Making a decision for a loved one, when they are unable to do so, is without a doubt a stressful experience for many family caregivers. Having to make such a decision with siblings who disagree can cause conflict. And while such conflict is prevalent between siblings, it is also common within stepfamilies. Within the realm of caregiving, a common problem that often presents itself within a stepfamily is distrust. Distrust associated with who has the loved one’s best interest in mind, who is most familiar with the loved one’s wishes, and who is most capable of making a life-changing decision. Barring legal documents like a health care proxy or power of attorney, distrust between an adult child and stepparent, for example, can lead to a lot of arguing, estranged relationships and in some cases legal action. So, what can a stepfamily do to potentially avoid such a turn out? Begin by having a conversation. One of the best ways of preventing extreme results, as those aforementioned, is to open the doors of communication and discuss who is expected to do what. Since approaching such a topic can be challenging, there are a few things you should consider in order to maximize the chances of having a successful conversation.
Don't Be Foolish
First and foremost, don’t be foolish in believing that your family will never face such a situation. Unless there are already legal documents in place, you cannot underestimate how strong of a barrier emotions can be when making a life-changing decision. While this type of discussion should occur in all families, it is definitely a must if your loved one is involved in a new significant relationship or has re-married since your loved one's beliefs regarding long-term care may have changed and relayed only to the new partner.
Don't Be Bashful or Afraid
Beginning such a conversation can be tough and in some cultures it can be viewed as taboo. For some, it can even be anxiety-provoking. It is extremely important, however, to check your priorities by weighing your options. Would you rather deal with 15 minutes of fear when bringing up the topic or days of trying to figure out what decision is best for your loved one while you are in the middle of a crisis?
Make Your Intentions Clear
During your discussion, be sure to be upfront about your reason for bringing up this issue. Maybe it's because you want to make sure your loved one’s assets are protected, ensure his/her wishes are honored, or simply to assure everyone is on the same page about who will be in charge of making decisions. Stating your “agenda” early on can generally alleviate any doubts someone else may have regarding your intention.
Aim to "Plant the Seed"
When planning or having your discussion, don’t expect to leave with everyone in agreement about a plan of action. Since most people generally do not like to think about their own health deterioration, reluctance or even disagreements between family members is to be expected. As a result, you should aim to “plant the seed” and simply ask your loved one to think about the issues you are discussing. At the very least, you want to be able to get an idea of what your role will be in an emergency situation. Will your loved one’s spouse be in charge or will you? Does your parent expect his/her new spouse to relay his/her wishes regarding life-sustaining treatments or do they expect you to do it? Getting the answers to such questions can open the door to communication about other issues that most families often don't think about until it is too late. It can also reduce the amount of tension and friction that can result during times of crisis.
While there are many more recommendations I can list, I would prefer to hear your thoughts regarding what has worked for you or what you would recommend. Please share them below.
Christine M. Valentin
As a licensed clinical social worker, I help individuals caring for a loved one reduce feelings of anxiety, depression and stress. This blog is meant to share with you, many of the suggestions I recommend to many family caregivers. Sign up to receive them directly.