Most people underestimate the difficulties of caregiving. In an ideal world, most of us would prefer to care for our loved ones ourselves rather than see them in an assisted living or nursing home. If we were the person needing care, we would also like to be with family rather than strangers. However, the reality is that it is hard to be a caregiver emotionally, physically and financially and the time may come when it would be best to bring in outside help or move a family member to a professional care setting. The problem is when spouses (or adult children and their parents) don’t agree about that decision.

In some situations, but particularly where dementia is involved, the spouse requiring care may deny needing extra assistance or express anger or fear about being sent away. He or she may not realize the burden of caregiving. Sometimes other family members may chime in with their opinions about what should be done. On the other side, the caregiver may feel guilty or selfish about getting outside help. When faced with resistance from a spouse or adult children, caregivers may relent and continue until their own health is sacrificed.

While there are no simple solutions, a few tactics can help the situation.

  • Be honest. Caregivers should not suffer alone and should share the effects of caregiving on them with their spouses and family members. It is also important to discuss the details of what type of care the person needs and how a professional can provide aid.
  • Have a dialogue with the one needing care. Unless the person no longer comprehends his or her surroundings and situation, it is essential to discuss options jointly. Competent adults have the right to make their own decisions and families must take care not to force decisions on them for emotional and legal reasons.
  • Bring in neutral third-party professionals. Depending on the nature of the conflict, there are many types of professionals who can provide assistance. A geriatric care manager or aging life care professional is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. Where family members are arguing over the guardianship or care of an individual, a mediation attorney may also be beneficial. Doctors, support groups and therapists may also be invaluable in addressing both physical and emotional issues.
  • Plan for the future. While many of us sign health care proxies, powers of attorney and living wills, we need to also talk with our families about our wishes and listen to each other’s concerns. This should also be an ongoing conversation as circumstances change. Spouses and family members may also suffer health or financial problems that may affect their ability to provide care. Review your plans and documents regularly to account for changes.
  • Continue getting assistance during and after the transition. Everyone will be affected by the caregiving decision and adjustments take time. Seek out professional help, spend time with family, develop a visitation schedule if the person has moved to a facility, connect with friends and get involved with other activities to ward off grief, loneliness and other emotions.

As a lawyer and mediator, I have assisted many clients with documenting their wishes and resolving conflicts over caregiving decisions. Contact me for a consultation.

For more suggestions, read When One Partner Needs to Move for Long-Term Care and the Other Doesn’t.