How to handle care decisions with your blended family?

Many people may find love later in life. Many couples are getting together when they are in middle age or later in life. Many times a couple may already have grown children from another relationship. This makes for a larger family for the holidays but you are putting together into one family people who don’t know each other and may not even meet but a few times a year. Adult children will usually have the best wishes of their own parent in mind when making decisions but what about the spouse? The matter becomes much more complicated when money is involved and that is a situation that is much more stressful. For now we are discussing medical decisions. For example let’s discuss a theoretical situation with “Joe” and “Mary”. Joe is an older widower and got married at the age of 59 to a woman he loved named Mary. Joe at the age of 70 was diagnosed with Alzheimer’s. Joe was still able to function for a while but has become increasingly confused and declined quickly. Joe has an adult child named John and Joe had named John his Durable Power of Attorney before he got married. John lives out of state and visits for holidays. John has not really been too involved with his father since his mother passed many years ago. John let's Joe handle all of his own matters and rarely worries about his fathers decisions. Mary is Joe’s second wife. Mary met Joe at church and fell in love and they were married. Mary has two adult daughters from a previous relationship. Mary’s husband walked out of their lives many years ago. Mary and her daughters have always been close. Mary’s daughters are very involved in her life and always come to help when needed. Mary doesn’t have a Power of Attorney set up but has discussed her wishes with her daughters. Mary has been caring for Joe for a few years as his Alzheimer’s has progressed. Mary has been there 24 hours a day making sure to orient Joe and make sure that he takes his meds and eats. Joe and Mary have talked about what they will do about care when Joe was first diagnosed and decided to be together forever. Mary fell in the shower and injured her back and is being sent to a facility. Mary will not be able to care for Joe and will barely be able to live on her own. If Mary recovers well she may be able to go home with some care or to assisted living. Joe is more confused without Mary to help him. Mary’s daughters have come to care for him but he is resistant and combative. Joe has refused any care from doctors or Mary’s daughters. Mary’s daughters have called John Joe’s son but he is too busy to come and doesn’t even call back most of the time. Mary wants her husband to go to an assisted living facility with her if possible or to have home care.  Joe refuses to do anything to allow anyone in the home to help or go into a facility. Mary can try to force the issue but it just makes Joe worse. If Joe becomes irritated he may not be suitable to go to assisted living with her because he will have to go into a memory care unit. Mary can try to force him to get help but doesn't have the power to make the decision. There is one big problem with forcing Joe. Joe never thought to change his power of attorney and if he has to be forced it has to be his son making decisions. Mary calls John and tries to get him on board with getting Joe care. John says it’s not that bad and was more concerned with the cost of care than getting the help Joe needs. Mary never worried about the cost because Joe has considerable assets and can afford the best care for him and Mary. Mary spoke with John and he decided that he doesn’t want to spend the money on homecare and will send Joe to a facility alone. John just wants his father to have the required care not the best care. This whole situation has made Mary very angry with John and her daughters are frustrated with the stress it puts on their mother. Mary's daughters have begun to call and argue with John when they can reach him. John doesn't really care about Mary or what she has to say. John respected his fathers wishes while he was still thinking clearly. John has realized that his father doesn't even know who he is half the time so why care?  What is Mary to do? This is a bad situation for Mary and Joe. Will Joe get the care needed? Will Joe and Mary be able to stay together like they had planned years ago? This is not a typical situation but it does happen. Most families are caring and cooperative when it comes to getting care for loved ones. Many times it will just be a situation when other family members just don’t want to be bothered. So what can you do to avoid uncooperative blended family situations?

1)      Have a meeting with your family members and let your loved one’s tell you what they want. Discuss and make it clear what your loved one’s wishes are and that it is known to everyone so that there is a consensus and your loved one is being respected.

2)      Sit down and delegate what responsibilities each family member will do for each parent and make it clear who will be the Power of Attorney for one or both. Power of Attorney can be shared so look into this option to make sure that the family member or members are going to be involved when they are needed.

3)      Hire a care management company to handle the decisions so that you know that their wishes will be respected and that the best interests of your loved one are the priority. Having a third party that is ready to take care of all the decisions is a good start to go ahead and get set up and ready before the time comes. This is the one option that takes it out of everyone’s hands and can save a lot of frustration and disagreements.

Not everyone will have this kind of problem. When this kind of situation happens it puts strain on the family that has an effect long after your loved one is gone. If you get a diagnosis do not wait until your loved one becomes too ill to make decisions. Try to plan ahead and iron out the issues early. When your loved one needs care everyone has agreed on what will happen and your loved one’s best care can be provided. This story is an extreme situation but it does show that early planning can really stop problems before they start. Be proactive plan ahead and always have a free and open discussion with your loved one's about their plans for the future.