Intervening in the Decision Making of your Aging Parent

If you think your parent is making poor choices and that you need to get involved how do you go about doing so? This decision, like the decision about whether to get involved at all, is a very personal one. My thoughts on this are only intended to help you think through the options – not to point you in any particular direction. The choices that you make about how to get involved in your parent’s decision making can have a long-term affect on your relationship so it is vital that you intervene thoughtfully.

Is there abuse?
If you suspect that abuse is occurring your options will likely be narrowed as most states have laws that require reporting of elder abuse that extend to the general public. If you are aware of a situation where an older adult is being abused you may be obligated to report it to the authorities whether you want to or not. The National Center on Elder Abuse has some helpful information about how abuse is defined in each State and the reporting guidelines. Although you may be obligated to report abuse, it can still be done thoughtfully.

If after reading the guidelines available from your State and other available information you are still unsure if a situation constitutes abuse, call your local Adult and Aging Services department and ask them for feedback – you can often do this anonymously.

The less intrusive the better

Intervening in our parent’s lives can be accomplished in various ways. I advocate trying the least intrusive approach first. For example, you might begin by finding out if your parent sees any problem with the situation that makes you uncomfortable. Is your father who suffers from macular degeneration concerned about his own driving ability? Does your mother who is giving a lot of money to charity worry about running out of money? If both parents are living, does the other parent share your concerns?

To begin you might start a conversation with the purpose of gathering more information. There are ways to raise these issues in a non-threatening manner. For example, over dinner you might say “there have been a lot of news reports lately about how bad the economy is …. do you ever worry about things like that?” As much as we may feel compelled to start giving advice, it usually works out better if we do more listening first. Find out more about why the driving or giving to charities is important to your parent’s life before you start talking about changing things.

Getting others involved

Eliciting the help of others who are trusted by your parents can also be useful. If you have siblings try to get the sibling who is most likely to get the desired result to intervene. If your parent has siblings they trust get them to help. In some situations it is appropriate to use an authority figure, like the family doctor. This may be particularly useful in situations where your parent is continuing to drive despite suggestions from you that they should not. It may also be useful to have the doctor be the first line of intervention so that you do not have to risk damaging your relationship by “trying to take the car away.”

When everything else doesn’t work

By soliciting the help of people with the highest level of trust and the greatest amount of credibility you will increase the likelihood of success. However, sometimes despite all of our best efforts we cannot get our parent to alter their behavior voluntarily. The question then becomes is it worth trying to coerce them to change using the law or by pursuing guardianship? I have a lot of empathy for the unfortunate families that find themselves pondering this question. Taking away a parent’s right to make a decision through the appointment of a guardian seems to always result in significant conflict. This is particularly true if there is disagreement among the children about the need to pursue guardianship.

If you find yourself considering this level of intervention I would recommend that you

1- Pursue all other options first,
2- Make sure your reasons for doing so are sound (e.g. for the health and wellbeing of your parent or others who could be harmed if you do not intervene),
3- Get input from professionals about your intentions,
4- Marshal support for the hard feelings and family conflict that will likely follow

As children we are used to our parents telling us that they think we are making mistakes and using various means to influence our decision making, but when we as children are put in the position of having to intervene with our parent’s decision making - this is a type of role reversal that can create internal and external conflict.

As loving children we are not deterred by the prospect of this conflict and we intervene when we need to and gratefully defer when we do not.