10 Do’s &Don’ts Doing the Dysfunctional Family Calls Post Holidays

September 5, 2023

Most Calls for Care Managers Post Holidays

More than half of the aging families who call you inquiring about services will be dysfunctional families post-holidays. The great majority of calls will come from adult children. If you want to make the sale during the inquiry you have to know how to handle these dysfunctional family members on the phone and give them enough trust in you to sign your contract and give you a deposit for your services.

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How Do You Get Them To Trust You Enough to Sign Contract with Dysfunctional family Post holidays?

Do Be Objective
Do Use Active Listening
Do Give them Hope you can solve their family problem
Do a two-part inquiry and have the problem defined in the first part done by a skilled administrative Assistant
Do study the problem before you do the second call and have exactly how you would solve the problem ready in a planned elevator speech
Do a complimentary 30-minute consultation
Do not give away the store but outline how you are an expert at solving the problems (moving, keeping at home, Alzheimer’s wandering and a bare outline of your solution
Do not criticize dysfunctional family post-holidays
Do not blame,
Do not take sides if several family members points of view and express them

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Dysfunctional Aging Family Adult Children Who Call You Where You Need Clinical Skills

August 22, 2023

3 Types of Dysfunctional Aging Family Children Calls

Where You Need Clinical Skills

# 1 Inquiry from a Narcissistic Adult Children

in Aging Dysfunctional Family

Dysfunctional adult children who inquire about your services can be a tough sell. First, let’s- consider The narcissistic adult child from an aging dysfunctional family who calls for help and has an “it’s all about me” attitude. The aging parent and or a midlife sibling could be narcissists. With aging parents, all siblings may have resented this self-absorption of their family their entire lives and have a love/hate relationship with older parents. Siblings, the other brothers, and sisters resent this, especially with parent care. The self-absorbed sibling either does not participate in solving sibling or aging family troubles but just makes them worse. They call after a disastrous holiday event like the coming Labor Day family gathering and you need clinical skills to work with them

#2 Inquiry from Devalued Child Entitled but Servile Adult.

Dysfunctional adult children who call you about your services can include devalued adult children from the aging dysfunctional family calls you, you need clinical skills to work with them.

As a kid, the adult child of a narcissistic parent was devalued in the parent’s eyes so that the now aging parent can feel superior and powerful in the world. These children mature into adults who are emotionally impoverished, inflexible, and needy.

As a geriatric care manager, the adult child presents as entitled. As clients, these adult children fear that unless they make inflexible demands, they will receive nothing. “ Get my mother into a concierge wing of a hospital by tomorrow”

An adult child of a narcissistic aging parent will present as nasty, aggressive, and devaluing of the service provider. Or they could be essentially insatiable and easily injured by the helping professional. The adult children of narcissistic entitled families are also often angry and frustrated at having to give care to a parent or parents whom they experienced as ungiving, demanding, intrusive, overpowering, and needy. They are members of an ultra-dysfunctional aging family. They call after a visit to aging parents and you need clinical skills to work with them

# 3-Inquiry from Needy Adult Children in the Dysfunctional Aging Family

The adult child who calls may be the needy adult child. Baby boomers must evolve beyond the needy child he or she has been, depending on aging parents’ fiscal,

emotional, and social support, to the adult who supports his parent. Adult Children of aging parents in the 21st century not only confront the delay of their own needs when their parent’s aging and reliance call them but confront their own future and very much more immediate loss of the central figure in their lives, their own parents.

Some don’t- especially in the dysfunctional aging family.

These adults feel starved for parental affection they never received and often seek affection from professionals and other people in their lives to compensate for the care they didn’t receive as children. They call after the holiday and you need clinical skills to work with them.

These 3 types of adult children have clinical difficulties that are coping and defense mechanisms allowing them to adapt to a dysfunctional family. The care manager must enter the family system clinically to address the needs symptoms and defenses of the adult children to get care for the elder.

