mark C. Palmer is Chief Counsel at the Illinois Supreme Court Commission on Professionalism. Mark writes on civility, professionalism and future law for the Commission’s 2Civility blog and delivers statewide professionalism programming, including a lawyer mentoring program, to attorneys and law students across Illinois. Follow him @palmerlaw.

Source: Diminished Capacity of a Client: How Should a Lawyer Respond? | Q&A

Negotiation Techniques for Adult Children of Aging Parents

August 11, 2023 / David Russell

In an insightful article published on KFFhealthnews.org by Judith Graham, titled “Negotiate with Resistant Aging Parents: Applying Business Strategies,” researchers at Northwestern University explore the application of negotiation and dispute resolution techniques from the business world to defuse conflicts arising from caregiving and financial decisions involving elderly parents. As we strive to provide the best care for our aging loved ones, this article sheds light on strategies to navigate complex situations while respecting their autonomy and dignity. The article delves into a training curriculum designed to help professionals and family caregivers approach caregiving as a collaborative effort and offers valuable insights for fostering productive conversations.

Reaching an impasse with aging parents in their late 80s who resist the idea of receiving home assistance can be frustrating. Negotiation and dispute resolution techniques commonly employed in the business world have shown potential for resolving such conflicts, according to a group of researchers at Northwestern University.

The team has developed a specialized training program focused on negotiation and dispute resolution. Aimed at social workers, care managers, and healthcare professionals working with resistant older adults, this curriculum encourages professionals to engage in collaborative caregiving approaches that honor the individual’s preferences, rather than imposing decisions.

Lee Lindquist, the chief of geriatrics at Northwestern University’s Feinberg School of Medicine, who leads this initiative, highlighted the prevalence of conflicts among older individuals and emphasized the program’s goal to de-escalate such situations, ensuring older adults receive the necessary support while maintaining their dignity.

A significant component of this project is the development of a computer-based training program for family caregivers dealing with mild cognitive impairment or early-stage dementia in their loved ones. Dubbed “NegotiAge,” this program employs avatars of older adults to simulate negotiation scenarios. Through practice, caregivers can refine their negotiation skills and techniques.

This project, funded by the National Institutes of Health with nearly $4 million, strives to make NegotiAge widely accessible after evaluating its effectiveness.

For family caregivers seeking to navigate conflicts with aging parents, the article outlines several proactive steps:

1. Prepare: Before entering negotiations, thorough preparation is vital. Jeanne Brett, a member of the NegotiAge team, suggests addressing fundamental questions, identifying issues, involved parties, their positions, motivations, and potential consequences if an agreement is not reached. Document your goals for the upcoming conversations.

2. Identify Common Interests: Finding common ground among the parties involved is key. Emphasize shared goals and interests, such as maintaining the older adult’s independence, safety, and social connections.

3. Ask Questions: Avoid making assumptions about the reasons behind a parent’s stance. Engage in open-ended discussions to understand their perspective. Show empathy and genuine concern.

4. Brainstorm Strategies: Emotions can run high during negotiations, particularly within family dynamics. Shift focus from conflicts to collaborative problem-solving. Encourage creative thinking and explore multiple potential solutions.

5. Third-Party Involvement: If resolution remains elusive, consider involving a neutral third party, like a mediator or healthcare professional. External input can provide a fresh perspective and facilitate productive discussions.

Applying these strategies can lead to more effective communication, allowing families to navigate challenging decisions while preserving relationships and respecting the autonomy and dignity of aging parents. As the Northwestern University research advances, caregivers and professionals alike stand to benefit from enhanced tools and approaches to address the complexities of eldercare.

To read the full article by Judith Graham on KFFhealthnews.org, visit: Negotiate with Resistant Aging Parents: Applying Business Strategies.

Supreme Court hears case of 94 year old’s home foreclosure by the state.

May 12, 2023 / drussellcfp

The US Supreme Court heard arguments in a case involving a 94-year-old woman who lost her home over unpaid property taxes. While the woman, Geraldine Tyler, does not dispute that Hennepin County had the right to foreclose on the $40,000 property, she argued that the county had violated the Constitution’s takings clause by keeping the $25,000 left over after the property was sold. Tyler’s attorney argued that the county should have taken Tyler’s condo, sold it to pay her debts and then refunded the remainder to her. The Biden administration filed a “friend of the court” brief in which it agreed with Tyler that the county’s actions violated the takings clause.

