I cannot number the times I have sat with families while they tried to make very difficult and sometimes life and death decisions about an aging loved one and all they could do was guess. Nor can I count the times I have walked a totally unprepared family through placing a loved one in a care facility and watched them face issue after issue with no idea what the loved one would want or how to pay the cost. 

Most care decisions are made on the spur of the moment. The doctor says a loved one must leave the hospital but they cannot go home so the family has twenty-four hours to find a place and figure out all of the details.

These sessions have made me almost an evangelist about having family meetings ahead of need. It is much easier to talk about the real issues when they are not imminent and staring us in the face. It is much more meaningful and effective if done while the loved one is lucid and can be a vital part of the conversation.

Believe it or not, I actually practiced what I preached. We had a family meeting, although my girls had to jokingly tell me they had read my books and attended my seminars so the first time I drooled I was gone. Our four girls live in the same city where we live so the meeting was easy to arrange. We would have done so no matter how difficult it might have been. I set up a very loose agenda for the meeting and we tried to cover the most vital of the subjects.

Our agenda began with my wife and me explaining in detail how we felt about future care. We wanted them to know that what we were saying that day is really how we feel about it no matter how much we might protest when our minds are no longer clear or when we actually face the need for long term care. Neither of us want to live with or burden our children and we tried to make that as clear as possible.

Both of us expressed our desires concerning extending our lives when we no longer have quality of life. We discussed our living wills and our Durable Power Of Attorney for health care documents. 

We talked about the fact that we will not realize when we need to stop driving a car, or when we can no longer take care of ourselves. These things come on us so gradually it is hard to notice. We asked our daughters to have check up meetings to tell us where they think we are and how they think we are doing. Our hope is by checking we will not be as shocked when we must face some rather drastic change. Aging is a process of loosing vital functions. Our hope is that having fair warning will make the loss easier to face.

The agenda then turned to the children. They were asked how they saw future care. This was a most difficult area to talk about especially with my wife and me in the room, but they gradually became comfortable sharing ideas. It seemed to me that just getting the subject into the room at least allowed them to begin formulating their own ideas. I think it was something they had tried not to think about until this meeting.

We talked about avoiding the Primary Caregiver syndrome. Since all of my family lives close, we may not end up with one person having to shoulder most of the care, and by talking about it, we hope to be able to avoid many of the problems caused when one person is hung with the care and the rest of the family become burdens to bear instead of lifters of the load. Geography alone will force this on far too many families. For that reason, this site has run a series of blogs called A Bill Of Rights For Primary Caregivers. I cannot think of anything more vital to discuss in the family meetings. Somehow we need to learn how to come through long term care still loving each other. In far too many cases, that is not how it ends.

As the meeting progressed, we realized there were several areas that would require us to seek professional advice and help. We needed to see an attorney, a financial advisor, and someone who understood our insurance plans and needs. We had already consulted these professionals but wanted the children to know every detail possible about out wills, our insurance policies, and our financial resources. I do not understand why it is hard to talk to our children about financial matters, but it seemed to me that both sides felt a little discomfort in doing so. We talked anyway.

We also talked about the need for the family to become acquainted and comfortable with the various physicians who give us care. In the future they will become either a source of great help or of great mystery depending on how they relate to our children. I am watching very closely, and if I am a patient of a physician I don’t think will take the time to inform my children then I will change doctors. 

I promise you, these meetings are not easy to schedule, nor easy to start, nor easy to sit through, but they can be the key to a meaningful and loving long term care experience. 

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Doug invites you to log in and post comments at the end of each blog entry. He looks forward to hearing from you. Any of Doug's books, CDs or DVDs are available at www.InSightBooks.com.