October 7, 2005

Aging Connection

Family meetings are essential communication tool

By Vivian I. Silva
Gerontologist/MSW
Special to the Times

Calling a family meeting to discuss an elder parent’s care is an essential tool used to diffuse communication breakdowns between siblings and other loved ones.

Families sometimes use a gerontologist or a doctor to facilitate these meetings. It helps to use an individual outside the family to keep emotions in check. I’ve worked with many families and find these meetings very helpful. Consider these examples:

The youngest sibling of a family of six calls for support and advice before and after she meets with her family to discuss care for parents. She wants reassurance she is doing a good job and asks for suggestions to make it a successful meeting.

Two brothers ask me to facilitate their family meeting. One thinks dad should stay at home and the other thinks he needs to be in a care facility. They want to know what other options are in the community.

Family meetings can be a way to discuss the changes their parents are experiencing and an opportunity to talk over solutions to meet their loved one’s needs.

Of course, not all elders have family. In that case concerned friends, neighbors, or anyone involved in the elder’s care can suggest a meeting. Often the elders will call a meeting themselves and include a minister, health professional or a lawyer to facilitate.

If relatives live out of the area, they can join in via a phone line. A recent family meeting I held at a skilled nursing facility had all the adult children communicating via a conference call. The elder couple didn’t have any children in the area. Another option is to send a list of questions, concerns and/or suggestions to the facilitator before the meeting.

The following tips should be helpful for family meetings:

• Designate a facilitator to keep everyone focused.

• The same person doesn’t have to always be the leader. Hiring a professional is another option.

• Designate a specific time to begin and end the meeting.

Remember the main concern is the elder’s care and situation, not the individual’s needs. Try to push aside sibling rivalry and family history. Focus on what is best for the elder and the reason for the meeting in the first place.

Set an agenda or goals beforehand. An example would be suggestions for what each participant can do to help. A few items for each meeting work best. Remember, Rome wasn’t built in a day so don’t expect that all the decisions will be made at the first meeting. I’ve facilitated meetings where only one meeting was necessary; but, often that is not the case.

Include the elder at the meetings unless he/she suffers from severe cognitive impairment or doesn’t want to be included. Allow the elder to express concerns, fears, and ideas. Don’t talk about the elder as if they aren’t there. Chances are the loved one might feel apprehensive or resistant to change so it is important to remain courteous and respectful.

Remind everyone to be good listeners and let only one speak at a time.

Use “I” statements and leave “You should…” out of the discussion.

Be open to compromise. Remember that siblings are individuals and come from different perspectives. (When my father and his sister talk about their parents, I sometimes wonder if they were raised in the same house!)
At the end of the meeting, everyone should know their tasks (if any), and be reminded of the decisions made. Written summaries help.

Communication and appreciation can make a difference. Saying thank you to a sibling for helping can improve relationships and even affect the success of the next meeting.

Take the leap and call that family meeting that’s been on the back burner. For those thinking, “easier said than done,” help is just a phone call away!

You can e-mail Gerontologist/MSW Vivian Silva at vivsilva@aol.com with questions for the “Aging Connection” column or call (408) 975-2988 to make an appointment with the Geriatric Advisory Program at the Almaden Valley Counseling Service.