by Alan S. Wolkenstein, MSW
Carolyn called several months ago. She had heard of me through her realtor, in that the two of us have collaborated on a number of home sales that involved elders and their adult children. Each of the situations was an emotional mess, and so was this one. Carolyn and her two sibs had “pushed” their widowed father to sell his condo and sign up for a retirement home. Now, he was refusing to sign the papers for the sale, pack his “stuff,” and move. He was essentially doing nothing in their view...but he was doing something. What I would have predicted.
I told Carolyn to call for a family meeting at the father’s condo, but not to expect too much. I showed up and rang the bell. Charles, the father, did not answer the door. Rather, he was in the kitchen reading The New York Times. Bob, one of the other sibs, had let me in and announced he had had it with the “old man” and did not want to stay. George, the oldest, was drinking a glass of wine in the hallway.
I convened the family and suggested that Charles tell the family of his disappointments in them. I chose that term for special reasons. Did he let them have it, and Bob started inching for the door. “No,” I said. “You of all need to hear this.” And then the adult-children explained their concerns about Charles’ situation: poor housekeeping, no food in the fridge, looking disheveled, not taking very good care of himself, and never satisfied for anything they did for him. Charles used both denial and rationalization in response. “These are not problems, and I can handle them anyway.” He was equally enraged that they had invited my friend the realtor over and conned him into thinking that Charles was ready to sell and move on. He was not! In fact, Charles prided himself with his independence and had lots of reasons to explain his behavior. They threw in his forgetfulness, and he replied that what he forgot really was not worth remembering.
I sensed there was enough blame, shame, anger, disappointment, and family rage to go around and decided to offer a plan -- that Charles not move, not sell, get a housekeeper on a weekly basis, a cook who would figure out what he needs in the kitchen and shop for him, make an appointment with a geriatric center for an evaluation, and we would convene in a month. Charles was lucky to have the funds to pay for all these home-based comforts, but each situation is different, and this one was affordable.
The children were to stay away, let tempers cool, and I would make weekly home visits with Charles to look at, assess, and do some reasonable planning with him, not for them. He refused and then changed his mind. He said I might be saner than they are, but I couldn’t guarantee much -- but what we could do was a lot better than the chaos they were in.
You know the conclusion already. Charles balked and gave me lots of grief, but indeed found a service in his community that provided all I asked for. He had an assessment and came out of it in good health, but saddened by so many losses in his life. He never seemed to get over one and he had another. He and I had lunch every week at his place (cooked by the terrific chef) and we talked, really talked, about all his losses and wishes yet unfulfilled. He was angry and unhappy and sad. He would not choose to go live near old folks, because he was only 81 and didn’t want to catch “old people” by being near them.
No more moves or changes for Charles…for now. Let him really settle in and try to find some balance in his life, learn how to grieve his losses, maybe even find some purpose in his life, and figure out how to work more effectively with his children. I insisted he get back on schedule with his primary care physician and retain all the people he had hired. They are his support to keep him out of the retirement home. I do hope this works for him and for his children. If the pressure is off of them, maybe they can get back to pursuing their personal goals and wishes, and let Charles struggle with his. The struggle is worth it.
In retrospect, we know that conversations like the ones they initially had as a family are difficult to do well; they follow major losses and are not existential on their own. Everyone seems to have an opinion as to what is best. Everyone has a major stake in the outcome, and no one feels very comfortable doing them. We seldom have the insight or skills or even to be aware of the big picture to do them well. But we do them anyway and lament how poor they become. Families can be splintered and dysfunctional in meeting the needs of any of their members.
I can’t promise a great outcome every time, but convening the family with a guide or mentor skilled in the process of family meetings can be very helpful. The final outcome for Charles is unknown, but he is still the father and still a brave and wise man. He just needed a companion for lunch on a weekly basis.
Professor Alan S. Wolkenstein is a 30-year veteran in graduate medical education. Trained in sociology and psychiatric social work, he is a retired Clinical Professor at the University of Wisconsin School of Medicine and Public Health. He was Director of Behavioral Sciences for primary care physicians in graduate training at the Aurora-University of Wisconsin Medical Education Group in Milwaukee, Wisconsin, and just completed a year as Professor of the Behavioral Sciences Consultation Service for the School of Nursing, Concordia University of Wisconsin. Alan is a 19-year survivor of cancer. Alan has a very special perspective on life based on his being a senior and having a long-term cancer remission, and continues to serve as a guide and mentor for men struggling with cancer.