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Ways to Approach Caregiving Decisions

When making choices for loved ones, it helps to reflect on their values, preferences and beliefs.

Portrait of a smiling father and son at home.

Lauri Scharf, LSW, MSHS, is a Care Consultant & Master Trainer at Benjamin Rose Institute on Aging.

Each day is filled with decisions—from the very basic to the most serious. You weigh information and options on everything from what to have for breakfast to how to organize your finances. It can be tough enough to make decisions for yourself, but when you have to make them for another person, it can be an even greater challenge. There are ways, however, to approach decision-making that can ease the process.

Caregivers face the dual challenge of having to make a number of decisions for both themselves and their loved ones. Although it’s always good to bring both voices into the picture, it’s sometimes impossible. If you find yourself in the position of needing to make decisions for a loved one in your care, it helps to consider his or her values, preferences and beliefs. This can make it easier to arrive at a good decision. Collaborating with one another, if possible, and with other family members and health care professionals, can also help you to arrive at good results.

Factors to consider when making a decision

Approaching a decision rationally is a helpful start. You might first identify the issue and the choice that has to be made, and consider who is involved. For example, the decision may concern your loved one’s:

· Environment

· Abilities

· Overall health

· Existing condition

Arriving at a decision can be more difficult when other people are involved in the process, as they may have preferences that differ from your own, or they may not even believe that a decision is necessary.

Any decision-making carries some possibility of uncertainty and doubt based on the circumstances. If you have enough accurate information, it can limit the number of factors to consider, which can help you to more confidently arrive at a decision. Your level of risk is lower. On the flipside, the level of risk increases when you feel you don’t have enough accurate information.

Not having enough information can make healthcare decisions harder. Because circumstances are continually changing, you may have to make some of these decisions with very little or no information. For instance, if your loved one falls, he or she may need surgery that requires anesthesia, physical therapy and rehabilitation away from home. In such a situation, you may have to weigh the uncertainty of whether your loved one is able to complete therapy and recover adequate mobility. A sudden change to your own health or an unexpected accident could also impact your decision, as well as the amount of time you have to arrive at the decision.

Changing the way you approach decision-making can be tricky. You may tend to do things in one way because it’s the way you’ve always done them. You may sometimes allow emotions to cloud your judgement. This is natural, but changing your approach to making decisions on your loved one’s care can sometimes yield better results.

Suggestions to improve your decision-making skills

According to Plato, “A good decision is based on knowledge and not on numbers. A fast approaching deadline may contribute to the stress of making a decision, and may lead to an unfavorable outcome, so planning ahead can be essential. Give yourself time to gather information. Work with family and professionals to determine what outcomes you want and to come up with a workable timetable. Discuss what impact delaying the decision could have. Once you have identified the problem, identify what success and failure will look like to you, and use that to guide your decision.

Yes, the black and white, or favorable and unfavorable outcomes may be clear, but look for all the shades of gray that represent opportunities for change. Talking with others can give you much more information, and allow you to explore new and different options. Incorporate the advice of potential healthcare team partners, including therapists and home health agencies. Seek input from family members you may need to rely on for more help in the future. Above all, keep the personal values, preferences and beliefs of your loved one in mind.

As challenging as decision-making can be, it’s a necessary process that allows you to give the best possible care to your loved one. Although well-meaning relatives and friends may try to guide the process, it’s important to maintain your autonomy. Be aware that choosing not to decide is also a decision that can take the control out of your hands. For options and solutions to decision-making that are right for you, consider visiting community resources such as WeCare…Because You Do.

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