Prevention of problems or smooth transition from one home to another - take your pick?

Attempts to predict the risks of someone stopping at home, struggling to retain their independence, becomes very difficult from inside the family.

Family and even friends can be too close to make clear, rational assessments.

However, recognizing just when to seek help outside the family, is equally difficult. As the saying goes when you are "keeping it in the family" outside resources become curiously out of focus or even invisible. Meanwhile in the 'scrum', so much depends on how problems have been solved in the past.

Sometimes it's important to bear in mind, that advice from family and friends is often what the advisor thinks you want to hear. Sometimes you need an indepedent 'sounding board', or 'mirror' to bounce or reflect thoughts, fears, and issues off.

Obviously, this will influence how things are managed now. And that is the crux of the problem for several reasons:

1. HEY WHO'S IN CHARGE?

So does this mean that 'growing up' involves becoming an adult - a parent ones self - only to become a 'child' again?

Within groups leaders emerge and families are no exception to this, leaders are accepted, their role recognised and negotiated wthin households and the extended family. Leadership may pass from one family member to another depending on the situation. This does not mean that people jostle for leadership, problems can also arise when people are forced to assume leadership when they have never done so before.

Indeed we may have an explanation here for the fact that so many families fail to communicate across the generations.

This is were the problems start for carers who are related to the patient/client. It is not easy for a child and parent to essentially swap roles. It can be very difficult when a parent becomes ill, but cannot themselves recognise the extent of their own illness. They find their autonomy, personal space being challenged or invaded by so many 'do-gooders'.

People do have to intervene to protect vulnerable people. What is unfair is when age is used to foist decisions on people who are (still) very much in possession of their faculties.

If referred to the community mental health team, and they find that you are sixty-five next month, should you automatically be passed the elderly mental health team. Some seventy year olds have more get-up-and-go than fifty-five year olds.
If you ask for help yourself, for mum or dad, how would you feel about this? How will they react?

"Goodness I've really joined the geriatric club!"

Sometimes, admittedly it isn't a case of being forced to do something. It's more a case of snowballs. Things gather momentum, rolling towards some half-formulated idea involving the move. It almost becomes an imperative.

Living alone + Anxiety = MOVE

2. WHAT STRATEGIES WERE USED BEFORE?

One solution may be that problems are denied on one side, while rationalised (making excuses) away on the other. Perhaps there is simply no dialogue beyond telephone contact.

3. WHAT STRATEGIES ARE BEING USED NOW?

Subtle hints of distance, time, ability to help, access to doctors and other essential facilities; hints ignored and answers avoided behind questions regarding Amy's school project, Tim's holiday, "how is work these days?"

4. WHO IS DRIVING CHANGE?

You? The eldest, youngest? Daughter around the corner;

son across the county, or son in Provence?

5. WHAT IS DRIVING THE CHANGE?

Physical frailty, mental emotional distress? Depression can be treated. Although the comprehensiveness of provision of community services is often much maligned in the media there are community services to be accessed. These can make a genuine difference between people staying in their own homes -

AND

having an improved quality of life as a result.

6. WHAT ARE THE PLAYERS WAITING FOR?

Crisis? What crisis?

A fall, another tearful episode played out down the phone (or web-cam) that (two months) after Mum passing away really shouldn't be happening now?

7. WHO ARE THE STAKEHOLDERS?

'How' is the house? That is:

• Whose name is it in; do you own it?
• Who if anyone has power of attorney?
• Who stands to gain if it is given up?
• What if anything is forcing the issue?
• Does another family member have a need for a home
  - possibly sooner than expected - a pregnant teenager?

How often does a mother move hundreds of miles to be closer to her single daughter, only to hear a wedding announced three months later? These things do happen, and do change the dynamics of you and yours - families. Sometimes the parent(s) realise that distance is now replaced by ‘lack of a crisis’ as the excuse for no contact. In their new home, contrary to expectations, they may actually see no more of their family than before. This is why it can hurt so much. Just who is the move for - really?

In today's jargon filled world perhaps families should conduct an -

‘expectations audit’

(in plain English - talk it through!).

Here each family member explain in turn, what their expectations are:

• pre,
• during
• and post

the suggested relocation.

They say a lot of risk we take for granted. Crossing the road, flying, having a family. No-one can ever predict the future, but such an audit - discussion - may at least prevent some disasters. Then that other statement may be heard less often - "Well I wish I’d known that!"