We have talked about our concept of an Advance Living Directive in prior articles. It is important that some tool be developed that will ease the difficulty of conversations between parents and their children about home care or even aging in place versus assisted living or a skilled nursing facility.
The discomfort that “both sides” share about those topics comes, to a large degree, from two factors:
- The conversations come far too late, in most cases, when the need for care is painfully obvious to the children, increasing their emotional level, which never makes conversations dispassionate and calm.
- The conversations are not driven by objective criteria, observable by both the parents and the children, as well as any outside facilitator, such as a social worker.
Our goal with the Advance Living Directive™ is to help create such an objective, behavioral tool, so that the emotional content of the discussions can be reduced. It is a tough topic, so we are not pretending that it solves all issues. However, using the Advance Living Directive™ is something that we can do at any time, just as we do or should do with our Advance Health Directive. We can make decisions at 40 that may endure for the rest of our lives, without the need for last minute, emotion-laden, crisis-driven discussion.
The tool we have developed uses research on Activities of Daily Living and Instrumental Activities of Daily Living (ADLs and IADLs). We created a scale from total independence, with no assistance required by a caregiver, through a score that would lead us to determine that staying at home was not safe, even with 24-hour non-medical care. The tool is not a medical diagnosis. It is purely about our ability to perform the normal behaviors or activities we go through each day.
We will talk more about how to use the tool in upcoming articles.
Best wishes, Bert