#FreeBritney, Part 1: Conservatorships and Guardianships

In this episode it is my pleasure to talk with Wendy Mitchell, author of the best-selling books Somebody I Used to Know, What I wish people knew about dementia and the recently published One Last Thing; How to live with the end in mind.

We connected back in 2022 to explore Wendy’s Advance Care Planning and spoke about the work we did together in an earlier podcast. Wendy writes about her Advance Care Planning journey in her recent book and in discussion today we reflect on missed opportunities to plan ahead, the importance of language and of normalising these important conversations.  We also talk about Assisted Dying and what Wendy learned through writing her book.

Wendy is a true inspiration, teaching us all how to live with the end in mind.

If you are a team looking to provide better end of life care, or set up a one off or complete education programme in end of life care head to www.speakformelpa.co.uk where I provide details on how I can help you. You will also find information about my Lasting Power of Attorney consultancy and the talks I offer for organisations.

As we age, the ability to take care of ourselves and make decisions about our healthcare can become more difficult. It is natural for us to want to maintain our autonomy and independence, but sometimes our decisions can put our safety and well-being at risk. This can be especially challenging for caregivers of aging parents who refuse medical or home care.

If you find yourself in this situation, you may be feeling frustrated and uncertain about how to safeguard your parent's health. In this podcast episode, we will discuss strategies for maintaining the safety and well-being of an aging parent who refuses medical or home care. We will explore the reasons behind a parent's refusal of care, and offer tips and strategies for navigating this challenging situation.

One important aspect to consider is advanced care planning. Having a conversation with your parent about their wishes for end-of-life care can help ensure that their preferences are respected, even if they are unable to communicate with them later on. A capacity assessment can also be helpful in determining if a parent is capable of making decisions about their own care.

For parents dealing with dementia or other cognitive decline, it may be necessary to consider substitute decision-making, such as a power of attorney, to ensure that their healthcare needs are met.

We will also discuss the importance of compassionate communication and family interventions, as well as the use of mediation to resolve any conflicts. It is important to consider the ethical considerations and mental health of all involved parties, including the aging parent and the caregiver.

Furthermore, we will explore the benefits of hospice and palliative care, which can provide much-needed support to both the aging parent and the caregiver. Additionally, we will discuss how to manage resistance to care and the importance of care coordination and multidisciplinary teams. Lastly, we will also provide information about community resources that can help in this situation.

By the end of this podcast episode, you will have a better understanding of how to approach this situation with compassion and sensitivity, while also advocating for your parent's health and safety.

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I discussed in last week’s post how a guardianship may not be possible where Mom needs help but is not necessarily incompetent.  So, what other options are there?  Mom’s health has been in gradual decline.  The family sees it.  Sometimes they agree that action is necessary, some times not.  They have had more than one conversation with Mom about the need for long term care planning, for example moving Mom to a safer environment. 

The problem, however, is that the family (usually the children) are uncomfortable in their role.  Mom, understandably, is not thrilled with the suggestions, and may even be hostile.  Roles are reversed.  The child assumes a parental role, taking care of the parent, who cannot, or will not, consider the risks that lie ahead.  Yet the child is waiting for the parent to say “yes” and can only go so far on his/her own without that permission.  So nothing is accomplished and the family simply moves from crisis to crisis, always seemingly reacting to events, not preparing for them.

That’s when you need to introduce an outside person into the conversation.  As I explain to clients, I can say things to your parents that will be heard differently than if you say them to your parents, or if I say them to my own parents.    I may, in fact, say the very same things that the family has been telling Mom.  But, now it’s different.  Mom may have been waiting for the children to take the next step.  It isn’t just talk anymore.  One step turns into the next and that’s how problems get solved.  That process can start with an elder law attorney.  It can also begin with a trusted advisor, such as your financial planner or accountant.

            Another opportunity that so many families let pass is when a crisis occurs.  Mom is in the hospital or rehabbing in a subacute care facility.  She wants to go home.  The family relents.  That may, however, be the best time to make a change.  It doesn’t have to be a permanent one from the start. But you’ve got doctors and medical staff to support you as well.  If everyone is telling Mom what needs to be done the focus isn’t on the children.  It is a whole lot easier for Mom to accept.

            Just a few options to consider.  Time isn’t on Mom’s side.  Her health will continue to decline.  Sometimes it’s a matter of waiting for, and recognizing, the opportunities that present themselves, and then seizing upon them.  In the end, Mom may come to accept the changes as necessary, or at least grudgingly allow the children to take the action they know is necessary to insure Mom’s continued well being.