Ask the Expert Planning Ahead July 2025

Ask the Expert (Amy Natt)

My dad has been to the emergency department multiple times in the past year. It’s typically something minor, and they send him home. We have tried to get him to come up with a plan for his increasing needs, but he says he is managing, and we don’t hear from him until the next crisis. How can we help him plan ahead for a better outcome?

This is a valid concern and one many people face as they get older and needs increase. First, it is important to understand why people tend to wait for a crisis before taking action. The answer is often human nature. People are hesitant to ask for help, especially when it might signal a possible loss to their independence. Acknowledging some of the changes that come with aging can feel like giving up control. We tend to be creatures of habit and resist change; sometimes it’s easier to pretend something isn’t happening.

The risk to this approach is that making decisions during a crisis can limit your options and lead to poor choices. People then get stuck in a pattern of going from crisis to crisis.

When under stress, people tend to react emotionally verses logically. Focus is on the immediate and not the long term. Decisions are made quickly, and it’s easy to overlook related risks and consequences.

While a crisis cannot always be avoided, there are things you can encourage your dad to do what will help him avoid managing life crisis to crisis. Increased communication and information sharing with key stakeholders, such as his adult children and a medical team will ensure his preferences are known if/when a crisis occurs. Assessing any changes currently happening in his life and putting support in place to meet immediate needs will help stabilize things, allowing you to focus on long-term needs and solutions. This may look like getting someone to help with yard work, cooking or transportation. Assessing changes in each area of his daily life will help you both determine what added support is needed to reduce the frequency of ED visits. If he is resistant to sharing this information with you, consider a professional care manager to work with him and create a plan with multiple solutions he can consider. AgingLifeCare.org is a great place to locate someone in your area. Once you open the door to accepting change and finding solutions, continue to talk through different scenarios and how you all can meet his changing needs.

Some people are resistant to taking this step; in certain cases, all you can do is be prepared for the next crisis and use it as a springboard for action. There can be benefits to experiencing a crisis, especially one that highlights medical or mental health needs.  These scenarios can be the wake-up call someone needs, a call to action or reality check. Going through a crisis can help build resiliency and provide strength to tackle the changes that are inevitable.

A great example of this is someone who winds up in the hospital and is resistant to having care in the home or moving to a care facility. The hospital can make the discharge contingent on a “safe environment.”  The person is now faced with a decision to lead to the outcome they want, going home. This may prompt agreement to put care in place or to consider an alternate living environment. You can be ready to present those options.

What are the steps some can take to plan ahead?

• Do estate planning documents, even if you think you don’t have a lot of “stuff”. What would you want to happen to those things if you died?
• Complete your living documents to make your wishes known. These would include things like Power of Attorney (health care and durable) and a Living Will (what you would or would not want in a terminal situation).
• Create a care team. Who is your support network? This can be a mix of professionals, family and friends.
• Host family meetings to communicate preferences and share information.
• Consider a care management or social service assessment to fully determine needs, resources and solutions.
• Complete a planning guide, with questions that will specifically prompt you to document important information.
• Take time to research care options in your area. Visit options and make pros and cons lists and explore all options before you need them.
• Have a plan B – plan A doesn’t always work out. Be flexible and prepared to embrace change and explore multiple options.
• Consider an on-call service or emergency pendant that can provide an immediate response if you find yourself in crisis.

While there are certainly speed bumps to getting a plan in place or getting your dad to acknowledge that his needs are changing, the continued effort to do so will help to stabilize the situation and avoid repeat crises. Have patience and continue to encourage him to follow through with the planning process. Contact CaregiveNC today to learn more.