Ways to improve family decision making


Solutions to help families make decisions together include:

  • Having family discussions

  • Discussing values

  • Breaking decisions into steps

  • Finding different options

Having family discussions

Suggest regular family check-ins. These discussions can help family members understand the situation and agree on how to support the older adult.


Ask family members:

  • Who will check in: Who does the older adult want there? Who might help make or carry out decisions, including in-laws or step-family?

  • How often to check in: Are the older adult's needs changing? Depending on the situation, you might want to meet as often as every other week, or as occasionally as twice a year.

  • How to check in: Does everyone live close enough to meet in person? If not, would phone meetings or video chats work?

  • What to discuss: Do you need to make decisions or plans, or share new information? At the beginning of each check-in, make a list of what to discuss.

  • How to keep track: Do family members want reminders before check-ins? What about sharing notes on what was discussed afterwards?

Suggest relaxing activities, too, like family dinners or movie nights. Enjoying time together can reduce stress.


Discussing values

When you make decisions together, ask family members how they feel about different options. Why do they like "A" better than "B"? Focus on understanding others' views.


Ask how family members feel about aging issues. For example, which of these opinions do they agree with? Why?

  • "We need to support the older adult's independence. Everyone takes risks," or "We need to keep the older adult safe. Older adults need to accept limits."

  • "As family, we need to take care of anything the older adult needs," or "We need to find others to help the older adult."

  • "We need to do whatever we can to keep the older adult at home," or "We need to move the older adult somewhere else."

  • "The older adult should get any treatment that might help," or "Some treatments could have more risks than benefits for the older adult."

  • "We need to put all resources towards the older adult's care," or "We need to figure out how the older adult can leave some inheritance."

Ask what's most important to the older adult. If the older adult isn't sure or can't say, think about the older adult's beliefs, past decisions and reactions to older family members' or friends' choices.


Ask family members if they can support the older adult's decisions, even if they might not choose the same for themselves.


Breaking decisions into steps

Think about the different steps in making a decision:

  • Seeing a problem or asking a question

  • Getting information

  • Finding different options

  • Asking for opinions and advice

  • Weighing the pros and cons of each option

  • Making a decision

  • Afterwards, asking if it was the "right" decision

  • Making changes, if needed

Which steps are easy or difficult for your family? Are there steps your family tends to skip over?


Make sure family members have or can get good information. Ask how they like to get information - from websites, videos, pamphlets, books, workshops or meetings with experts.


When making decisions, does your family generally:

  • Agree about what the problem or question is?

  • Work together, sharing information and listening to each other?

  • Agree about what is accurate information or good advice?

  • Consider different options before making a decision?

  • Agree about who should make the final decision?

  • Look back at how past decisions turned out?

Encourage your family to take time to make decisions, when possible.


Focus on the more difficult steps. Ask family members what would help with each step. Do they want more information, expert guidance or advice from people who made similar decisions?


Finding different options

Ask if there are other options that might work well for the older adult and others in your family.


To explore different options:

  • Talk to experts. Legal, financial, health and social work professionals can discuss options and resources.

  • Talk to others who help older adults. Ask people in online or in-person family caregiver support groups for advice. Local Senior Centers, Aging and Disability Resource Centers, Aging Units or Area Agencies on Aging can suggest resources.

  • Ask family and friends. They might have advice or contacts who can help.

  • Split the problem into parts. Could each part have different options? For example, diet changes could be split into meal planning, grocery shopping and cooking.

  • List general strengths. Having family or friends nearby, living in a community with good services or being able to pay for help are all strengths. What options draw on available strengths?

  • Combine different options. For example, family members might help on some days and paid staff on others.

  • Think about previous decisions. What options that worked well? How did you find them? What made them work well?