| As the so-called “greatest generation” edges into old age and the baby boomers follow close behind, this once invincible group is forced into slow down mode. And while contracting a debilitating condition is a life changing experience, those connected to the newly diseased face some changes of their own.
Much of the conflict comes from a family’s expectation that a parent or spouse remain the same as they were before illness struck.
“You can’t expect them to be the same person they were six months or a year ago,” said Kimberly Krusi, social service director at the Island Health and Rehabilitation Center in Bainbridge Island. “They once never left the house without makeup, now they don’t want to mess with it. Or they were always dressed nicely, but now it’s not a possibility. But it’s important that the family adopt to these changes in a positive way.”
Families often try to hang on to what the afflicted person once was, leading to impossible expectations. For instance, Krusi relates the story of one resident whose daughter insisted on dressing her in the expensive silk shirts she always wore when she was well.
Such attire was not compatible with the needs of long term care. “She didn’t want to accept that her mom was changing,” Krusi recalls.
Linda Batway, director of social work at Harrison Hospital in Bremerton, said the primary issues are medical and financial: What kind of care do they need, and how will they be able to afford it? Will the family need training in order to administer this care, and should they consider “alternative” treatments? If the patient is unable to make basic decisions, than the family needs to appoint someone to take over. And they need to organize their lives, delegating responsibility and following through on these responsibilities.
The obvious solution, “sit down and talk,” isn’t always simple.
“Every family attacks problems differently,” Batway said. “All the people involved need to understand what’s happening and how it affects all of them. And it can be hard for people with a history of being angry at each other to sit down and talk. Most families are pretty complex.”
It is often necessary for the family to talk to a professional to sort things out, or even to referee. And this usually won’t cost any extra. Hospitals like Harrison often provide social service support as part of the bed rate, and it does not discontinue after discharge. And you should stay away from a long term care facility that does not have a capable social worker on permanent staff. Beyond that, families can always find a way to pay for the support services they need.
“Most patients are in tune with what’s happening” Batway said. “But they don’t always want to discuss the details with their families. Or they understand what is happening and they just don’t want to deal with it directly. And everyone is different. You can look at the way a particular family copes with a crisis of any kind, and it will indicate how they will deal with something like this when it happens.”. | 
