The Power of Denial in Decision-Making

Every family brings their own dynamics to the table when they start planning for the long-term care of a loved one.  Complicated relationships and family histories, guilty feelings related to “not doing enough,” and the general stress of unexpected and unplanned-for transitions all have the potential to get in the way of establishing the best plan for the person who needs care.  One of the most common stumbling-blocks for sound planning and decision-making is denial.

Denial takes many forms and plays out in various ways within families.  Sometimes we catch a whiff of denial as soon as a family calls in to inquire about services.  An out-of-town son may be confident that his elderly mother is not showing any signs of dementia, all the while describing a situation in which she is neglecting her own care and permitting an obviously predatory person to spend her money in ways she never would have allowed.  At other times, denial shows up in the conference room:  a husband cannot accept that the cost of his future care needs may exceed his life savings, or a wife cannot imagine a time when she will not be physically capable of taking care of her spouse.

Often denial rears its head even after the family has a care plan in place.  A guilty daughter removes her mother from a residential facility, insisting she can provide better care or that her mother will be happier at home.  Adult children decide that despite their father’s advanced dementia, they will remove him from a facility and split the responsibility for his care by moving him from home to home on a monthly basis, preventing him from ever settling in to a familiar environment and routine.  These types of denial-based choices seem reasonable and logical to stressed-out family members facing uncharted territory as caregivers and decision-makers, but they almost always end badly for everyone involved – especially for the person whose care is in question.

The children, spouses, and other caregivers making these denial-based decisions are well-meaning and genuinely want to do what is best for their loved one.  But they may be so stressed by sudden changes or their loved one’s progressing illness that they can’t see the proverbial forest for the trees.  Adult children may be so accustomed to thinking of their parents as strong and competent that they fail to notice an important turning point:  when the parents are no longer able to make sound decisions, a role reversal takes place, and the adult child must honor his or her parents by making good decisions rather than going along with whatever the parents decide.  Furthermore, guilt may play a role in the power of denial over family members.  No matter how much they do, many caregivers feel they are not doing enough for their loved one.  And when there is no perfect outcome, as is often the case, caregivers and decision-makers may grasp at any idea that they think might make their loved one happier or allow them to fulfill their duty as a spouse or child.

In these situations, inviting an objective third party to assess the situation and help the family consider their options can be a potent antidote for the influence of denial.  Sometimes it takes an outsider to provide the reality check that the family needs to make the best possible decision for everyone involved.  Not only can the unbiased third party evaluate the situation without the burdens of emotional attachments, complex family dynamics, and feelings of responsibility, but family members may also be more open to suggestions from a neutral party than that of their siblings, parents, or spouses.  This approach helps many families cut through the fog of denial and make what are truly the best decisions for their loved ones.

Helping families become aware of denial and overcome its power is part of what we do at Elder Law of East Tennessee.  Our attorneys steer people away from dubious legal and financial choices and provide guidance to help families make decisions that will achieve their goals in the long-term, not just in the short-term.  Our care coordinators deliver a comprehensive care assessment and present long-term care options, helping the family to understand which options will provide sufficient care, how they will be paid for, and how to balance health and safety needs with maximized independence, dignity, and quality of life.  Our team is committed to providing compassionate guidance to help the elder or person with disability receive the best possible care.  When we break through denial to achieve this goal, the whole family can experience greater peace of mind.