midlife siblings Archives ⋆ Cathy Cress

Ten Warning Signs You Are Working With a Dysfunctional Family

August 8, 2023

Ten Warning Signs you are Working with Dysfunctional Family represents critical information to share with long-distance caregivers before their holiday visit. Do you know them? They include contentiousness, anger, and cut off and all are listed below. These clinical issues give the visiting caregiver signs that they need to call a care manager and you the care manager the most challenging job of an aging professional. What you have to know is family system theory and be clinically skilled in entering this treacherous family system – to get care for an older person

1. Contentiousness – Old fights erupt; the siblings and parents get into arguments with one another about an old issue

2. Anger – Siblings and family members express physical anger, emotional abuse, financial abuse

3. Distancing & cut off – Some siblings or parents have nothing to do with family and may not speak to parents or siblings for long periods of time.

Ten Warning Signs You are Working with the Dysfunctional Family – Fusion, Denial, Triangulation, Entitlement

4. Fusion – Siblings and family members, such as the mother and eldest daughter, blend into one another, For example, the daughter sounds, acts, and has the same prejudices as the mother. . Think of the media’s portrayal of Lindsay Lohan and her mother.

5. Denial – Adult siblings do not see a decline in a parent, do not face reality, and do not take care of parent if he or she needs care.

6. Triangulation – Tension between two family members or siblings causes one to enlist a third family member or sibling to avoid change For example, two adult sibling object to the cost of care of an aging parent. They gang up on the third adult sibling who thinks the cost of care is reasonable and justified.

7. Sense of Entitlement – Siblings who are accustomed to purchasing services need not personally solve their own, children’s siblings or parents’ problems. This lack of engagement leaves them, unprepared and unwilling in getting involved in solving family tribulations.

Ten Warning Signs You Are Working with a Dysfunctional Family – Narcissism, Needy Adult Siblings, Substance Abuse, and Cut Off

8. Narcissism – One or more siblings has an “it’s all about me” attitude and

other siblings resent this. The self-absorbed sibling either does not participate

9. Needy Adult Siblings – These adult siblings feel starved for affection and often seek affection from professionals and other people in their lives for compensation for the care they didn’t receive as children.

10 . Substance and Other Abuse – The family and siblings have a history of drug, alcohol, and/or child abuse.

If this fits you you and your aging parent needs care may need to contact a geriatric care manager.

SIGN UP FOR MY HOLIDAY WEBINAR –

Get Ready for the Holiday Rush

WEDNESDAY, November 16th, 2022, FROM 2 PM – 3:30 PM PST

Learn how to create!

Pre-Holiday Social media campaigns to reach worried caregivers
Pre- Holiday-Materials about the warning signs that a parent needs help
Pre-Holiday Marketing to help you sign up families who might face a serious decline in aging parents

How to sell services to desperate post-holiday callers from Normal dysfunctional & long-distance family
How to use tools to contain holiday chaos & arrange care in festive family fright
How to move the family to New Year’s stability

Know The Ten Warning Signs you are working with a dysfunctional family and position Your Agency ahead of Care Managers who do not have great pre-holiday marketing campaigns and lack the clinical skills how to work with Adult Children and families during the chaotic aging family holiday visit when adult kids find their aging parents need care
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Cathy Cress MSW author of the Handbook of Geriatric Care

Management

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Caregiver Assessment- What Does It Takes Professionally ?

March 30, 2021

Doing TWO Assessments

To meet the needs of the whole aging family, the care receiver, and the caregivers, GCMs need to begin assessing the caregiver as well as the care receiver. There is a synergy between the caregiver and client – they are interdependent. If the caregiver is stressed or weak the client does not receive good care. They both suffer without supports that a care manager can give them.

A caregiver assessment helps the GCM see this faltering interdependence by using a caregiver assessment. The National Center on Caregiving at the Family Caregiver Alliance calls this a process gathering information describing the caregiving situation and identifying the family caregivers’ particular problems, needs, resources, and strengths. This means that the care manager can see issues from a caregiver’s perspective and can focus on what supports they need to give them the best care. The GCM compares this to the client’s assessment of needs. The result of doing two assessments is discovering both the client/ care receiver needs and restore health and well-being, prevent poor care, client injury or illness, caregiver burnout, trauma or quiting, and unnecessary placement in a nursing home.

