How to Hold Family Meetings to Discuss an Older Loved One’s Care

We all fondly remember occasions of our favorite TV family having to come to grips with a problem. Everyone sat around the table discussing the issue. What was remarkable was an agreement with everyone was reached in the 30- or 60-minute time slots, minus commercial interruptions. 

Fast forward to today. An older parent needs help in the home. The oldest child is trying to organize everyone according to her identified needs. The youngest is absent from the family discussion, as usual, because work and family obligations have priority. The golden child can’t understand what the problem is because they just spoke to mom, who said she can take care of herself. The call goes out, “We need a family meeting!” and everyone groans. 

Family meetings can be a valuable tool. Each person can express their thoughts and concerns at the same time. Everyone will hear the same message and come together to support their parent and each other. This will help to reduce misinformation, and make it easier to develop a plan and next steps.  

Planning for a family meeting

Initiating a family meeting needs as much preparation as the attention paid to the meeting itself. Let’s start with the reason for the meeting. Making plans for a family reunion will require coordinating schedules, but if the purpose for the meeting is more somber—such as , dad declining and mom needing more help—then arranging a time to talk may come with its own challenges.  

If a family meeting is in your future, here are some tips to keep in mind: 

• Limit the meeting to one or two topics. Identify the most pressing need(s) so that everyone has a clear direction for the discussion. It would be helpful to include these topics in the meeting invitation that goes out.  
• Time and place. Zoom, Microsoft Teams and other platforms have helped to gather people together from various locations. Pick a date and time that can accommodate most people. 
• Decide ahead of time which participants will have the opportunity to provide input and which one of these participants will have a deciding voice. (E.g. All adult children and their significant others may be included in the meeting, but only adults in the loved one’s nuclear family will be involved in the final decision). 
• Encourage participants to bring relevant information to the meeting. This may include doctor visit summaries, observations and financial records if desired. 

Holding the meeting

Prior to the start of the family meeting, it may be helpful to remind everyone of some general rules that include allowing the person to finish speaking without interruption and refraining from having side conversations. If someone introduces a topic not identified in the agenda, gently remind everyone of the focus of this meeting. It may be helpful to discuss the first topic before starting the second one. 

Stick to the facts rather than emotions. Mom/dad may want to stay in their own home, but the issues of safety, having ongoing oversight or the continued decline of physical and emotional health may carry more weight. This is where disease education, knowledge of community resources and the eligibility criteria to participate is important to know. Don’t be afraid to discuss how this will be paid and where any additional money maybe drawn down (IRAs, stocks, other assets, etc). 

Don’t forget about the person. If the meeting is about mom or dad, consider their beliefs and values when talking about making changes. If able, include them in the conversation and decision making. It is easier to exclude a person rather than asking them to leave if the topic becomes upsetting. Rely on documents such as Power of Attorney for Healthcare, Power of Attorney for Financial and Living Wills that have the wishes of your loved one already in place. 

Deciding on next steps

Once everyone has had the opportunity to share their thoughts, create a plan for the next steps. Try to be specific about the steps that need to be taken and if possible, create a timeline for completion. Don’t assign tasks but invite family members to come forward. Build upon the talents and strengths of individuals to fill in where needed.  

“Mary, you are good at research, could you please contact the five health care agencies we talked about to see what we need to get started?” 

“Bob, your home is well maintained, could you please do an outside inspection of the house and let us know of any repairs that need to be made?” 

Every family comes with its own challenges including how they relate to each other, past injustices, and their relationship (past and present) with their parent. Remind everyone of that the purpose of the meeting includes the wellbeing of said parent. You won’t be able to fix old misunderstandings; however, the purpose of building a team may help to redirect expectations and outcomes. Use “I” statements (I feel..., I need…) to help express thoughts. Even in disagreements, find the one truth that you can agree.  

It may be helpful to include a moderator in the family meeting to maintain the focus, solicit feedback from all the participants and help to draw up the next steps. Social workers, ministers and Care Consultants can be used to fill this role. Many times, these family meetings come upon the heels of a crisis and planning next steps can be of the essence. A moderator can help to prioritize the immediate needs as well provide insight into pieces or steps that are missing. The moderator may also lend additional insight into accessing community programs, presenting different options and helping to build the family team. 

The conclusion of the family meeting is when the real work begins as everyone takes on their next steps. The moderator can continue to help navigate the obstacles that occur, cheer the family team on and serve as a person for everyone to check in with. Ongoing family meetings are easier once a pattern of cooperation and collaboration are in place.