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Need a Midlife Family Meeting for Aging Parent Disaster Plan

August 21, 2023

MidLife Sibling Meeting Needed for Global Warming

A midlife sibling meeting needs to be convened after the catastrophic global warming nightmare of Hurricane Dora unleashed on Maui, where 1000 people missing many probably older residents who could not get out quickly creating a midlife sibling nightmare. The identified dead are all elders. Scores more victims will be identified in the weeks and months to come. While the final list of fatalities will almost surely represent a broader cross-section of ages, the deaths underscore that elderly people are at greater risk in fast-moving blazes.

I was in Los Angeles during Hurricane Hilary when the hurricane struck along with a 5.0 earthquake. It was the first in 84 years because the global warming nightmare of the week is the Pacific Ocean is now warm enough to produce big hurricanes. My daughter and family whom I had a housesat for, took off for Maui finding out Maui was on fire, and went to the big island all this catastrophe in one week. I had to scramble to find flashlights etc. and call her in Hawaii. I ended up being an example of this post.

According to the US Fire Administration people over the age of 65 face the greatest relative risk of dying in a fire: 2.6 times higher than that of the general population. Research from the National Institute of Standards and Technology and the Fire Administration ties this trend among the elderly to greater frailty and difficulty escaping.

This back-to-back global warming nightmare smacks the climate change catastrophes right in our faces. On Dora’s and Hilary’s heels, we will have more hurricanes with hurricane season upon us, that insanely could be on both coasts, with global warming making them monster storms, with the huge elderly death toll. This should terrify adult children enough to take emergency action to protect their parents.

Midlife Family Meeting of Siblings Need Emergency Disaster Plan

This recent confluence of hurricane deaths and hurricanes looming in this global warming nightmare should be a deafening roar in the ear of midlife siblings convene a midlife sibling meeting to create a disaster plan family protecting any aging family members-, no matter where your elderly parents live or what level of care. You need that disaster plan because older people are more likely to die in catastrophes than any other population

So before another hurricane, tornado, earthquake, flood, or any disaster hits, you need to have a midlife sibling meeting to come up with a disaster plan for aging family members.

What would be the agenda of that midlife sibling disaster family meeting?

If your loved ones are in a FACILITY- do not trust the facility to handle the situation.

Remember Hurricane Irma where above -Florida Nursing home residents are sitting in flooded water. Avoid this

Emergency Disaster Plan Have Midlife Family Meeting

1)Get a copy of the facility’s disaster and evacuation plan. Compare it to state regulations. If it does not include calling the family before the disaster, consider moving your loved one or make sure that is changed.

2)Appoint a sibling to be in charge of reading the disaster evacuation plan and be the contact person.

3)Call your state facility licensing body and find out the state regulations to see if they match the facilities- CCRC, Assisted Living, or Nursing Home

4) Have a telephonic family meeting before the disaster if possible

5) make sure the state requires backup generators for heat and air conditioning- a flaw in Florida’s regulations in Irma

If the loved one is LIVING AT HOME alone or with an adult child have midlife family meeting

1) Create a disaster plan for the older person. This would map out what each sibling and family member needs to do

2) Create a disaster team. This would include every adult sibling all over the country, family nearby, caregivers, and neighbors.

4) Include someone on the team who can carry heavy objects like wheelchairs.

5) Name a substitute caregiver if the regular one can’t get there.

6) Make an evacuation plan for your aging family member’s house. Where is the nearest Red Cross shelter

7) What disaster supplies do you have on hand? Get a list from your local Red Cross

8)Find out how many people do you need to make the move to safety or a shelter?

9) Put all of the above in writing.

10) Share a copy of your disaster plan with everyone. E-mail copies to everyone on the family disaster team including all adult siblings, neighbors, and friends.

11) Get everyone’s agreement especially midlife siblings and the older person. Be a unified disaster team.

12 ) Call a geriatric care manager to manage the plan or help you create it with your elderly parents, if you live long distance. They can do the heavy lifting, can help moderate a family meeting- can research state laws, be there in a disaster immediately, and create and implement a disaster plan for your parent, that you approve and can be part of.

