Managing Up in Caregiving: How Adult Children Can Help Aging Parents and Themselves
Many families wait until a crisis to talk about caregiving. Learn how caring for aging parents can be easier by using the concept of managing up. If you’re not familiar with the term “managing up,” it’s typically applied to a working relationship with a boss that offers positive results.
Managing up in family caregiving involves building a working relationship with a primary care physician, also known as a PCP in medical terminology. It can also be establishing relationships with financial planners, tax accountants, estate planning attorneys, and other experts. Managing up involves building or rebuilding working relationships with other family members.
The goal of managing up in family caregiving is a healthier and happier parent who enjoys a good quality of life.
Managing up in caregiving isn’t something to put off. It’s a process that everyone can start doing today.
Why Managing Up in Caregiving Benefits Everyone
If you have a disconnected family, a blended family with step-parents and step-siblings, or if you are an only child, never married, divorced, or widowed, there’s more to navigate.
Because when aging parents and children don’t discuss priorities, unstated expectations can cause high stress or drama in family relationships.
If you’re a caregiver already doing too much, or if you’re in a challenging family situation, you may already be struggling. Instead, decide to shift from stress and fear to hope and possibility.
Here are two stories of families experiencing caregiving challenges that could have benefited from managing up.
The absent daughter
1 A daughter who is upset because she recently learned that her stepmother and stepsister were named as the medical and financial power of attorney for her father. Her concern is that they, the stepfamily, are not really family and won’t make good decisions for her father, who now has a diagnosis of dementia.
The daughter lives 1000 miles away. She had not maintained regular contact with her father, stepmother, or stepsister during the past ten years.
She never spoke about health or caregiving with her father. Considering these facts,
- It’s no surprise that her expectation of being the power of attorney for her father was a disappointment.
- When the daughter learned that Dad had chosen someone else, she felt rejected.
- Rejection was not her father’s intention.
- She never told her father he could trust her to be there to help when he needed help – so he made other plans.
2 Dysfunctional sibling relationships
In a family with five siblings, a parent named one child as financial and medical power of attorney agent.
This child, who thinks she knows best, refuses to communicate with the other four siblings or to involve them in their parent’s care.
Under normal circumstances, the other four siblings say that Dad would never have allowed this to happen. But today, Dad has Alzheimer’s and can no longer speak for himself.
- If Dad had met with all five children years ago when he created his estate planning documents, he could have been clear about his wishes. For example, this is what I want; this is what I don’t want.
- Dad could have put his wishes in writing to avoid potential family squabbles. He could have stated that no child, including the power-of-attorney agent, can restrict visitation by other children. He could have required transparency of information.
- But he didn’t.
How to Maintain Strong Family Relationships
Discussions about priorities and goals are a practical step for parents and children who want to maintain strong family relationships. Yet this rarely happens.
Why? Is it
- Distance?
- A too-busy life?
- Competing priorities?
- A lack of connection?
- Not knowing how to manage up conversations?
- A lack of trust?
The answer could be one or all of the above
In the two stories above, a lack of consistent communication and failure to maintain close relationships led to unnecessary relationship conflict. These disagreements affect parents’ ability to see their children, and vice versa. They also affect other family members who might take sides.
Managing Up Health Tips for Caregivers and Aging Adults
Watch this video for an example of managing up, specifically for the early identification of a health problem. Learn steps you can take to evaluate what to do next to improve, maintain, or slow the rate of chronic disease progression.
Click the red arrow button in the picture below to watch the video.
Watch Over 1000 Videos About Caregiving, Aging, and Health on Pamela’s YouTube Channel
What Does Managing Up in Caregiving Look Like?
Let’s start by looking at what it’s not. It’s not about taking control or telling others what to do. These two issues happen all the time in family caregiving relationships.
It’s more about asking questions, researching information, considering benefits and risks, and being proactive in consistently making choices related to health, daily care, money and financial planning for retirement and care, estate planning, and family conflict resolution.
Parents say, ” My kids have no patience. They don’t understand what I’m going through. Being old isn’t easy. It seems my children want to control my life instead of listening to my concerns or needs.”
Adult children say, “My parents expect me to do more and more for them without asking if I have the time. Mom or Dad are never satisfied. They only complain, criticize, and never listen.”
Both of these perspectives have a common gap. Not listening.
Previously strong relationships can turn into a blame game, excuses, and feelings of guilt or being unappreciated.
Changing Family Dynamics to Manage Up
Instead of feeling like you’re always running behind to solve problems, flip the script and get ahead of the curve by learning to manage up and gain participation from family members and others.
Identify and align family caregiving priorities
While families who grow up and grow apart may not feel like a close family, talking about priorities is critical to maintain positive relationships.
In good relationships, the goal is for everyone to thrive and do well.
This is a positive statement rather than saying, “we don’t want to see our parent suffer. So one child in the family will have to bear the burden of caring for them regardless of what it does to their life.”
While some families focus on negative or harmful goals because of generational, religious, cultural, or family expectations, this plan can result in more harm than good to multiple family members.
Why focus on avoiding suffering when you can focus on a family that thrives and does well? It’s a mindset shift and a way of living. Managing up in family caregiving means shifting away from fear to hope.
- Focus on proactive strategies instead of fear or limitations.
- Retrain yourself to break the habit of making choices based on fear by paying close attention to the reasons you make decisions.
When you do shift from reacting to being proactive, the entire family will have a better plan to care for aging parents and themselves.
The result will be less stress, worry, burnout, and fewer surprises. Family relationships where everyone thrives.