Whether the Court sides with Tyler or not (although it does appear that it will), it highlights the importance of having a trained and attentive financial caregiver who can pay any property taxes or other obligations that, if unpaid, can severely impact the older individual.

Source: Justices appear likely to side with homeowner in foreclosure dispute – SCOTUSblog

Indiana Case Highlights Family Tensions in Selecting Financial Caregivers.

March 27, 2023 / drussellcfp

Most people should be able to choose a loving and honoring adult child or family member as a financial caregiver. An Indiana case highlights the importance of integrity when making the choice.

In the case of Biggs vs Renner, Terri Renner and Sherry Biggs are siblings locked in a court battle over their mother’s care, with Terri claiming that Sherry abused her position as agent under her mother’s Power of Attorney, and used their mother’s funds for her own benefit. Court records would confirm Terri’s fears.

Sherry admitted to converting her mother’s accounts first to a joint account, and then to accounts only in her name. She offered a promissory note to court as evidence that she intended to pay the money back, but the the note was largely unenforceable due to her mother’s incapacity, and no payments had been made so far. In addition, Sherry allowed her daughter and husband to live rent-free in her mother’s home and paid several thousand dollars of improvements from her mother’s accounts that did not directly benefit her mother.

Terri sought a court’s intervention to remove her sister as attorney-in-fact, and to insert a disinterested third party as guardian of their mother’s estate. The court granted Terri’s petition, but Sherry objected on appeal.

A Power of Attorney is a legal arrangement whereby one person grants authority (let’s call that person the grantor) to another person to act in their behalf as attorney-in-fact, or agent while they (the grantor) are alive but unable to act for themselves. Acting as agent under a power of attorney is a fiduciary responsibility that obligates the financial caregiver to exercise the powers granted solely for the benefit of the grantor. A financial caregiver has to keep accurate records and is prohibited from using the property of the grantor for their own purposes. Being a financial caregiver is an honorable position when conducted honorably.

Why name an adult child as financial caregiver?

It is understandable that an older person would want to name an adult child as financial caregiver on their behalf. We want to believe our own children would act honorably on our behalf, or perhaps we have regrets about our own parenting and feel guilty if we do not atone ourselves by putting them in charge. Sometimes a parent will name an estranged child in hope that the trust shown by the parent will mend a broken relationship. Parents will often do whatever it takes to keep a child close to them. However, the selection of a financial caregiver should place emphasis on the dependability and the integrity of the individual over familial connections. This may require difficult decisions and may even alienate family members, but if early and intentional discussions on the subject can be held with the appropriate family members, perhaps these kinds of conflicts can be avoided.

Note: The information above is for general information only and should not be relied upon to make legal or financial decisions Advice as to the preparation and use of Powers of Attorney should only be provided by a qualified attorney licensed in your state.

Adopt a Code of Honor when caring for an aging loved one.

August 9, 2022 / drussellcfp

I am fortunate that both my mom (93) and mother-in-law (86) are still living and doing quite well. As I have visited with them and their close friends, there is a tremendous amount of wit and wisdom to glean from these encounters. Unfortunately, one of the things I have also witnessed in our culture is a loss or lack of honor towards those who have lived more years than most. I would like to challenge myself and the reader to make a resolution for 2022 to honor our older citizens – especially our parents. What does it mean to honor an older person? Often hearing a familiar principle from a different cultural context can clarify its meaning. In recent years, I’ve attempted to learn more about the ancient philosophies of Taoism, Confucianism, and Buddhism. These belief systems share many core principles with the Judeo-Christian ethics and scriptures that are more familiar to us Westerners than these less represented traditions.

Take the concept of Filial Piety, one of the eight virtues of Confucianism. Scholars attribute the Eight Virtues to a line in the Sage Emperor Guan’s Book of Enlightenment, saying

“It is through Filial Piety, Sibling Harmony, Dedication, Trustworthiness, Propriety, Sacrifice, Honor, and Sense of Shame that we become fully human.”

