Many people find it helpful to have a plan for making eldercare decisions, whether the decision is made alone or as a family. The following is a seven-step model for systematically making an informed decision.
| 1. Identify the Problem |
| 2. Gather Information |
| 3. Generate Options |
| 4. Evaluate Options |
| 5. Create a Plan |
| 6. Act on the Plan |
| 7. Reassess the Plan |
Contents |
Step 1: Identify the Problem
It’s been said that a problem well-defined is a problem half-solved. Pinpoint the problem as specifically as possible. Move from generalizations, such as “Dad is a poor driver” or “Mom is not safe living in her home” to describing specifics. For example, “At least twice last week, Dad did not stop at stop signs"; “A month ago he was cited for running a red light"; and “Dad straddles the center lane when he drives.” Unless specifics are identified, a problem can seem too large or vague to tackle. Once a problem is clearly identified, describe it in writing as specifically and objectively as possible. Putting the identified concern in writing helps to keep everyone “on the same page” in addressing it and making decisions.
Step 2: Gather Information
Having the best information possible results in the best decisions. This means getting the facts--not making decisions based on assumptions, emotions or opinions. A good starting point is objective information about your family member’s health and level of functioning. Gather information from all relevant sources; this might include a formal assessment by a physician and/or other health care professionals.
Investigate ways to meet your family member’s needs. Find out about available community services. Professionals who do assessments can help identify relevant resources. Information also is available from Area Agencies on Aging, information and referral services, and senior centers. To locate an Area Agency on Aging near you consult http://www.eldercare.gov.
Talk with family members to identify what each can contribute to meet identified needs. It’s also important to explore your family member’s financial situation. While talking about finances may create some uncomfortable feelings, it’s crucial to decision-making. Finances often are a significant factor in determining available options. For more information, download the Oregon State Extension publication number PNW 44, Helping Older Family Members Handle Finances, from http://extension.oregonstate.edu/catalog/html/pnw/pnw344.
Step 3: Generate Options
Once the problem is clearly identified, it’s time to brainstorm options. Brainstorming is the free exchange of ideas without the fear of criticism or rejection. Keep this step separate from evaluating the options. Critical thinking comes later. It’s important not to have preconceived ideas about the best solution. A common mistake is thinking there is only one approach to a situation, before examining all potential options. Health care and social service professionals can help identify options.
Step 4: Evaluate Options
The next step is to figure out which option will have the best outcome for your family. In most cases, there is no “right” or “perfect” course of action. Any decision is likely to have both positive and negative consequences. Consider both short-term and long-term consequences, as well as the least restrictive option for your family member that does not unfairly burden you or others.
Agreeing on criteria—such as financial limits, personal preferences, family values, and time commitments—for evaluating the options will also help. It's possible that combining two or more options will be the best decision. You might consider prioritizing options and developing a back-up plan. Developing a chart and writing down each option, including its benefits and limitation, can be helpful.
Step 5: Create a Plan
Develop a step-by-step strategy for implementing a plan. Getting clear commitments and writing down specifics about who is responsible for certain tasks and when they will be carried out can reduce misunderstandings among family members. It’s best if people volunteer and if their tasks draw upon their strengths and what they feel comfortable doing. It’s important to be respectful of family members who say “no” or set limits on what they will do.
Step 6: Act on the Plan
Try to establish a trial period, using the perspective that “This seems like the best decision for now. Let’s give it a try for _____ weeks/months and see how it works. Then we’ll reassess it.”
Step 7: Reassess the Plan
Because situations change, flexibility is the key to quality decision-making. Reassessing a plan can be hard, especially if you want closure to a difficult situation. You might feel like skipping this step because it takes you back over old issues. However, asking “How well is the plan working?” and making necessary adjustments, is decision-making at its best. Be prepared to try a different option or go back through the decision-making process.
This decision-making process is a guide. No plan is foolproof, but by following this or a similar process, you have a greater chance of making a decision that works and that you feel better about implementing. For more information, download the Oregon State Extension publication number PNW 246, Aging Parents: Helping When Health Fails, from http://extension.oregonstate.edu/catalog/html/pnw/pnw246.
