Who Should Attend a Family Meeting About End of Life Issues?
Ø A professional mediator if you are a dysfunctional family.See below for the red flags of the dysfunctional family:
§ You actively compound already difficult decisions with intractable, interpersonal conflict
§ You create additional problems independent of the decision that brought you together in the first place
§ You pit themselves against one another
§ Family members assume they are right (and the others are wrong)
§ You assume the roles of adversaries in their individual quests to solve the problem
Ø A facilitator if you are a nearly normal family. See below for the red flags of the nearly normal family:
§ You Communicate well enough
§ You accept differences of opinion as inevitable and an opportunity for more effective decision-making
§ You lock arms to address the problems they encounter.
Ø The older parent, if they are mentally competent and can sit through the meeting. If he or she cannot attend, due to health probelms,let him or her know who has been invited and what you plan to discuss. If he or she cannot attend, report back to him or her right away about the meeting. This keeps the control with the patient where it belongs. It is after all their life being discussed. If the elderly parent can’t attend, then the person most familiar with the needs of dying person should attend
Ø The power of attorney for health care, (if there is one) who is the health care agent and who carries out the advanced directive parent’s wishes and makes health care decisions if they are incapacitated
Ø All adult siblings
Ø A representative from( a case manager or medical social worker) Hospice if Hospice is involved
Ø A geriatric care manager if one is involved
Life-threatening illness ratchets up stress on midlife siblings caring for an aging parent. Sibling family meetings about end of life issues are a great tool to discuss the eventual or imminent death of aging parents. They can be used to establish a safe environment where plans, decisions, conflicts, and grief issues can be discussed honestly and openly. Family-centered care, which is what midlife siblings want to offer an aging parent, is an integral part sibling family care at end of life. The overall goal of a sibling family meeting about end-of-life care is to coalesce or enhance supportive communication, and family functioning and carry out a parent’s wishes about death
Family dynamics and functions can be improved by a siblings family meeting about end of life through:
· Promotion of cohesiveness
· Reduction of midlife sibling conflict
· Encouragement to share thoughts and feelings with each other
· Promotion of “cooperation and communication among family members in decision making”
Integral to this process is the sharing together of family grief if the parent is at the end of life or fear of end of life .If the family meeting is preemptive it also a way to make a preventative plan about family roles and responsibilities at end of life for a parent.
It’s important to realize that discussions involving end of life decisions can take be quite lengthy, can involve numerous family members, including midlife siblings in a series of meetings spaced over time.
In future blogs I will cover who should attend these type of family meeting and how to do an agenda.
For more information check out by book Care Manager’s Working With the Aging Family, Jones and Bartlett 2009 Gwendolyn Lazo Harris MA, CT and Diane Le Van, MA, Gerontologist, wrote an excellent chapter entitles Dying Grief and Burial in the Aging Family
Are you a baby boomer, a sibling and worried about retirement, a parent’s death or a blood thirsty fight with siblings over inheritance. Or do you just need some financial guidance among you and your baby boomer siblings over financial matters in your aging family? There is an excellent radio show covering this-
The Boomer Financial Radio Network airs Saturday mornings 9:30 – 10 a.m. EST on WMTR-AM (1250) Cedar Knolls, NJ. .
I was interviewed this week for the show on many of these baby boomer-sibling issues. The show will be aired on and if you are in the east coast tune in. As I frequently do ,I refer to geriatric care managers, financial planners to help aging families with inheritance issues?
Financial abuse does happen in families among siblings and adult children
The terrible truth is the worst perpetrators are not professional con artists. The most dangerous elder financial abusers aren’t folks running a scam like Bernie Madoff or crooks offering free lunches to retirees then swindling their money .The most vicious financial abusers are most frequently the older person’s own family adult children and midlife siblings/ .
All we have to do is look at the infamous Brooke Astor case, where a geriatric care manager was actually involved to help the court with this infamous case.
Mrs. Astor’s son Anthony was convicted of siphoning millions and sentenced to one to three years in prison.
After the trial one prosecutor called it “grand theft Astor,” with Mrs. Astor’s son on a “a six-year crime spree involving a series of larcenies.”
I also highly recommend the book Mrs. Astor Regrets by Meryl Gordon Houghton, Mifflin, Harcourt, 2008.
Mrs. Astor lived to be 105 and was a storied philanthropist. She gave her entire Foundation away to great causes, many in New York. Her 83 year old, only child ( no siblings ) -was indicted on charges of robbing her estate of millions. The story catalogs three generations of a quintessential dysfunctional family, who use the treacherous tools wielded by these kin to eat away at each other, in a bloody multigenerational family war.
They even produce art that tells the ultimate dysfunctional family story, when Philip Astor, the accused son, teams with his devious wife, to produce a revival Long Days Journey Into Night, on Broadway. I personally consider this play the ultimate dysfunctional family story.
The allegations of undue influence, where new wills are signed by elderly Mrs. Astor when she may not have the capacity to legally sign, are pure elder fiscal abuse material.
This novel makes make the stiff dry legal morass of undue influence, a compelling read and the swirl of probate attorneys, elder law attorneys, conservatorships and even a geriatric social worker who acts like a geriatric care manager, in the end, create pure theater for our aging profession.
A survey of State Adult Protective Abuse of Adults Over Sixty showed that the most common fiscal abuser was a son or daughter. Adult children perpetrated 33 % of the fiscal exploitation substantiated by APS. Other family members were the next biggest group of fiscal abusers investigated by APS. These other kin represented almost 22% of the financial abuser reported nationwide to adult protective services.
So Tune into, The Boomer Financial Radio Network airs Saturday mornings 9:30 – 10 a.m. EST on WMTR-AM (1250) Cedar Knolls, NJ. To hear me this Saturday talk about siblings and their sometimes-seamy side.
Hear my interview this Saturday, The Boomer Financial Radio Network airs Saturday July 28 9:30 – 10 a.m. EST on WMTR-AM (1250).
What is the aging family? Emily Saltz, a noted geriatric care manager and aging family expert, says that no two families are alike.
Every family is its own complex, unique, constantly changing system of important relationships, including the strongest dyad, siblings. Each connection in the clan, at one time or another, must deal with life’s most important events and issues: birth and death, marriage and divorce, intimacy and distance, growing up and aging.
That brings us to the aging family http://www.cathycress.com/books/care-managers. Dealing with the aging process within a family is a complicated matter. It can be a struggle even for families that are close-knit, well integrated, and highly functioning,
It can be overwhelming and even destructive for the dysfunctional family. What is that? The dysfunctional family that is marked by strained relationships and unresolved conflict.
Saltz tells you how to look for signs of the dysfunctional family in her chapter on working with the aging family in the third edition of my book Handbook of Geriatric Care Management http://www.cathycress.com/books/geriatric-care-management Jones and Bartlett, 3rd edition.