How to rally a family and honor parents' care wishes

This is the second in an occasional six-part series on how to plan for and talk about our — or our parents' — aging.

None of us ever has total control over our lives, but many older people today have no control — because disability forced others to make decisions on their behalf.

The single most important way to avoid this is to put plans into place while we're able that will provide for our needs when we're not. Planning and communication is key. There are many different ways to initiate these conversations, but one of the best is to hold a family conference. Here are some ideas to get you started.

Invite everyone to participate who has a role in the outcome, even (or especially) a sibling you don't like. Someone left out of the loop can easily sabotage the best-laid plans.

In almost all circumstances — if the parent is competent mentally — invite the older person to attend. None of us wants decisions made "for" us. The older person needs to be able to offer his or her preferences and opinions. In addition, family members will describe what they've observed, which can be a critical eye-opener. Sometimes hearing the truth will hurt the older person's feelings, but when they hear it from several people at once, it's more likely to register than when they hear it from one person at a time.

Make decisions grounded in reality, not wishes or memories of how the person used to be.

Family members must go into these meetings with the agreement to cooperate and listen to each other, even if they don't like each other. As much as you dislike your sister's arrogance, try hard to set these feelings aside. Focus on the older person. I've seen wildly dysfunctional families rally, despite decades of venom.

Consider asking someone outside the family to facilitate, such as a family friend or counselor (like a geriatric-care manager). Their presence can defuse combustible relationships — we tend to be on our best behavior when an outsider is in the room. Their role lends structure, keeps the conversation organized and on track. Plus, if you hire a care manager to facilitate, their expertise gives them the "authority" to speak that others in the family lack — and knowledge about available services.

Family conferences can be helpful at almost any time — to get your ducks in a row before there's a crisis, to plan for short-term or long-term changes, or to go into action when a parent needs immediate assistance.

To help your parent agree to make changes, talk about it as a "testing period" (if the circumstances fit). If you'd like your mom to move to a retirement community, say, "Try this for a while, mom, and if you don't like it, you can move back home."

Ask her to give it a reasonable period of time, like six months. All of us need to think we have options, an escape hatch in case we're trapped into something awful. Once time passes, chances are excellent she'll make friends, get comfy in her new arrangement, and be fine.

So what if you've tried your best to convince your parents to make necessary changes — and they still refuse? The options are less polite.

Use the truth and apply the guilt. Spell it out: "Mother, you're not eating properly, you're an accident waiting to happen every time you drive, and I lie awake at night worrying you're going to fall and nobody will find you." Countless adult children have told me these exact words — but not their parents. Blunt honesty is sometimes required.

For some, the only solution is to back off. Stop enabling your parents to fail. It's the "tough-love" concept that parents discovered decades ago when their teens (perhaps you) were being self-destructive and out-of-control. If you're running yourself ragged helping parents maintain the fiction that they can still live without assistance, stop. The hard reality is, you may have to wait for a crisis to occur that puts you in the driver's seat. Now, here are two important ground rules underlying all these efforts.

You're still equals with your parents. Your goal is to "partner" with them. Your mom and dad aren't children, and you're not "parenting" them (despite some book titles). It may feel like that sometimes, but a healthy caregiving relationship between parents and adult children is still an adult-to-adult transaction. As long as they're mentally competent, they need to participate as much as they can and be part of the decisions that are made.

No matter how frail, sick or dependent an older person becomes — as long as they're mentally competent — they have the right to make the wrong choices. They may do nothing when they should take action or they may do the wrong thing. In America, each of us has the right to self-destruct, to be wildly eccentric, and not to be forced to do something against our will.

Next: what to do when a parent has dementia.

Liz Taylor's column runs Mondays in the Northwest Life section. A specialist on aging and long-term care, she consults with individuals and teaches workshops on how to plan for one's aging — and aging parents. E-mail her at growingolder@seattletimes.com or write to P.O. Box 11601, Bainbridge Island, WA 98110. You can see all of her columns at www.seattletimes.com/growingolder/.