Create a Circle of Care

One resource that a GCM can bring to a caregiving family is what Gail Sheehy calls a circle of care. To create this supportive connection, the GCM needs to take her or his coaching skills and put together a support system around the formerly isolated, solitary family caregiver. The GCM can coach the family caregiver to ask for help so the GCM can assist in reorganizing the family so adult siblings can share in the care of the older client with the identified family caregiver. The GCM is what Sheehy calls a compassionate coach who can help the beleaguered caregiver attract and assemble a platform to keep on giving the care she or he wants to give the aging person.

Caregiver Resources

A circle of care includes emotional resources for the direct family caregiver. These emotional resources could and should include adult siblings. Reconnecting midlife brothers and sisters, through the circle of care, is an important GCM task, as siblings are the longest and deepest relationships in any person’s life. The GCM may have to depend on his or her clinical skills in helping siblings with forgiveness or reconnecting siblings who live long distances apart to add them to a circle of care. Midlife siblings have often spent the last 30 years tending to their own families, so the point of reconnection of midlife brothers and sisters often happens when they are in middle age in the midst of a crisis in parent care. This is where the GCM needs to employ clinical skills in midlife sibling work or to find the resources for the family to help with this healing sibling reconnection.

The 2 Deadliest US Sites of COVID-19 Nursing Homes & Prisons

May 2, 2020

PRISON INMATES AND NURSING HOME PATIENTS NOT 6FT APART – 6 FEET UNDER

70% of inmates in federal prisons have COVID-19. In Kansas, the Lansing Correctional Facility had a riot of inmates over COVID-19 lack of care or protection It took the rebellion to get the coronavirus testing PPE and care. The Bureau of Prisons in Kansas confirmed finally that 79 staff have coronavirus and 88 prisons and prisoners dead.

Older residents in nursing homes cannot rebel like prisoners. Many can’t even walk. The Atlantic Magazine just published an article, We are Killing Elders Now. The writer states “In at least six states, these fatalities account for half of all COVID-19 deaths, and according to the World Health Organization, half of all coronavirus fatalities in Europe have been traced to nursing homes too. Some of this mortality is linked to long-term-care facilities that are shoddily run or that violate health standards. But most of them are doing the best they can with what they have. And they don’t have much”.

KAISER FOUNDATION NURSING HOME STAFFING AND USE OF PPE NOT REQUIRED IN MOST STATES

Kaiser reports -Staff Screening. It is more common for states to recommend rather than require daily screening of staff for illness in NFs (24 states recommend, 16 states + DC require)

Use of PPE. More states recommend (23 states) than require (7 states + DC) staff to use PPE

Two States that require testing for coronavirus of ALL residents of nursing homes are Maryland where 556 have died as of the Washington Post article. and Tennessee

THE FEDS HAVE NO CMS FEDERAL GUIDELINES OR REPORTING

We have no federal guidelines for safety testing according to an article by the Kaiser Foundation

It is now estimated that 16,000 deaths have occurred in nursing homes and that is without the federal government revealing any numbers and not making available any testing. But the numbers are probably huge- if we could just do testing.

CMS announced it would have a meeting of a “panel” of experts “ sometime at the end of May”. After probably 20,000 older people died and the feds did nothing this shows their sense of urgency about this pandemic’s national “elder cleansing”.

WHAT CONNECTS PRISONS AND NURSING HOMES – CONCENTRATION CAMPS

So, what is the connection between the viral spread of COVID-19 in nursing homes and prisons- 6 feet ? Prisoners and residents, in nursing homes, and prisons cannot social distance. Jails and prisons have human beings crammed together with no choice. Nursing homes have 2 beds or if you are on Medicaid three to a room. Neither group has a choice to social distance. They are ” concentrated” as in concentration camps or death camps.

Do SOMETHING – HELP NURSING HOMES PREVENT MORE CARNAGE

So, as someone who has spent her career in aging, I am calling out to everyone, especially professional in aging – do something. Since the feds appear to be doing little- call your congressman, write a letter to the editor.

BE KIND LIKE RACHEL MADDOW REPORTS LA JEWISH HOME LA WAS

Rachel Maddow suggests calling your local nursing homes and see what they need. Be kind like the LA Jewish Home was to a smaller nursing home LA Brier Oaks. They wanted to test their residents and had no tests and the larger LA Jewish Home had tests and shared them with the smaller as a good neighbor. What they found was ravaging but it also showed caring and generosity. Care and be generous and show the helpless elders in nursing homes in your town you are opposed to -nursing home being prisons or concentration camps.

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