Professionals check out the chapter “ Preparing for Emergencies” in my Handbook of Geriatric Care Management fourth edition,

Professionals Check out my book Care Managers Working With the Aging Family, Jones, and Bartlett, with its chapter on Family Meetings and the Aging Family by Rita Ghatak, director of Stanford’s Aging Program.

Calls From Aging Dysfunctional Families-Handling the Entitled Type

August 15, 2023

Calls From Aging Dysfunctional Families-Types of aging dysfunctional families who can call you over the summer vacation

Narcissistic-Entitled Families

Calls from aging dysfunctional families’ adult children or Narcissistic Entited Families’ adult kids will happen during the summer. These VIP Clinet’s adult children call you desperately for private care over the summer visit. Their problems usually develop from a specific kind of “not good enough parenting” where the parents themselves struggle with personality disorders, like narcissistic borderline personality. Families who can afford geriatric care management and home care long-term can do so because they are VIP clients. These narcissistic families, who can afford care-managed home care are often headed by a scion with a narcissistic borderline personality. Watch Succession, Yellowstone, or reruns of BIG Hair 89’s Dallas- award-winning shows you stream and you know who these Scions are. We love to hate them but binge on their evil ways. These VIP Clients have the financial resources, to pay 4-6K for home care and long-term geriatric care management which is usually over a million dollars in assets. When gathering with their adult children during the summer vacation at the family summer house or a family reunion they see the seams shredding in their parent’s minds or bodies and call you for help because they did not have those good enough parents and have no model to care for them as the parents usually did not care for the adult children as kids. They often have no interest in caring for the parents themselves, as they themselves are entitled. You need clinical skills to work with these families because of the diagnosis of narcissism, which can tear a country or family apart. Part of this is drawn from Claudia Fine and Nick Newcombe’s excellent chapter “Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett)

Calls From Aging Dysfunctional families-Real & TV Narcissistic-Entitled Families:

Calls from aging dysfunctional families will come this summer- with adult children looking for help. They may see their parents faltering and face caring for them, which they have no plans to do. They will hire you like the private chef or the gardener, a service to carry out their wishes. Entitlement in their family causes the adult children to at times be as difficult and nasty as the parents. These VIP families usually develop from a specific kind of “not good enough parenting” in which the parents themselves have struggled with personality disorders, most typically, in this type of family, narcissistic borderline personality (for example Former President Trump)They struggled with a borderline personality that went undiagnosed or was formally diagnosed and untreated. We can also see this Narcissistic entitled family head in Brian Cox who in Secession plays the beloved Scion to Love and Hate Logan Roy based on real-life narcissist Rupert Murdock. The adult children will call over the summer when they notice their aging parents’ confusion often because they still fear their aging, more confused will be a perhaps more fierce parent, and the adult kids have no nerve to approach telling them they care. You need clinical skills to deal with them because they are not on TV but asking for your help in real life and narcissism and borderline personalities take the kind of clinical skills Claudia Fine and Nick Newcombe’s excellent chapter “Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett) gives you if you read it. But if you watch HBO Succession you see them in a series that can be an instructive clinical accompaniment.

Calls from Aging Dysfunctional families-Sumner Redstone’s VIP Family Struggles

Calls from aging dysfunctional families like Sumner Redstone’s is another example of this type of narcissistic borderline personality in heading a VIP family. He was a Media Magnate who founded CBS Viacom with a net worth of 500 billion. His narcissistic borderline personality created a long-term struggle with his family over inheritance and control after he developed dementia. Mr Redstone was conserved by his daughter

These families call you often because they see you as a way to get control of their parents and their parent’s money. These are tricky situations where you must face conservatorship and real war with both parents and adult siblings fighting against each other for power and money, a replacement for the love they never received in the nest. So clinical skills are critical to handling them of all entitled families – they are Tyrannosaurus of dysfunctional families.

