Four types of aging families, who can afford geriatric care management and private duty home care as they have the financial resources, will call you to inquire about your services. You need to have excellent clinical skills to manage these families.
Two are dysfunctional aging families who take extensive psychodynamic skills. One is the narcissistic entitled family.
Part of this is drawn from Claudia Fine formerly of Senior Bridge and Nick Newcombe excellent chapter ” Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones, and Bartlett)
Narcissistic-Entitled Families:
Entitlement in these families usually develop from a specific kind of “not good enough parenting” in which the parents themselves have struggled with personality disorders. Typically, in this type of family, narcissistic borderline personality .( example President Trump)the parent had a borderline personality that went undiagnosed or was formally diagnosed and untreated. The narcissistic or borderline parent 
essentially does not experience the child/children as separate and discreet from themselves and, moreover, uses the child/children to serve parental needs. This parent-child relationship is characterized by severe boundary issues in which seduction and abandonment are ever-present dynamics and where emotional unpredictability and instability are constant.
What Will Take Your Great Clinical Skills With These Families?
Fine and Newcombe point out the adult child finds him or herself in is either of two categories. They can be elevated to the” perfect” child in the mental health challenged mother or father’s eyes, so that the parent feels worthwhile.
These children grow up to be your client’s family and the person who usually calls the care manager. If they hire you they are demanding because they are afraid if they are not inflexible with you they will get nothing from your services.
Or the second category where the child is devalued by the parent so that the narcissistic entitled mother or father feels superior ” perfect” and all-powerful. They will present, according, to Claudia Fine and Nick Newcombe, as needy and insatiable, and easily ” injured” by the care manager who is attempting to help them.
Both types of adult children who interact with you are frequently angry to care for the parent who never cared for them, gave little to them as a child, thus demanding and needy themselves. All this repulsion comes from never having a mother or dad who was there for them so in response will be difficult family caregivers to work with.
( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working With the Aging Family)
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