Be the adult in the family who leads a healthy, happy, and fulfilled life and who begins family discussions
Managing up in caregiving doesn’t happen without family members’ interest and participation. This means parents and siblings.
So how do you start this conversation?
Mom and Dad, brothers and sisters, I’ve been researching healthy families and healthy family relationships that begin in childhood and carry on through the end of life.
There’s an opportunity for us to share experiences and help each other live better lives. So, I’m asking if you would consider scheduled, regular conversations with everyone in the family about four themes.
Four Themes for Managing Up in Family Caregiving
These themes focus on planning for the future and also creating stability for younger generations in the family:
- Staying healthy, remaining physically able, and self-sufficient
- Being financially stable and saving for a dream retirement
- Creating legal plans in the event of health problems or incapacity
- Identifying ways to manage family conflict and disagreements about care for Mom and Dad when needed
Now, it’s possible that your family may not understand the purpose of the meetings.
In that case, be blunt and say:
“Mom and Dad. Brothers and sisters, I’ve seen what happens in other families when grandparents or parents don’t need care, and there are expectations or disagreements. Families who haven’t planned struggle. Those who have conversations do better. I’d like for our family to do better.”
The focus of the first meeting can be asking everyone to bring topics they would like to discuss or learn about based on the four themes above.
Be sensitive and realize this can be challenging, as you’re asking everyone to share personal information they may not want to share.
Then create a 12-month calendar of topics for each monthly meeting. If beneficial, invite an expert to attend even if you have to pay for their time.
An hour with a financial planner, a CPA, an elder law attorney, or a caregiving expert can fast-forward family sharing, learning, and education.
Focus on information gathering, sharing information, and asking questions without judgment or criticism
The goal is more regular contact between family members and information sharing. The monthly meetings should be a positive activity everyone looks forward to rather than dreads or avoids. If on site, share a meal. If virtual, open the meeting by sharing one good thing that happened in the past month.
These discussions aren’t just for aging parents. They are for everyone in the family and can eventually benefit children and your grandchildren.
The four areas of managing up in caregiving apply to everyone. The sooner these are acted upon, the more manageable daily life and caregiving responsibilities become.
This isn’t to say that some of these conversations may not be difficult or uncomfortable. Talking about issues or problems may not be easy, especially if one’s actions have created the problem.
Think of family meetings like a meeting you might have at work. Stick to facts and do your best to set emotions aside.
Managing up includes agreeing on priorities and problems and asking everyone to bring ideas or solutions
For example, navigating health or the healthcare system isn’t easy.
The podcast accompanying this article takes an in-depth look at decision-making around a single health condition, heart disease, and what that looks like.
It can be challenging to find the right doctor and to get good care. Maybe mom or dad needs a good cardiologist, and they’re not sure who to choose. A geriatrician, a medical specialist in aging, can be a valuable resource for people over age 65.
There are times when getting a prescription filled at an affordable co-pay can take a lot of time and effort to find. A parent may need to call the insurance company, pharmacy, and their doctor’s office. Your parents may need tips on what questions to ask.
Support family member self-sufficiency and confidence
Instead of taking on tasks for parents or siblings, show them how to do their own research. Help them use a computer or access their doctor’s healthcare portal.
Maybe a brother or sister has a superpower around getting things done, and they can share how they do this with others.
Realize that everyone in the family has strengths. Share and celebrate them.
Never permanently take on a task for another person if they can learn or do it themselves
As adult children, it’s important to recognize and accept that your parents are doing the best they can based on their knowledge and life experience, just as you are doing the same.
Even so, promote independence, not dependence. The more your parents can do for themselves, the longer they will remain self-sufficient.
For most people, the learning process can lead to greater confidence, greater interest in trying new things, and greater motivation to follow through on investigating a health concern or completing other important tasks.
Anticipate needs and work through roadblocks
Caregiving discussions about health, the healthcare system, and saving money to pay for care do not have to wait until the day an elderly parent has a heart attack or is diagnosed with dementia.
- Parents may not be proactive in managing their health. Encourage them to work with their doctors and get involved when necessary.
Do you know how or if your parents or siblings are taking steps to plan for their retirement? If not, why not ask and offer to share what you’ve learned and your experiences?
- Do you have a 401K at work that has helped you learn about investing money? Do you have a financial planner helping you invest for retirement? Share this information.
How you share information matters
The way you approach sharing information matters.
It’s best to be unattached to the outcome or what others do with the information you offer them.
Some will do nothing; others will see the benefit and move ahead.
- Provide enough information to encourage others to take the next step.
- Don’t put yourself in the position of being too helpful and having someone in your family say, “You told me to do that, and I did it, and it didn’t work out. It’s all your fault.”
Plan for the positive; avoid being swayed by naysayers
Know that your parents, siblings, or even your spouse may not initially be interested in formal family meetings. Don’t give up.
Changing habits and thought patterns from being reactive to being proactive can take time.
Be the adult and the model for others in your family who say, “This is important for everyone. I know you may not be able to see it now, but one or more years from now you might be glad you participated.
While it’s easy for families to grow apart. It can be challenging to come back together when parents need care. It’s more difficult in stepfamilies with children who didn’t grow up together and who don’t have established relationships.
And if you’re alone because you never married, got divorced, or lost a spouse or partner, maintaining family relationships and being proactive about your life is even more important.
Looking for Support on How to Manage Up In Caregiving or Other Topics? Schedule a 1:1 Consultation with Pamela D Wilson.
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