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Having the Conversation

In the care planning process, it's important to ask questions to discover the wants and needs of the care recipient and support group, including family members and friends. In addition, professionals such as doctors, nurses, geriatric care managers and social workers should be involved to help guide early decisions. These conversations should be repeated on a regular basis to ensure that everyone's changing circumstances are acknowledged.

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Many caregiving challenges are linked to communication. By starting off on the right foot with frequent and effective communication,

    • a positive environment including the care recipient, family and other support group members can be established,
    • the care recipient is kept informed and can take part in decisions,
    • stress due to misunderstandings, hurt feelings or family discord can be prevented or minimized,
    • the caregiver is more likely to receive needed support from others in the care group.

Be sure to communicate about

    • care decisions,
    • changes in the recipient's condition or living situation,
    • caregiver needs and wishes,
    • important events and activities,
    • family meetings,
    • medical issues,
    • legal and financial issues.

Consider and decide early about the best methods for communicating and how often you will communicate. These decisions may change, but they're a good starting point. The type of communication — face-to-face, online, by phone — will depend on care team members' schedules and geographical location. For example, the following are useful tools for various communication needs:

    • online communication is effective, quick and flexible,
    • instant messaging for "real-time" discussions,
    • e-mail communication,
    • forums that permit in-depth discussions between care group members and professionals, detailing important caregiving information and challenges through journaling.  

The Larimer County Office on Aging, through a national online data service, provides a personal health record keeping service (My PHR) that can be accessed by members of the identified care team across the country. This Network of Care web service allows all caregivers to stay abreast of changes in status.  Just click on the "My PHR" link in the upper right corner of the site to get started.

The following are useful questions to ask:

Do living arrangements need to be changed?

Can the care recipient safely remain in their home?  Do they even wish to remain in their home? Finding the most appropriate living arrangement is often one of the first issues that family members must confront once it is determined that an elder may be in need of some assistance.  It is helpful to understand what options are possible even if this is more of a concern for the future.  Following are a few links that might be useful:

What are the potential caregiving roles of family members, friends, and others in the social network?

It is important for all participants in the caregiving process to discuss their capability, availability and willingness to provide assistance. Roles should be clearly defined and lines of communication open. Expectations and reality often butt heads, and personal situations and care requirements invariably change. For these reasons, it is important to regularly revisit the assigned roles to ensure that each party's needs and circumstances are acknowledged. It is not unusual for this particular conversation to raise old wounds,  stir up relationship issues, provoke difficult  emotional responses or even disagreements about the nature of the problem at hand. These issues should be resolved at least to the point where family members can work together and support each other effectively.

  • The Elder Care Network membership includes several professional care managers experienced in helping families clarify necessary tasks and assess appropriate resources both within the family and from professional services in the community.
  • Family members who experience personal or interpersonal struggles around the caregiving situation may find it helpful to seek a professional counselor for help working through them. 

Are financial affairs and legal documents in order?

For some families this is a particularly difficult part of the conversation as it raises questions about money, medical treatment, death and dying, and who will be in charge when the care recipient is no longer able or no longer wishes to manage part or all of their affairs. If documents defining an elder's wishes regarding their health care, funeral arrangements, distribution of their estate, powers of attorney, etc. have not been established and recently reviewed, this is the time to ensure that these matters are in order.  It is also important to review the financial situation in light of current and future needs to pay for services.  It is almost always a good idea to have a professional review documents with you in light of changing circumstances.  

  • A Professional financial manager can sit down with the care recipient and chosen family members, review current assets and make recommendations regarding investments appropriate to support both short and long term needs.
  • It is always wise to consult an elder law attorney who works with wills and trusts and is familiar with legal issues that affect seniors and their families.  The professional commitment is to the care recipient to serve their best interests and to see that their needs and wishes are legally documented and secure.
  • Discussion about funeral preferences may be challenging to initiate but are appropriate for any family wishing to avoid the emotional difficulty of making these decisions at the time of death.  It can be a good idea to sit down with a funeral counselor to simply explore options.  Many adults of all ages incorporate these choices into their wills.
  • The Larimer County Office on Aging funds the Senior Law Project which provides a free (donations encouraged) consultation with an attorney on common legal issues facing seniors. 
  • If limited financial resources are a concern, Medicaid may be an option. Consult with an elder law attorney, or seek an assessment through Larimer County's Senior Law Project (see above), UCH's Aspen Club or Banner Health's Seasons Club.



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Dorry Black
Golden Peaks
1005 East Elizabeth Street
Fort Collins, CO 80524

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