Filial Piety means to be good to one’s parents; to take care of one’s parents; to engage in good conduct not just towards parents but also outside the home so as to bring a good name to one’s parents and ancestors. The Fung Loy Kok Institute of Taoism further expounds on the concept of filial piety by stating,

“You should also attend to your parents’ well-being. There are three basic needs you must provide for your parents. First, you should provide for their food and clothing. Second, when they are ill, you must take responsibility for nursing them back to health. Third, when they die, you must provide them with proper burial and care for their graves. As a son or daughter, whether you are rich or poor, whatever profession you are engaged in, whether you are married or not, whether you have children or not, if you can perform these three deeds with sincerity and dedication, your parents will be happy while they are alive and rest in peace when they are deceased. Your parents cared for you without selfish interests. Your mother carried you in her womb for ten lunar months and nursed you for three years. Your parents constantly tended to your needs while you were growing up. You should show your gratitude to them by fulfilling the virtue of filial piety.

For we Westerners, the concept of Filial Piety is rooted in both the Old and New Testament scriptures. Exodus 20:12 commands,

“Honor your father and your mother, so that you may live long in the land the LORD your God is giving you.” (New International Version). Ephesians 6:2-3 repeats the same command and adds parenthetically “which is the only command with a promise.”

When parents age to the point where they lose independence or capacity to perform certain functions of daily living, families should adopt and adhere to a personal code of honor that maintains the dignity that the older person deserves. In a curriculum developed to teach adult children how to be effective financial caregivers, I provide a model code of honor that is available for download here.

Calling Aging Parents, the “New Children” is demeaning and ageist.

July 10, 2020 / drussellcfp

A recent Fox Business News report that otherwise does an admirable job of discussing the challenges faced by families with aging parents nevertheless steps over the line with the title of its report. While likely unintentional, the title of the story – “Aging parents are the new ‘children’ | Fox Business – is demeaning to older adults who are already fighting to preserve their dignity and overcome ageist attitudes towards them.

Referring to aging parents as “children” instead of simply older adults, or adults with limitations, reinforces negative stereotypes about older people that have been shown to contribute to their poor health and more rapid decline.

A 2015 article in the Journal of Geriatrics titled, Stereotypes of Aging: Their Effects on the Health of Older Adults, discusses several studies that affirm the health benefits of healthy age stereotypes (messaging) as well as the harmful effects of negative stereotypes. For example, subjects primed with more negative stereotypes such as sick, needy, dependent, burdensome, and childlike, were more likely to suffer from memory loss, hypertension, coronary disease, and depression, than subjects primed with positive messaging such as wise, valuable, experienced. Those who were exposed to negative stereotypes at home died on average seven years before those who received positive reinforcement.

Nearly all of the world’s wisdom traditions include honoring the old as a core tenant of belief and practice. Negative stereotypes and demeaning labels such as being called a child does little to bring honor to those whose guidance, advice, comfort, affirmation, and support we earnestly sought for years.

Otherwise, the report contains a lot of useful tips for families.

Source: Aging parents are the new ‘children’ | Fox Business

How Much Do I Need to Know About My Parent’s Finances?

July 26, 2019 / drussellcfp

Few people want to stick their noses into their parents’ business. For many, it’s the last taboo to inquire into your parents’ financial lives. This is one of those “it depends” questions. It isn’t always necessary for you to know every detail about your parents’ financial affairs. In fact, the less you need to know, the more likely they may be to tell you what you should know.

If your parents are still in good health mentally and physically, and are managing their affairs with no need for assistance, then the amount of detail you need to know is limited. They may be reluctant to tell you how much they are worth, or to reveal the contents of their wills. That’s okay. In that case, let them know that your concern is to know where to find important records in the event something happens.

If one or both of your parents are beyond their 80’s or if they are showing some signs of needing assistance with financial matters, then you are going to need to know more than simply where things are. And if you are serving as a conservator, trustee, or exercising authority under a power of attorney, then you have truly become a financial caregiver and will need to know as much as possible about their arrangements.

I use the “Continuum of Dependence” graphic below to visually show how much information an adult child or other family member needs to be aware of depending on the level of dependency someone is experiencing.

How Much Do You Need to Know?

