How to Create a Family Care Plan for Your Senior Loved One

April 30, 2018

Whether it’s your grandparent, parent, or older aunt or cousin, there will probably come a time when you realize that a loved one needs a bit more help doing even the simplest tasks in their daily life. For some, this change can occur suddenly — as the result of a major health emergency – such as a heart attack or stroke. For other family members, however, you may find that they are gradually falling behind in matters of hygiene, health, nutrition, or housekeeping. Once this happens, it’s time to start discussing the family care plan.

What is a care plan? The term can be broad, including everything from daily chores to doctor’s appointments.  It should span the entirety of a loved one’s life, from when you start seeing that they need help with little things and continuing to include end-of-life decisions as they are warranted. It should be detailed enough that anyone can come into the home, read the plan, and pick up on duties as needed. It shouldn’t be so full of medical jargon that loved ones can’t use it, but it should include all the specifics for it to be used to communicate with medical professionals, when appropriate.

Consider the family care plan to be a “cheat sheet” for getting your loved one from early morning to overnight with all the important questions answered and documented.

How a plan is laid out isn’t nearly as important as how it is developed, however. Your loved one should be involved in as many details of the plan as is reasonable and possible. Since much of the plan will be focused on the comfort of your loved one, it’s vital that they are included in answering essential questions of care. Don’t be afraid to get their ideas for how even the stickiest of situations should be handled; you may be surprised that they have the best solutions already figured out!

What’s included in a care plan? Here are some basics, but feel free to add other categories of care not specifically covered below:

Health Care

This section should be broken out into “Immediate” and “Ongoing” duties. If the initial care plan is created as the result of hospitalization, for example, then the immediate care duties will probably be a combination of discharge papers and orders from health professionals for continued care while recovering. Ongoing details can include:

  • Vitals needing monitored and who is responsible
  • Medical equipment used, along with maintenance, replacement, and care instructions
  • Upcoming doctor appointments, including testing or lab dates, and how to change or cancel
  • Health insurance details, along with how out-of-pocket costs will be paid for
  • Personal hygiene concerns

With the average older American taking a minimum of four prescriptions drugs at a time – plus two OTC meds – it’s becoming more difficult to keep track of what’s going on. This section of the care plan may prove to be the most useful when several people are involved in care.

  • Medication doses, including when to take them and any special instructions (such as foods or activities to avoid while taking)
  • Reasons for taking each med and side effects to watch for
  • Pharmacy details, including how to refill, and who is responsible for picking them up
  • Medication expiration and disposal instructions
  • Storage details (including how to lock or count controlled substances)
  • How meds will be tracked (software, a notebook, etc.)
  • Financial details for meds, such as insurance coverage and how out-of-pocket costs are paid

Often, letting these duties go is the first sign someone needs help. Get them back on track by including these items in a care plan.

  • Nutrition details, including grocery shopping, meal plans, and food allergy instructions (along with who will prepare)
  • Housecleaning assignments, from basic daily duties to more involved tasks of carpet cleaning and windows
  • Disaster preparedness planning, including what to do in case of fire, tornado, or power outage
  • Outdoor maintenance assignments, including grass mowing, snow shoveling, roof and gutters
  • Repair resources, such as who would be called for a broken A/C unit
  • Instruction for regular home safety checks, including door locks, railings, and fall hazard removal

If an outside agency or professional is hired to handle any of the above duties, there should be one family member in charge that can monitor, hire, or fire individuals. While it is the job of the whole family to watch and make sure things are going well, one decision maker (and only one) can have the job of making the final call for continued employment. With many families, this person is also the executor of the estate, health care power of attorney, or another legal guardian.

A Word about Finances

One of the most difficult duties to take over for a loved one is money. In fact, it’s often the one that’s met with most resistance, and that’s understandable. With all of the terrible stories of elder financial abuse and elder scams, it’s very important for family members to be aware of the ways their loved one may be taken advantage of so that they can take preventative measures to protect the family.

We’re already shared how one family member should have the role of handling paid caregivers and outside help, and this person may be taking on additional financial and estate duties, too. In reality, however, it may take many family members to tackle the day-to-day money matters an older relative may have, including:

  • Paying bills
  • Paying taxes
  • Updating the will or trust assets
  • Keeping insurance current and at the best value for needs
  • Dealing with Medicare, Medicaid, and Social Security agencies

Be sure that all loved ones responsible for sensitive financial information know how to keep data safe, are careful with how they store and share this info and are authorized to do money transactions on behalf of your loved one. Do a monthly check of accounts to ensure everything appears in order and notify the authorities immediately if something seems alarming. Your state Attorney General can tell about new scams and how to deal with suspected fraud. (You can also get update details from the FBI.)

Getting Everyone On Board

It can be difficult at first for other family members to admit that a care plan is needed. This is completely normal. Understanding that things will be different, and that documentation may be used for every little thing, can take time to accept. You can explain to your family that this will help keep everyone on the same page and that all will have a chance to be involved. Even the relative popping in for an hour once a week can have an active and vital role in a loved one’s health and happiness with the notes included in the plan.

As far as your loved one, they might not appreciate all of the sudden fuss over their care and may be resistant to having so much information available about their routine. Remind them that this is necessary, but also acknowledge their feelings. Don’t minimize their hesitation or tell them not to be embarrassed. Older people value their privacy like anyone else. Letting them know that you hear them is the best way to respond.

Changes to the Care Plan

One unfortunate fact of care plans is that they may need to be frequently changed. A deteriorating health condition or sudden changes in living conditions can make it necessary to redo the entire care plan. Even with most things staying stable, however, things like medication can change as often as weekly. Have one person in charge of making formal changes to the care plan, whether that be from information they receive from a doctor or another caregiver. Print out new copies of the plan and keep it in a 3-ring binder or folder in a centralized location that all caregivers and loved ones can access. Make sure that changes to the plan are approved by those in the know (doctor and nurses, for example) before they are implemented.

Most families don’t have a lot of experience with care plans when they first create one. If this is your first plan, give yourself time to figure out what may work and lots of flexibility to create a format that will be utilized. Many of the sample care plans online look good but could have limitations for your specific circumstances.

Remember, the best care plan is a utilized care plan. No good can come from a plan that’s hard to understand, doesn’t cover what’s needed, or can’t be accessed by all caregivers. Consistency and use over time will eventually make the care plan a welcome addition to your loved one’s life. Many families are discovering a new normal with a few simple spreadsheets and patience from all involved. Your family can, too!


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