People are often unprepared
when faced with difficult decisions about the care and maintenance
of older relatives. Family meetings can be the best way to address
When family members confront problems together,
discuss issues and support each other, the dignity of the older
relative can best be preserved. In many cases, family members
can become closer themselves as they work toward a common goal.
However, to make this a positive experience,
one member of the family should take responsibility for gathering
information and planning the agenda for the first family meeting.
An outside assessment should be done to evaluate
the physical and psychological needs of the older individual,
such as the primary physician's evaluation based on a recent
exam. Vision, hearing and mobility assessments should be done.
An occupational or physical therapist can also evaluate changes
needed in the home to help maintain autonomy and provide a safe
Today, geriatric medical teams are available
to evaluate the problems associated with memory deficits and
dementia. Geriatric care managers also specialize in assessing
the daily needs of an elder and can recommend appropriate services
and resources in the community.
The most important goal of a family meeting
is to work together on a plan for the older relative's future.
The group should stay focused on that goal and not revert to
petty rivalries and unresolved family issues. Everyone should
participate and give opinions that can be discussed by all.
If you feel that a family meeting might deteriorate
into a fight among the participants, it might be best to ask
an outside professional to take charge of the meeting. This
can minimize friction and keep the meeting focused.
It is important to include the older person
at the meeting so that he or she can participate. This is the
time to distribute any medical and psychological reports to
the group. Seek a consensus and, perhaps the biggest challenge,
ask for commitments from family members.
Each person should accept a responsibility to
make the plan a success. !f a person cannot contribute time,
perhaps they can contribute financially toward the costs associated
with the care plan. Recognize that there may be some people
who want their voices heard, but are not willing to accept any
Don't expect too much from the first meeting.
Follow-up meetings may or may not be a good idea. Communication
can be by telephone, fax or e-mail. Responsibilities can also
be delegated on a rotating basis so that no one is left burdened
with a specific responsibility.