Bulletin #4207, Caregiver Series: Planning Ahead

Print Friendly, PDF & Email

Bulletin #4207, Caregiver Series: Planning Ahead (PDF)holding hands

Prepared by Rae Clark-McGrath, Extension human development specialist, University of Maine Cooperative Extension.

For information about UMaine Extension programs and resources, visit extension.umaine.edu.
Find more of our publications and books at extensionpubs.umext.maine.edu.

Think about the last time that you made a decision. Maybe it was something as simple as doing the weekly grocery shopping. Now ask yourself some questions. Did you accomplish what you set out to do? Aside from the fact that you may hate to grocery shop, how did you feel about the experience? Did you accomplish the task in a timely fashion? What did you forget?

Many times, things do not go the way we expect or intend, simply because we did not take the time to plan. Other times, the plans may be fine, but we did not follow them. Sometimes, we get caught in the trap of thinking that if we don’t plan for something, then it won’t happen. This often occurs when the event is unpleasant. The possibility of a debilitating illness, either our own or that of a parent, is a good example. Few people actually have a plan to handle such an event if it happens.

When people are in the midst of a crisis, it can be hard to make the best decision. All of the options may not be explored, or perhaps some are not available. Usually, the best action plans are made before one is in a crisis.

Whether you’re planning a trip to do the grocery shopping or planning how to care for a parent who can no longer stay alone, you’ll want to involve all who are affected. It is very important to include the elderly person in making the decisions, even if his or her ability to think clearly and rationally may be lessened. Having a say and influencing the outcome of what occurs is important to each of us. Assuming the person won’t understand or can’t provide input may not be accurate.

Remember that people who are somewhat flexible have an easier time accepting a decision. Decide what is non-negotiable for you, and then ask yourself if there are any circumstances under which this would change. By being willing to change, you may achieve a better outcome.

Getting Where You Want To Go

Before making an action plan, consider your values, assess your resources and be specific in what you want to have happen. For example, a family’s goal could be never to put one’s parents in a nursing home. This may be consistent with your family values. Ask your family whether or not this is realistic. Consider what resources you have that would allow you to do this. Our first thought is often financial. Although this is a major factor, there are other considerations. Some of the questions to ask yourself in this situation are:

  • How much will it cost financially, and can we afford extra help?
  • Who is available to be a part of the care on a long-term basis and to what extent?
  • What is the physical status of the person who needs care, and that of the caregivers?
  • How will everyone feel if this situation continues for several years?
  • What facilities are available in the home where the person will be staying?
  • How do you feel, deep down, about providing long-term care, especially if someone is incapacitated?
  • What does the person receiving care want?

There may be other things for you to consider as well. Each family’s situation is different and will change over time.

Developing action plans and making decisions are learned skills. The more we complete these tasks, the easier they become. For some people making a decision is easy, and once it is made they seldom change their minds. Others have a much more difficult struggle. They look at the “what ifs” and consider other information as it surfaces. For them, there is more than one way to reach the goal.

Because family members have different skills, experiences, values, and preferred styles of making a decision, leave enough time to find the “best” solution. Those involved need to appreciate and accept everyone’s differences. The more people who are a part of the process and the greater the differences, the longer it will take to make a decision that everyone accepts, feels comfortable with and, most important of all, will support wholeheartedly.

Developing an Action Plan

Illustration of the action plan cycleAn action plan has five basic steps:

  1. Defining or redefining the problem.
  2. Gathering information.
  3. Weighing the alternatives.
  4. Making a decision and acting on it.
  5. Reevaluating your decision.

This process usually operates in a cyclical fashion. Once a decision is made and action is taken, you may need to redefine the problem, starting over again.

Here’s an example. Let’s say your aging aunt can function well alone, but has trouble taking her medicine. This is the problem (step 1). At first, you and other family members think she would do better in a nursing home. After gathering more information from her doctor and others involved (step 2), you realize there are other options. Once everyone, including your aunt, weighs the alternatives (step 3), you decide to have an attendant come to her home on weekdays to help her with the medications. Family members agree to assist on weekends and holidays. (This is step 4: making a decision and acting on it.) After a month of this arrangement, everyone re-evaluates the decision (step 5). After some discussion, the family agrees that a simple phone call can take the place of the weekday visit and will be an even better solution for all involved.

When defining the problem, fully explore the situation so that all of the information is available. When decisions are being made that involve more than one person, and most of them are, everyone needs to be a part of the total process. This builds ownership of the final outcome; people will be less apt to feel that some information is being withheld.

Once the family has a good understanding of the problem, the next step is to gather information. This includes factual as well as emotional information. Talk to the family members who are involved, as well as friends who may have faced a similar experience. People not as close to the situation may give you a more unbiased view. Community resources, such as the Area Agency on Aging and the Bureau of Elder and Adult Services, may also have information that will be helpful.

Next, develop and weigh the options. Be as innovative as you can. Consider each one and think of all of the positive reasons why this is a good solution. Then list all concerns you have about the option. Use this process to explore each option. Recognize that you may not have all of the answers or that they may not be available.

The next step is to make a decision based on the information and your assessment of the options. Involve all family members in the decision and meet together as a group. Give each person an equal voice.

Follow these guidelines:

  • Speak honestly.
  • Avoid making assumptions, and encourage people to ask questions if they don’t understand.
  • Share thoughts and feelings.
  • Be specific and, if possible, give examples.
  • Be positive.
  • Make constructive suggestions.

The decision that the family makes needs to clearly state what is expected. Tell what action will take place and include a time frame. Setting a time frame may be the most difficult part of all. Another way to review the decision is to ask yourself three basic questions:

  1. What is to be done to reach the goal?
  2. Who will do it?
  3. When will it be accomplished?

Although everyone may not be pleased with the decision, keep the lines of communication open. Work toward developing a group consensus that everyone supports. Your decision may not gain total agreement, but it may be the best decision at the time.

Most decisions can be changed and adapted as the situation changes. On a regular basis, revisit the solution that you have chosen. Some family members may join the group and others may leave. Reevaluating the decision is often the step that is overlooked, but it is an important one.

Remember that not making a decision is, in fact, making a decision. Sometimes, this is because someone else makes it for you, as is the case when a family member dies without a will. In this case, the state makes the decision for you, possibly not in accordance with your wishes. Usually postponing a decision will not make the need go away.

For more information on caregiving, contact your local UMaine Extension county office.

Information in this publication is provided purely for educational purposes. No responsibility is assumed for any problems associated with the use of products or services mentioned. No endorsement of products or companies is intended, nor is criticism of unnamed products or companies implied.

© 2004

Call 800.287.0274 (in Maine), or 207.581.3188, for information on publications and program offerings from University of Maine Cooperative Extension, or visit extension.umaine.edu.

The University of Maine is an EEO/AA employer, and does not discriminate on the grounds of race, color, religion, sex, sexual orientation, transgender status, gender expression, national origin, citizenship status, age, disability, genetic information or veteran’s status in employment, education, and all other programs and activities. The following person has been designated to handle inquiries regarding non-discrimination policies: Sarah E. Harebo, Director of Equal Opportunity, 101 North Stevens Hall, University of Maine, Orono, ME 04469-5754, 207.581.1226, TTY 711 (Maine Relay System).