Making Decisions For Elderly Parents

Question: My father has been deteriorating physically and mentally over the last year. He is making poor choices, refuses all outside assistance, and should not be living alone. I was shocked when I was told I couldn't legally make the decision to put him in a nursing facility. He certainly can’t determine the right thing so why can’t I do that for him?

Answer: There are several answers to your question. They range from a philosophical point of view to a strict legal interpretation along with some ideas that may help provide the support your father needs now and in the near future. Most of us strongly believe the right of self-determination and freedom of choice should be protected, particularly when it involves us. It can become less clear when the issue of decision making and self-determination involves a loved one, often a parent. However, the law states that adults should be able to make decisions about their own lifestyle as long as they are not endangering others or putting themselves in grave, imminent risk. The question is what is grave, imminent risk and who determines that fact?

The law presumes an adult is competent to manage his or her own affairs and to recognize the consequences of decisions until a time when he or she has been proven incompetent in a court of law. It’s important to note that there is a fine line between competency and incompetency. This state of mind is often viewed differently among laymen and health care professionals. It is an extremely difficult ruling to legally take someone's decision-making power away from them. The court does not act in haste nor should it in such situations.

You may justifiably disapprove of the legal explanations that govern your situation. It is understandable how frustrating it may be to sometimes see a person make “bad decisions” that leave him or her in a less than desirable situation. Still, what one person views as undesirable, someone else may see as normal and acceptable.

Like you, most families are well intentioned and act out of love and concern. However, family members do not automatically have the right to make choices for their older relatives. There are times when it is best to take a step back and offer support—but accept the fact it may be rejected. This doesn't necessarily mean you should give up. Instead, pace yourself in your efforts to assist your father. Contact MVES to receive help from a caregiver support coordinator or elder care advisor. These individuals understand the challenges that you are facing and can direct you to appropriate home care services and general information for help. They can also meet with you and your father to discuss options that he may be more open to hearing from a third party. Our staff can tell you about other useful resources in the community such as clergy, medical help, and transportation. Remember that your father’s situation didn't develop overnight and you can’t be expected to solve it overnight.

Are you in a dilemma caring for an aging relative? You may speak with one of our experienced staff by calling 781-324-7705. Consultations over the phone or in the home are offered at no cost.