Dysfunctional Aging Families Can Wreak Havoc at End of Life

December 6, 2022

What do Feuding families do at the end of life?

When a family member is facing death and dying dysfunctional families have flawed conversations. Often they do not communicate at all or engage in destructive banter. They see one another as enemies. They demonize one another.

Feuding families are what I call dysfunctional families. They blame each other instead of locking arms in a crisis.

They sabotage resolution.

They actively compound already difficult decisions with intractable, interpersonal conflict. They create problems independent of the underlying issues.

Facing Fractured Communication

What are some of the struggles that these aging dysfunctional families with fractured communication can face?

Aging parents who lack the capacity to make decisions have no advance directives, DPOA and a

health-care proxy, and adult siblings, who must make end of life decisions, can’t agree

Withdrawal of life support with no designated health care agent and adult children and/or spouse disagree

Pain management adult children and/or and spouse disagree.

Answer to Fractured Family at End of Life – Mediation.

Mediation is a tool that can be a good resource for dysfunctional families at the end of life. It can help with these difficult families face the death of a parent without fracturing the entire family. It can allow an older person to die without pain inflicted by their own family.

Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

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Learn to guide the patient/family through the five stages of death. Understand how to help clients be active participants in their care. Give the family caregivers tools to manage care. Find out how to provide family-centered care to caregivers and family. Learn to choose the right support services for the client through all stages of death.
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2. Help clients be active participants in their care

3. Give the family/caregiver tools to manage care

4. Provide family center care to caregivers and family

5. Choose the right support services through all stages of death

6. Introduce Hospice and Palliative care and work with their team

7. Use ALCA End-of-Life Benefits During COVID

8.Use COVID -19 Family Coaching for GCM

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Know the 3 Dysfunctional Aging Family Adult Children Who Call Post Holiday?s

January 4, 2022

3 Types of Dysfunctional Adult Children Call You After Holidays When you Need Clinical Skills to Work with these Callers

# 1 Inquiry from Narcissistic Adult Child in Dysfunctional Family

– The narcissistic adult child from the aging dysfunctional family who calls for help 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 their entire lives and have a love/hate relationship with older moms or dads. With 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 the disastrous holiday season and you need clinical skills to work with them

#2 Inquiry from Devalued Child Entitled but Servile Adult.

The devalued adult child from the aging dysfunctional family calls you after the holidays you need clinical skills to work with them.

As a kid, the adult child of a narcissist 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 the holiday 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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End of Life-When Do You Need Mediation?

February 23, 2021

Why do some families need mediation at the end of life? Mediation is a voluntary process in which the parties, with the help of an impartial third party mediator, work together to resolve their differences or solve a problem they were unable to address satisfactorily without help. These family differences especially happen to dysfunctional families but can beset any family at the end of life. They are faced with overwhelming emotions and decisions that demand that the family work together as a team. What happens to dysfunctional and even nearly normal families during this trying time? They don’t gather as a team. They fight. They fret and they feud. What are the results of this fighting, fretting, and feuding in families at the end of life?

Unresolved family conflicts emerge

Dysfunctional families become more dysfunctional

Family members’ grief, pain, and anxiety are often masked as anger and presents as conflict (past and present)

Older person dies without resolving important family issues

Older person dies in conflict, not in peace

Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

Serve Your Client Until Death Do You Part

Join me Thursday, March 11, and learn why End of Life Services Are a perfect new service for care managers

In this 1 ½ -hour webinar you will learn how to

Transition the patient/family through the five stages of death
Help clients be active participants in their care
Give the family/caregiver tools to manage care
Provide family center care to caregiver and family
Choose the right support services through all stages of death
Introduce Hospice and Palliative care and work with their team
Use ALCA End of Life Benefits During COVID
Use COVID -19 Family Coaching for GCM
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If you really want to add End of Life to your care management business sign up for this webinar now

130 million Dead COVID- Trump will not require the #1 deterrent -Masks

July 9, 2020

Number 1 Prevention of COVID -19 Wearing A Mask

The Coronavirus yesterday reached the 3 million mark in mark in cases The number one preventative step we could have taken is to wear masks

Citing Lone Ranger-TRUMP Refuses National Order For Masks

Yet, President Trump refuses to issue a federal order to wear masks and leaves it up to the states. In Texas, where the coronavirus rampages, the Republican governor has also refused to issue a state order to wear masks. Like ordering the US to wear masks, has something to do with his looks, Trump said a mask makes him look like the Lone Ranger. The Lone Star state topped over 1000 cases 5 days in a row

33 Million Would Not Be Dead if Masks Ordered in October

A new study says wearing masks would have saved 33 million lives since last October. Yet there are still no federal mask requirements.

