Challenges in Family Decision

Making & Communication

Keiro Caregiver ConferenceOrange County Buddhist Church

May 21, 2011

Frances Chikahisa, MSW, LCSW

Chicago, IL 1

Family Decision Family Decision MakingMaking

• Understanding family, past and present.• Changes undergone over time.• Current status of family.• Complications arising in process.

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Care giving in JA Care giving in JA familiesfamilies

•Historically.•Currently—parents providers of child care.•Sandwich generation.•Parental inability to provide care.•Grandchildren as caregivers.

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Family Decision Family Decision Making Making

• Best time is when will writing and living will are being considered.• Be aware of this as a process.• Consider POA for medical and financial at this time.

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Talking pointsTalking points•Where parents want to live.• Live by themselves for as long as possible.• Live with family member.• Live with full time caregiver in home.• Live in a structured senior program. 5

Financial Financial considerationsconsiderations

• Long term care insurance.•Medicare does not pay for SNF care.•When resources are depleted, public aid is option.

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• Death of spouse.• Surviving parent has accident or becomes ill.• Family’s ability to deal with this becomes stressful.

When crisis occursWhen crisis occurs

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Professional helpProfessional help

• Social workers and other professional counselors.• Resistance to getting outside help.• Cultural shame interferes with obtaining help.

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Example of Example of successful successful

interventionintervention

• Case of Emiko

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CommunicationCommunication

• Elements of good communication.• Difficult family communication systems.• How to cope with long standing family dysfunctions.

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Example:Example:

Case of Kiyo

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Dynamics of Dynamics of “gaman”“gaman”

• Recent events in Japan.• Dark side of “gaman.”• Awareness as tool to aid in communication.

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