“I don’t need your help.”
“We’ll cross that bridge when we come to it.”
“I don’t want to be a burden.”
Sound familiar? If so, you have likely been talking with an older or ill loved one who is resistant to planning ahead. But you know all involved would feel better if a contingency plan was in place.
Aging presents no shortage of challenges, and perhaps one of the greatest is the transition from caregiver to care recipient. The ego can take a hit when a younger loved one begins to express concern about the elder’s decreasing ability or lack of independence. If your well-intentioned encouragement and questions are landing on deaf ears, it may be time to contingency plan.
While you can’t force someone to talk about care planning, you can give yourself the gift of a contingency plan. At The Care Plan we have developed these plans as a way to equip our clients who can’t seem to “get through” to their loved one. One daughter in particular was at the end of her rope with her father. He’d had a stroke, didn’t take care of himself and made decisions that endangered himself and others. Anytime she brought up questions like “well what are you going to do when you can’t take care of yourself” he shut down and told her it was none of her business.
During our initial conversation she broke down in tears a number of times and eventually we were able to get to a place of action: a contingency plan. After the plan was developed she was able to relax knowing that when crisis hit, she had resources in place.
Contingency planning is about Anticipation, Assumption, and Organization. If you are able to build a very basic plan that incorporates those three concepts, you are as prepared as you can be for the future needs of your loved one.
Identify the likely paths ahead. Understand your loved one’s care landscape and ask the question, “What will I need?”
- What is their medical profile? Objectively consider health history, conditions that run in their family, and what the progression of those diagnosis looks like over time.
- What are their financial assets? Understand if they have protected their assets, are likely to need Medicaid or have a long term policy in place.
- Is their current living situation sustainable? Elevators in the building, clutter, proximity to medical providers and support team are some factors to consider.
- Who can help? Identify who could help with care responsibilities: friends, family, neighbors or former caregivers should be considered. Try to connect and build goodwill over time. When your loved one begins to decline, coordinate regular check-ins with the team to keep everyone informed.
If your loved one will not share their thoughts, there are some important dots to connect. Step outside of yourself to clearly see who this person is. Even though they may not tell you outright what decisions they would make, review what you know of them. Try to keep your biases, wishes and any guilt out of this process. Stay focused on their mindset.
- When other people around them have been ill or aged, what were their responses? What kinds of things did you hear them say?
- What things have been important to this person their whole life? How can their identity be preserved?
- Ask the tough questions over time and in a way that feels conversational. Maybe start by asking about people they trust in their lives to get a sense of the support team. Share an example, your thoughts, and ask for theirs. For example, “My friend’s mom passed recently, and they are having the hardest time because she didn’t leave a will or any estate planning documents. It really got me thinking that I need to get my affairs in order. Do you have any attorneys you trust?”
- Document, document, document. You will be glad you did! Keep a contingency plan document that references the basic information, resources, support team members, medical history, care tips, and any other relevant details you may need to refer to.
- Keep notes in a notebook or electronically to refer to the conversations, visits, support team meetings, etc. Evernote, google drive or other app-based systems really simplify this process and keep the information right at your fingertips.
- Identify resources specific to their anticipated needs, for example Veterans benefits, Meals on Wheels, caregiving agencies, home health, etc. All of those service providers can be vetted well ahead of time so when a crisis occurs you are making targeted calls to trusted resources.
- Store information electronically whenever possible. An example that often comes in handy is keeping the POA forms, and insurance cards accessible electronically. We utilize tools like efax and turboscan to document and exchange medical information with providers. When time is short, the electronic access is a real benefit.
Creating a contingency plan is of particular importance to people who are LGBTQ+; do not speak English as their primary language; or who may feel marginalized when accessing health services. Looking ahead offers the opportunity to find companies like The Care Plan who serve you specifically. As an example, here in Chicago, we have come across a long term care facility, Grosse Pointe Manor (http://www.grossepointemanor.com/) who has a floor with dedicated Korean-speaking staff to serve their residents better. Renewal Care (http://www.renewalcare.org/) is a caregiving agency who screens their applicants for LGBTQ+ cultural competency. Thank God For Hands Like Yours is a mobile massage therapist who specializes in seniors and those at end of life. (firstname.lastname@example.org)
The field of aging is changing and it is possible to find service providers who have invested in your particular needs. Planning ahead affords you the opportunity to find the right providers for your loved one. If you are interested in learning more or creating a contingency plan of your own, call us at 630-479-0083, or e-mail Jacqueline@the-care-plan.com.