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Rural Living Elders Greatest Risk to Perish in Massive Hawaii Fires

August 14, 2023

RURAL LIVING ELDERS AT GREAT RISK IN FIRES _ELDERLY 2XMORE LIKELY TO DIE IN FIRES

Rural Living elders are at great risk of fires. The U.S. Fire Administration estimates that older adults are more than twice as likely than the general population to die in fires. One-quarter of the Paradise residents, in the devastating fire that burnt down an entire California town in 2018, through PG&E Malfeasance had a disability which is double the statewide statistic. One geriatric care manager who lives there lost his home and practice trying to rescue a local older client.

Rural Living elders at great risk in fires showed up again in the present Hawaii fire. The devastating Hawaii fire that just destroyed the entire town of Lahaina on Maui where over 90 people have now been found dead and this number is growing fast and 1000 are missing. This fire is rated above the Campfire which destroyed the town of Paradise in 2018. Many of those suspected dead in Lahaina are thought to be older people who could not escape quickly enough as it was a fire that was swept by Hurricane Dora’s 80-mile-an-hour winds spread the fire so fast that many many just could not escape. Lionel Montalvo, retired fire chief in Lahaina, said that many dead elderly would be found

Decades of research confirm that the physical limitations that accompany advanced age make it much more difficult to escape disaster, but so do the social isolation and stubbornness that experts say is common among the elderly.

BREATHING PROBLEMS FOR SENIORS UBER RISK IN FIRES

The elderly are at the greatest risk for fire-related breathing problems according to the CDC.So if they just live in fire-prone areas and do not lose their home the very air they breathe can make them ill or actually kill them. Wildfire smoke can in the worst cases be deadly, especially among older people. Studies have shown that when waves of smoke hit, and patients experience respiratory problems, heart attacks, and strokes.

In 23 counties, older Californians overwhelmingly choose to live in fire-prone areas. Including in San Luis Obispo County, where 82% do live in rural areas.

Rural Living elders are at great risk of fires. That means nearly 2 million older Californians live in areas where wildfire is a formidable threat. It is not only the elderly who are losing homes in these rural Forest fires but those in facilities.

According to NPR in San Francisco, there are more than 10,000 long-term care facilities in California, from six-bed assisted living homes to large nursing centers.

Their analysis found that 35% of these facilities are in risky areas. With as many as 105,000 residents to safeguard if fire comes, these care home operators must now consider how to evacuate during a pandemic, a more complicated and difficult task.

California is aging faster than the rest of the country. In 10 years, the state projects the number of people over 65 will grow to 8.6 million.

RURAL LIVING ELDERS AT GREAT RISK IN FIRES SANTA CRUZ COUNTY FIRES TURNED REDWOODS INTO INFERNOS

In Santa Cruz, California, where my home and my home office are located wildfires in our Santa Cruz mountain forest burnt down 25 % of our county in 2020. Of the two most damaged areas in the county was Bonnydoon, a rural area overlooking the Pacific which is very beautiful and rural. Among the many senior facilities damaged was Brookdale Senior Living which was evacuated due to smoke damage and inhalation by residents. They had to send patients to the Bay area, and in the Brookdale case, frail confused elders were sleeping on cots close to each other, risking COVID-19 and exacerbating their confusion, according to one daughter who moved her mother to her home in Santa Cruz permanently.

ELDERS COLLIDE WITH CLIMATE CHANGE

“There is absolutely a colliding of the events of both population aging and climate change,” said the University of South Florida gerontologist Kathryn Hyer. The elderly population represents 1/5 of our population and growing. Climate disasters as we can see from one climate catastrophe after another this year -like the Maui fire explode in power and frequency. According to the EPA, these colliding statistics are a formula for a disaster in a disaster.

Climate change is having a significant impact on wildfires according to the National Oceanic &Atmospheric Administration

Rural Living elders a great risk of fires and it is only getting hotter, harder to breathe more dangerous for all worldwide US residents reflected in the heat wave in Arizona and Texas with a high-risk population of aging individuals but radically more so for elders, who are number 1 in health problems and live at home or in facilities in the middle of these mammoth forests, turned into infernos of death

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