Lack of President’s National Response Leading to New Depression- Says World Bank

This lack of federal response, like no federal order to wear masks, is not only killing huge swaths of the world population but has torpedoed our economy. President Trump wants to reboot the economy yet by not using federal controls, according to the World Bank the President is moving us to a recession and the cusp of depression worldwide.

Less than half the States Require Masks

Only 20 states require masks as Trump, instead of requiring masks, has left it up to the states. He relented recently, narcissistically, saying he thought he looked good- like the lone ranger in a mask but ordered no federal requirement.

Dr. Anthony Fauci predicts a few days ago that the huge COVID spread could leave 100 million a day dying. Masks are our # 1 deterrent again this slaughter by the omission of using federal powers

33 States Now in Crisis Surge of Virus Sunbelt Devastated

A total of 33 states now have a coronavirus surge with 7 states in the southwest at a crisis level.

Without required preventative steps from the Trump government and the wildfire surge immolating ¾ of our states, COVID 19 is not going away, in fact, may last well into 2021

Mixed -Messaging by President, States, Counties Gives Families no Path to Virus Safety

The problem is made more confusing by the administration’s mixed messaging with different states, cities, counties telling residents what to do to be safe. Families have no idea which way to turn to keep themselves and the most vulnerable senior family members safe.

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Products from sheltering in place through the hospital, recovery at home, discharge from an SNF, or hospital for local and long-distance elders.

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Help a Local Family Help a Loved One Safely Shelter in Place

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Help an Aging Family Help a Loved on Hospitalized for Covid-19

Help an Aging Family Help a Senior when Discharged from Nursing Home

Help an Aging Family Help Elder Recover when Discharged from a Hospital

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Why is CMS Loosening Nursing Homes Infection Control in Pandemic ?

May 9, 2020

When 20% of COVID-19 cases are in Nursing Homes -CMS Rolling Back Infection Control

Insanely CMS and the FEDS are considering rolling back infection control in a nursing home in the middle of a coronavirus pandemic -when more than 20 % of the cases in the US are in Nursing Homes.

The mind-boggling idea was reported in USA Today. A rule proposed last year by the Centers for Medicare and Medicaid Services (CMS) would modify the amount of time infection prevention must devote to a facility from at least part-time to “sufficient time,” an undefined term that lets the facility decide how much time should be spent.

Why do you need infection control in a nursing home- even before COVID -19?

Over 4 million Americans are admitted to or reside in nursing homes and skilled nursing facilities each year and nearly one million persons reside in assisted living facilities. Data about infections that occur in these skilled nursing home include on a normal day before coronavirus

1 to 3 million serious infections occur every year in these facilities.
Infections include urinary tract infection, diarrheal diseases, antibiotic-resistant staph infections, and many others.
Infections are a major cause of hospitalization and death; as many as 380,000 people die of the infections in LTCFs every year.

Nursing Homes deaths May Be 50% of All Deaths in Pandemic

These infection control rationals were before COVID-19. Now, in the midst of this black plague of the 21st Century, it is thought, according to the Washington Post that nursing homes may account for 50% of death BEFORE infection control is further diluted by CMS.

Cities& States Reduce COVID-19 Risk in Nursing Homes -Feds Increase Them

In contrast to the blighted policy idea of the Federal government, Detroit, as a city, has tested every nursing home and in addition, is testing all staff and providing them with PPE.San Francisco is also now testing every resident of a nursing home. States like Maryland and Wisconsin and testing all nursing homes.

The Kaiser Family Foundation reports that at the end of the pandemic we may find out half of the deaths in the pandemic were from residents of nursing homes. In light of all of this carnage and potential destruction of the elder population in the US- why then are CMS and Trump loosening infection control? Is this throwing salt into the would of frail elders, madness, an attempt to delete people on social security, incompetence at CMS or CMS following the bedeviled destructive policy of the Trump administration? We need answers but will we as a country get them in time?

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