The Phone Rings: Its 2 AM

It’s your mum. She had fallen and can’t get up. She wants you to drive there and get her. It’s a 45 minute drive, so you call an ambulance instead. When you meet her at the hospital a while later, she is angry with you and accuses you of betrayal. She wanted you to help her up and into bed. She never returns to her home, never sees it again.

How common is this story? How many adult children dread this exact scenario? Every time the phone does ring at odd hours, how many people think of their vulnerable family member with dread, thinking this is it, this is the call, it all changes here and now?

What can be done to prevent this worry, to set up a reality where your loved one is safe as well as independent? We talked in another blog about safety devices that can monitor an individual and know if there has been a fall. These are helpful, but they won’t prevent the sudden, life altering change.

It is generally thought that moving to a condo/retirement community/family members suite is a great idea and one that provides a good quality of life and safety. And yet people don’t do it, can’t do it, won’t do it.

I was talking to a Coordinator at a seniors recreation service this week. She serves about 2000 older adults who live in the neighboring areas. What she sees over and over again is the fear, the inability to change and unwillingness to make a plan. But why, you ask? Ah.

Let’s talk about that. Sometimes it has to do with dementia. At the early stages of some types of dementia, the executive functioning is the first process to become compromised. The definition of executive functioning is as follows:

The executive functions are a set of processes that all have to do with managing oneself and one's resources in order to achieve a goal. It is an umbrella term for the neurologically-based skills involving mental control and self-regulation.

So planning and executing something like a move from the family home is the first thing that becomes impossible with dementia. So not only is it not possible to make and execute such as plan with early stages of dementia, the individual and the family are still most likely unaware that there is any impairment going on.

Dad is just being stubborn, surely? Nope, he isn’t. He literally is no longer capable of pulling off and planning a move.

Even if your family member does not have any dementia, they may have age-related decline. This type of issue is usually a slower processing speed and the tendency to stick to historically successful patterns of problem solving. So, if Dad always just hired someone to fix problems, he would expect to do that in this situation.

Other areas that become harder over time include multitasking and multiple processes going on at once may be become more difficult. Another factor is that health, diet, medical conditions, medications or lack of sleep may make planning harder than it would be otherwise.

Finally, perhaps the toughest barrier is emotional the fear. Today’s senior citizens were raised in a culture that did not discuss the personal, private, anxieties and fears. Talking about what scares them is not going to be easy. Perhaps it’s never been done. Even if your family member is ready to talk about what worries them the most, or why they don’t want to move into your nanny suite, YOU are not going to be the person they can discuss this with. You are family, perceived as perhaps the small child you once were to them. They are not unaware that you have your own reasons for wanting one particular outcome, and like many family members, just want to be ornery and thwart you.

So what can you do? I have created a course on downsizing that includes looking as some of these issues, that will be available in early 2020. But it is also true that sometimes an objective outsider with skills in social work can manage that conversation in a way that plants the seed at the very least.