MED e-care Blog

You are a Family Counselor

By Len Fabiano  |  04 October 2017


You may not have expected that role when you started working with the elderly. It may not be included in your job description. You probably believe that you don’t have the time to do what is needed. You may not even have the skills to deal with what is experienced. Regardless, you are smack dab in the middle of families in crisis.

Understanding the family of the frail elderly can be as complex as understanding the frail elderly themselves. However, it is paramount that we do. Unlike most other specialties in health care, ours is in constant contact with family for an exceptionally long period of time. Those families of our older clients can support us in what we do, challenge our every move, or simply be absent from our client’s lives.

Many families present a mix of responses. Certain family members will be willing to work through the problem in an open and realistic manner, while others in that family criticize and disagree with everything that is done. Still others are unwilling to be involved in either the care or decision making regarding mom/dad. In long term care, no one is spared from family contact. No one can avoid the variety of family responses.

This is a complex topic that presents a variety of challenges. There is no clear cut challenge where we are dealing with only one issue, and often no clear cut solution that provides a simple answer. In our setting there are many players, with many different views and reasons for their actions. Usually we are simply getting from family what they have always done. We cannot change family dynamics, the personality of the family members, their coping abilities, their view of life, their parents, their circumstances, etc. To effectively work with families of our clients, we must: 

  • understand the family’s motives.
  • increase the family’s coping ability in dealing with their parent’s situation.
  • integrate what family needs with what their parent wants and we require.

In many instances this is not an easy task. However, if the limits of our influence are accepted and the mechanism used to assist family is well defined, then we can be successful.


Condensed excerpt from Len Fabiano’s book “Doing Our Best for Your Mother: Working with Families of Aging Parents” ©


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