Advising, Not Choosing

By Catherine Brown, Elder Law Clinic Student, Fall 2015

Watching the people we love begin to slow down is hard.  The health problems may be physical or mental, occurring as part of the natural aging process or being exacerbated by a specific diagnosis.  Either way, the question often arises: can this loved one continue to live at home, or does he or she need institutional care?

At the risk of sounding heartless, I am a big advocate for institutional facilities.  Three of my grandparents have received or are receiving institutional care: two were in Alzheimer’s/dementia wings for the final years of their lives, and one currently lives in an assisted living facility.  Personally, my family has had positive experiences with the facilities and the staff who work there.  I have peace of mind knowing that Grandpa – who was widowed twenty years ago, can no longer drive, and doesn’t pay attention to medical details – can socialize with people his age just by walking down the hall, and gets the correct doses of medication each day with the help of the nurse on call.  Similarly, it was a relief when my other grandfather started receiving institutional care: if he had another fall, a worker would help him; telemarketers wouldn’t trick him into buying another state-of-the-art sound system or collectable DVDs; and he’d have someone to ensure that he bathed regularly and wore clean, unstained clothes.

Not everyone views facilities as favorably, however.  People have well-founded concerns about institutions, and argue that the facilities provide impersonal or loveless care, limit residents’ autonomy, and simply don’t have the charm that a home with decades of memories can bring.  When I expressed a pro-nursing-home view to one client, she incredulously asked me, “Why do you feel this way?”  To her, keeping her mother at home for as long as possible with in-home caregivers is the top priority.  This arrangement is causing her – and us at the Elder Law Clinic – a lot of extra work and concern that would be mitigated if her mother was receiving institutional care instead.  However, it is important to remember that it is not our job as attorneys or law students to make personal decisions for the clients based on our individual preferences.  Instead, we have a duty to outline all of the available legal options, let the client choose what is best for herself and her family, and work rigorously to help the client achieve her chosen goal.

When a loved one slows down, there is no easy, “one size fits all” solution to their care.  In my family alone, my grandfathers got to their respective facilities very differently: one voluntarily stopped driving and checked himself into assisted living, while the other one refused to admit that he had become incapacitated and nearly sued his power of attorney for acting on his behalf.  Therefore, when counseling clients, it is important to remember to listen to their goals and tailor your advice to fit those objectives, rather than simply projecting your personal views onto their unique situations.