According to statistics, more than 50 million people provide care for a chronically ill, disabled or aging family member or friend during any given year. (1) With the front edge of 75 million Baby Boomers now hitting sixty years of age, the need for family caregivers is only expected to rise in the coming years.

Unfortunately, caregiving is a demanding, full-time job with little training that can ultimately wreak havoc on a family. Adult children, for example, may find themselves disagreeing over how much care is needed, who should provide it and who should pay. Geography can also stir up conflict, causing resentment between those who live close to the elder and those who live far away.

Forced to navigate through the unfamiliar and complex world of health service systems, caregiving can test even the strongest family. However, those challenges are multiplied when a family has a history of dysfunction.

Identifying the Difficult Family

A recent survey by the National Alliance for Caregiving and the American Association of Retired Persons found that 22.4 million U.S. households – nearly one in four – are providing care for a relative or friend aged 50 years or older or have provided care during the previous 12 months. (2) These people typically spend 18 hours a week managing the older person’s finances, helping with grocery shopping and trips to the physician and providing hands-on personal care. Two-thirds are also employed. Of these, slightly more than half had to make workplace accommodations, such as arriving late, leaving early, shifting to part-time work or even passing up promotions to provide elder care.

Some families respond well to these age-related challenges and develop a healthy partnership where each member assumes a certain role. Other families, however, do not and are emotionally unprepared to deal with the shift. For the “difficult” family – or one marked by strained relationships and unresolved conflict – dealing with an aging relative can be overwhelming and even destructive. In these families, the adult child may be thrust unwillingly into the role of the caregiver with a parent who may not have provided support in the past. These families are typically in need of an intervention.

A Geriatric Care Manager (GCM) or any other professional assisting a family should have no trouble identifying one that is deemed “difficult.” Whether they are overly demanding, armed with a strong sense of entitlement or excessively sensitive to criticism and disappointment, they tend to quickly blame others when things go wrong.

Evaluating Family Interaction

To evaluate the quality of interaction and determine the roots of conflict among family members, Dr. Dan Blazer, a professor of psychiatry and behavioral sciences at Duke Medical Center, has created five parameters that are useful in helping to assess the foundation at home for caregiving

. · Compatible vs. Conflictual – Do family members easily reach an agreement over care issues or do they argue constantly, even over relatively unimportant issues? Do old conflicts between siblings or between adult child and parent resurface during the crisis period?

  • Cohesive vs. Fragmented – Does the family present as a unit, or do they contact the GCM individually with their problems? Do family members ask the GCM to keep conversations secret from other family members?
  • Productive vs. Nonproductive – Can the family respond to the GCM’s suggestions and take necessary action to create change in the elder’s life? Are there individual family members who feel powerless to act?
  • Fragile vs. Stable- Has the family been stable over time? Is there a history of emotional distance on the part of one or more family members? Is there a pattern of divorce, remarriage or other disruptions in relationships that changes the balance within the family system?
  • Rigid vs. Flexible – How has the family handled previous crises? Did the members accept the need to change roles in those times? Are members able to exchange or share important roles in managing family affairs? If one member is unavailable to provide care, can other members assume the caregiving role? (3)

The Aging Boom

Statistics show that healthcare was the largest single industry in 2006, providing 14 million jobs. Between 2006 and 2016, healthcare will generate 3 million new jobs, more than any other industry. That industry growth is partially due to the booming elder population. What that means is there is a tremendous need – and a variety of opportunities – for those able to work with seniors and their families. (4)

More often than not, family caregivers need help. This could range from counseling to transportation, applying for income assistance or obtaining future medical services and planning for future care.

Regardless of whether the family is healthy or dysfunctional, its members are under stress as they navigate uncharted territory and work together to negotiate appropriate care for the elder. And they need professional help moving toward a more effective system of giving and caring. Recognizing the aging parent as a complete person who can provide and accept care will reward healthy and difficult families alike.

Advocare Care Management is your preeminent care manager in Boca Raton. We work with you to get the resources, tools, support, connections, and advice to care for a loved one. We assist families throughout South Florida including Miami-Dade, Broward, and Palm Beach counties. We are available 24 hours a day and will give you the help you need. Contact Advocare Care Management today and let us help you.

Reprinted with permission from Advocare Care Management is the place to go when caring for an aging loved one.