Seven Conversation Starters to Initiate Talks about Money with Your Parents

July 23, 2019 / drussellcfp

The question I am most often asked is “How do I begin the conversation with my parents?” I always answer, “Very carefully.” The truth is there is no one best way to begin the conversation. So much of it depends on circumstances and personality. Circumstances – usually health issues – may be at such a crisis point that you simply must take action with or without your parents’ approval – either by asserting your authority as attorney-in-fact under a valid Power of Attorney, or by seeking a court ordered guardianship or conservatorship. Your proximity to your parents, sibling agreement over what needs to be done (or the lack thereof), whether both parents are living, and the complexity of your parents’ financial affairs are just a few of the circumstances to consider. You also need to act quickly if you begin to notice impulsive spending or investment decisions.

Personality and family dynamics are also factors, and the relationship between child and parent doesn’t always make a lot of sense. Your eighty- eight year old father may still view you as the “baby” of the family even if you are sixty-two years old and have raised a family, managed a medical practice or a business of your own, and are practically retired yourself. You are the baby and you always will be. So before you begin the conversation in the first place, you might want to talk to a family counselor, their personal physician, or clergy member before you set yourself up for resentment. It’s okay if you are not the one to initiate the conversation.

Nevertheless, here are some ideas on getting the conversation rolling that you can try out.

The “I’ve got this friend” technique. This ice-breaker allows you to set up a hypothetical situation involving a real or fictitious friend who is wondering how to talk to their parents about money. It starts something like this: “Mom (Dad), I’ve got this friend who needs to ask her parents some personal questions about their finances, but isn’t sure how to ask. What should I tell her?” Chances are your folks will be on to this one soon after you ask it, and hopefully you can turn it into a good laugh by your honest confession that the “friend” is you. Once the chuckle is over, you can come back to it with a “Well…what would you say?” and just let them talk.
Ask how their friends are doing. Once your parents pass the age of seventy-five, chances are they will be attending more friends’ funerals or visiting more friends in nursing homes. You probably will have known these friends for a long time yourself, as well as the children of these friends. While remaining sensitive to the situation, use these events to ask how their friends are doing. Something like, “Mom, now that Jane is widowed, who is watching out for her?” Or “Dad, it’s sad to see your friend Sam lose his independence like that. Does he have children close by who can help with his business?”
Ask for help with your own finances. If your parents are past seventy, this means you’re probably past forty and are making some important financial decisions yourself. Asking for Dad’s advice on preparing your will or how to invest your retirement funds can go a long way to opening up a dialogue on his own business. Maybe your dad is fully capable of managing his finances now, but this conversation can ease the next one when the time comes for you to be a little more inquisitive.
Use the headlines. Unfortunately, the headlines can give you a lot of ammunition to use to open a conversation about your parents’ finances. All you have to do is google the phrase “financial abuse of elders” and you’ll be provided with dozens of sites and news articles about the vulnerability of seniors for financial scams and high-pressure sales tactics. Print out one of these articles, or clip one from your local newspaper and show it to them. Use an opener like, “I doubt this could ever happen to you, but…” Their response will tell you how open or closed they are to the subject.
Movies are great ice breakers. If your parents’ sight and hearing haven’t diminished, a good movie that deals with the subject of aging is a great ice breaker. One caveat, don’t use movies that are too dramatic or serious. Humorous movies are better at breaking down barriers to talking about this. Also, be sensitive to ratings that may not be comfortable for a generation that may see many of today’s PG-13 movies as too “racy”.
Try point blank honesty. If your parents are cut-to-the-chase kind of folks, then just try being upfront with them. “Mom and Dad, you’re both getting older and quite frankly, you’re not as sharp as you used to be. If something happens to either or both of you, I don’t know where to find your wills, or even where all your accounts are.” You may be surprised at how open they are willing to be if you show a compassionate yet firm resolve.
Ask about their advisors. If your parents use a financial advisor, ask for an introduction, or for permission to attend their next meeting with him or her. Sometimes advisors will be hesitant out of privacy concerns since they are bound to certain confidentiality standards. Getting written permission from your parents that the advisor is free to discuss their situation with you will generally alleviate these concerns.

However you begin the conversation and no matter the reception you get, the point is that the adult child is (and should be) the first line of defense for his or her parents just as they were (or should have been) your first line of defense growing up. Perhaps your past was more tumultuous, and perhaps your present is not conducive to you taking on the responsibility now. But you can be an advocate, and you can be involved to ensure that their financial affairs continue to provide security and dignity in their twilight years.