Welcome Wisdom

The divergent paths couples often face as they age

by Gail Arno, CMC, ECM Director of Care Management

Imagine an adult child, niece or nephew, or the spouse of an individual who is aging, tasked with trying to balance and meet the needs of both individuals, all while trying to continue on with their own life. This is likely the most challenging scenario we manage with our clients; couples who have spent a lifetime together working in unison (for the most part!), tackling whatever life throws their way. Then along comes the aging process, a journey rarely done in tandem with others as we are all unique individuals who face different medical and emotional journeys. How do you plan so that you are addressing each individual’s needs while at the same time honoring each one’s wishes?  As Aging Life Care Managers, it is our job to make sure that our client’s needs are met, both from individual planning efforts to honoring the wants and wishes of a partnership. Planning is key for everyone in their pursuit of successful aging.

A good example can be found in our clients, John and Sarah. A couple married for decades, who together raised four children, had active careers and lives, and were living independently in their own home without any formal assistance. John had numerous medical issues mostly focused on his need to attend dialysis three times weekly, along with a significant and complex medication regime.  Sarah, his devoted wife of 60+ years, had mild to moderate confusion, didn’t drive anymore, was no longer able to get meals on the table, and could not manage the tasks necessary to run the home as she did in the earlier years. John had to be transported to and from his thrice-weekly dialysis sessions as he had given up driving, stating he was often too tired to even consider getting behind the wheel (Thank you, John, for willingly making that decision!) All four children lived out of town and worried constantly about mom and dad’s well-being and showed genuine interest in their parents’ situation.

As Care Managers, we came into the home and assessed the client’s needs, individually and with full respect to their shared history as a long-established couple. We were able to ascertain that the couple’s legal house was in order, by confirming the completion of their power of attorney documents, their Advanced HealthCare Directives, and POLST. We organized and documented their medical diagnoses, treatment plans, facilitated support systems, and opened good lines of communication with the remote adult children. Ultimately, we were able to put into place formal support mechanisms such as experienced caregivers and meals prepared by a professional chef. We brought durable medical equipment into the home after a safety evaluation that recommended adaptations made to the home to assure their ability to remain at home as desired.  A Care Manager accompanied them to all their medical appointments, making note of detailed changes of the clients’ status and of their evolving medical needs. These steps honored their wishes, supported the adult children’s vision of their parent’s living arrangement and allowed the couple to remain successfully and safely at home together. Their aging journeys were quite different and had to be addressed differently but with the same end goal of staying together at home.

Next month we dive deeper into the details of managing couples and facilitating the ups and downs and twists and turns of the aging process with a particular focus on the divergent paths each person faces as they age.

*names have been changed to protect the client’s identity