Parent-Centered Decision Making
My brother and I had decided: our mother Janice could no longer continue to live independently. We just hadn’t told her yet, nor had we solicited her input.
The formal conversation about her living arrangements would be our responsibility. Our parents had separated over 20 years ago. Janice also had one sister who lived three hours away in Richmond. Our goal was to share honestly about the changes in her we had noticed, to listen carefully to what she wanted most out of life the next decade, and to keep her at the center of the remainder of the decision making.
How We Got to This Moment
Prior to this, every few months during a phone call, I’d mention to my mother that she should consider moving from West Virginia to Michigan. I’d lightheartedly ask her, “What’s next, mom?” I’d suggest that she had so much more life to live. Did she really want to spend the next two decades away from her grandkids?
We talked about her living in my home, and we talked about her having her own apartment. She’d considered moving to Richmond near her sister, but moving into “the big city” (Washington, DC) wasn’t really her speed. The door to the conversation had been cracked open.
In early spring of 2019, I received a phone call from one of Janice’s closet friends letting us know that my mother’s radius of driving comfort was growing smaller and that she had recently backed into a parked car.
My mother was repeating herself more frequently, calling others several times a day to confirm appointments on her calendar, and that despite repeated attempts at decluttering, the piles of objects and paper had begun to overtake her living areas.
I had been noticing my mother’s memory gaps on and off for several years by this point. The close friend who called to share her concern had been her daily money manager for the last couple of years. Janice often had close friends attend doctor’s appointments with her but wouldn’t remember the exact details of the visit. She’d carpool to hair appointments and had intense anxiety around driving to visit her sister. Grocery shopping and cooking had become a burden, and she had stopped cleaning the house. She had lived in the same small town for her entire adult life, but her vibrancy and outgoing personality was starting to disappear.
My mother had become chronically disorganized. Circa 2018.
No Better Time than Now
Discovering our mother’s needs and wants became the foundation of our conversation. My brother Zach and I were unclear of how aware our mother was of her memory changes and shifting sense of time. We didn’t want to presuppose what type of living arrangements she would want — assistance in her home or assisted community living.
We planned a visit to her home; I would stay for a few days to map out a plan for her finances, gather the contact information for her friends, and begin to think through the decluttering and packing process.
My brother and sister-in-law would come from DC for a day-long visit. My sister-in-law planned to take notes during our conversation so that Janice’s wishes would be documented. It also allowed my brother and I to focus on showing our concern with compassion while setting the requirement that she no longer lived alone.
We asked a lot of open-ended questions:
What are your favorite features of your current home? (windows, living area, separate bedroom)
Are there spaces that are less important? (office, outdoor deck)
Do you still enjoy cooking, housekeeping, driving, house maintenance, etc? (a firm no)
If you were to stop driving, how would you get around locally? Would you be open to a senior mobility service for grocery shopping and church? (seems complicated to depend on others)
How willing would you be for someone to come into the home and provide medication and housekeeping support? (not super willing)
If you were to move out of your home, would you want to stay near friends or move to DC/Richmond/Michigan? (Michigan was her top choice)
Our conversation lasted about two hours. My brother and I shared that we wanted her to lead the way. Parent-centered decision making was about retaining her dignity and her having as much control for as long as possible. We clearly stated that we were concerned about her memory and that her immediate circle of friends had noticed changes too.
Her response was quiet understanding. She wasn’t defensive. There were lots of hugs, a few jokes, and a few tears.
Afterwards, we decided to go for a walk. We didn’t belabor the topic but reminded her later that her input about living arrangements had been recorded. I would return to Michigan and begin to look for assisted living communities.
She had decided against living in my home. Having three active school age grandchildren nearby was exciting enough; their busy schedules would be too much for her preferred mellow way of living.
There’s no right way of telling someone that they are aging. Deep down they are aware. The key is building a plan of action that keeps your loved one at the center and in control. This requires active listening, courage to put your own interests to the sidelines, setting non-negotiable guidelines (if needed), and mutual respect. Because one day, we will all be on the opposite side of this conversation.
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