WORKING WITH FAMILIES

The Family Meeting and the Art of Optimism

 

When we experience a change in our ability as Doulas to provide caregiving, or the care receiver undergoes a decline in health or ability to function, other family members and friends are often affected by these changes. And we may need their help in sharing caregiving responsibilities, problem solving, or making a tough caregiving decision. A family meeting can be a useful tool.

 

Have you held a family meeting to talk about caregiving issues. How did it go?

How can a family meeting help us as Doulas and help the family, as well? 

 

Consider these potential benefits:

• Builds understanding and reduces misunderstandings

• Increases communication

• Clarifies expectations

• Provides a chance for everyone to share their views

• Helps everyone to be “on the same page”

• Finds workable solutions

• Clarifies caregiving responsibilities

• Determines who will do what

 

Guidelines For Family Meetings

The sooner a family meeting is held, the better. To help with planning and facilitating a family meeting, you may find the following recommendations helpful. 

 

Involve the care receiver.

When possible, plan WITH, not for, the care receiver. Regardless of how wise a decision might be, a plan is likely to backfire if the care receiver is not involved. Involving the care receiver is NOT the same thing as the care receiver making the decision. When a person has memory loss or reduced mental capacity, others need to take an active role in making and carrying out the decisions.

 

Include everyone.

Meaning everyone who is concerned and potentially affected by decisions or changes to be made. It’s important not to exclude a family member because of distance, personality, or limited resources. If family members are at a distance and cannot attend a family meeting, get their input by phone and keep them informed. This can help avoid undermining the decisions that are made at a family meeting. A family meeting also may include friends and paid help who are involved in the caregiving, but are not family.

 

Gather information before the meeting.

Depending on the situation, it may be helpful to hold an initial meeting without the care receiver to air feelings, identify concerns, discuss responsibilities, look at gaps in information, and discuss ideas. The purpose is not to gang up on the care receiver, but to establish a foundation for the meeting that includes them. In lieu of a prep meeting, you can ask the family members to provide their concerns and the responsibilities that they are willing to share.

 

Consider a facilitator.

If there are disagreements among family members and potential for conflict, you may want to have a professional facilitate the family meeting. A facilitator can help provide objectivity and reduce conflicts. A counselor, health care professional, social worker, care manager, or a member of the clergy trained in family counseling may be able to facilitate a family meeting. 

 

Use a neutral setting.

If possible, hold the meeting in a neutral setting.

 

Plan an agenda in advance.

It’s important to be clear about the purpose of the meeting – that is, what do you want to accomplish? For example, do you just want ideas about something? Do you want to make a decision? Do you want help?

 

Clarifying the reason for the meeting allows those involved to prepare and gather information and materials, if needed. An agenda also helps to keep a meeting on track. 

 

During the Meeting – Useful Tips

• Before the meeting gets started, it’s important to set expectations that emphasize respect, trust, support, and confidentiality. 

• As the meeting progresses, work to maintain a positive tone. Keep focused on the current concern rather than on other issues or past conflicts. 

• Ensure that everyone has a chance to express feelings and offer suggestions.

• Identify what each person can do, encouraging folks to be honest about their capabilities.

 

After the Meeting

Caregiving decisions are rarely simple or easy. Family members often have strong emotions and honest differences in priorities and opinions. Many families find it helpful to have a plan to follow as they make decisions. That’s why it’s advisable to prepare and distribute a written plan that lists what each person will do and when they will do it. This can help to prevent later disagreements. Check in with all who have signed up for tasks to see how the plan is progressing and if changes need to be made.

 

Building an Optimistic Outlook

As we’ve heard throughout our lives, attitude is everything. A positive attitude is a key in adjusting to change, making transitions easier, and making the best possible decisions.

 

An optimistic outlook is helpful and lifts our spirits. A pessimistic attitude usually pulls our spirits “down” and sets the stage for depression. Being optimistic doesn’t mean we ignore, deny, or “put a lid on” our negative feelings and reactions. It’s important to listen to our emotions and use them to take better care of ourselves. People who are optimistic get beyond these feelings to make the most of a situation.

 

Caregiving can involve many difficult events and decisions – for example, a decline in our family member’s health, placing our family member in a care facility, having to take over our family member’s finances, or our family member no longer recognizing us.

 

How we perceive the difficult times and setbacks in our lives plays a large role in

whether our outlook is optimistic or pessimistic. It’s important to ask ourselves:

“What does my attitude tend to be? Do I tend to be optimistic? Or do I lean toward

pessimism?” Think about it as we look at the “tools of optimism.”

 

Tools Of Optimism

An optimistic attitude does not change a difficult situation, but it generally makes it easier to deal with it. There are seven “tools of optimism” that are helpful to have in our “caregiver tool box.” These are:

 

1. View setbacks as temporary. 

An optimist sees difficult situations as temporary and believes “things will work out eventually.” A pessimist views setbacks as permanent and believes that “things never work out.”

 

2. View misfortune as specific, not universal. 

An optimist sees life as generally good and a negative event as affecting only a part of life. An optimistic caregiver might say, “Despite my spouse’s illness, we still enjoy some favorite activities.” A pessimist tends to view a negative event as affecting their

entire life. A pessimistic caregiver might say, “My spouse’s illness has ruined everything.”

 

3. Seek solutions to problems. 

When faced with a difficult situation, an optimist will usually ask, “What can I do?” A pessimist is likely to think, “There is nothing I can do,” and so may not try anything.

 

4. View mistakes as opportunities. 

An optimistic person sees a mistake as an opportunity to learn. A pessimist tends to see a mistake as evidence that “I can’t do anything right.”

 

5. Give yourself credit for what you do. 

Optimists take credit for the good things that happen. They do not feel responsible for the bad things over which they have no control. Pessimists tend to blame themselves for negative situations over which they have no control.

 

6. Recognize beliefs are not facts. 

One mistake people often make is to believe that the negative things they think or say to themselves are true. We need to challenge self-criticism just as we would challenge someone who wrongly accused us of something that we didn’t do.

 

7. Practice positive self-talk. 

Optimistic people use positive self-talk. Pessimistic people use negative self-talk. Negative self-talk increases pessimism and vice versa.

 

Here’s the good news: It is possible to “unlearn” pessimism. But it does require

a conscious effort. The first step is to listen to our self-talk. Our self-talk will

tell us a lot about whether our outlook tends to be pessimistic or optimistic.

 

A Word on Realism

Sometimes when we listen to ourselves, we mistake pessimism for realism. Here’s some “food for thought” about realism. Realism is healthy and useful. It helps us to make good decisions and future plans. However, sometimes when we are under stress, realism can unintentionally slip into pessimism. With pessimism, problems grow and get worse, fueled by negative self-talk. 

 

Notice the subtle difference in attitude of the following two statements. Which statement is realistic? Which one is pessimistic?

“I can’t get help – it never works out.”

vs.

“The last person I hired didn’t work out. I don’t know how I’m going to do it. I just know I need more help now.”

 

Realism and optimism are useful tools; pessimism is not. Pessimism creates additional obstacles for us. It undermines optimism and self-confidence. Pessimism creates stress, discourages us from taking action, and sets us up for depression. An optimistic attitude is hopeful. It helps motivate us to take action.