Remember when dealing with family members that everyone has their own feelings, fears and agendas. These tips on general communication and holding family meetings will help keep communication open and more productive.

General Tips for Talking to Family Members:

• Be a good listener. Listening is the most important aspect of communication.
• Talk openly about your fears, worries and needs.
• Discuss topics such as finances, insurance, wills and advance directives (what the loved one wants done in case of a medical emergency). These are difficult discussions, but preparing for the future can help relieve stress. Chances are your loved one is also concerned about these issues.
• With heart disease and stroke, caregiving often arises from a crisis. Remember that everyone is feeling the pressure and insecurity of the event. Try to be patient. A family member who has never been good at dealing with troubles probably won't be very good at dealing with this crisis in the beginning. Give everyone time to adjust in his or her own manner.

Holding a Family Meeting
Family members need to work together when one of you is ill. The more people who participate in the caregiving, the better, and the less alone you'll feel in the role. Holding periodic family meetings can keep communication lines open and avoid misunderstandings.

Who Should Be There?

• All family members who will be involved with your loved one in any way. Even if they aren't going to be involved in the actual care, they might have opinions, fears, etc.
• Anyone who is "connected" to your loved one and may feel they need to be in the loop (including anyone who might be in a will).
• Any outside caregivers, friends or neighbors who will be involved.
• You have to decide whether your loved one is part of these meetings. Every circumstance is different. You might have one meeting where the loved one isn't present so everyone feels free to speak their mind, then another after decisions have been made and feelings have been aired and where the loved one is present.
• Family members who can't be present can be included on a conference telephone call.
• Make a video or audio tape of the meeting for those who can't attend.
• Use e-mail to invite, update and recap.

What Do We Discuss?
Have an agenda. Place time limits on each item and — before the meeting — send the agenda to all who will attend. People can add items that they want to discuss and notify you. Items that might need to be discussed include:

• Latest report from the doctors.
• Sharing feelings about the illness/caregiving, such as fears, sadness, confusion, anger, guilt.
• Who's going to do what? Who has space, time, skills, etc.? Everyone can contribute something, even if it's only making scheduled phone calls to the loved one to cheer them up or see how they're doing.
• Death and dying are on everyone's mind. It's best to get it out in the open.
• What has the loved one said they want? Can you fulfill the loved one's requests or do you have to manage their expectations?
• Can the loved one stay at home, or will he or she have to be moved to a family member's home or a care facility?
• Financial concerns. What type of insurance does the loved one have? What are out-of-pocket expenses that must be met? Who is going to contribute financially?
• What resources do you all know about that can ease the burden and result in better care?
• Who is going to be in charge of making decisions? These include day-to-day care, long-term care, financial, medical, finding/hiring extra help, etc. Different people may be responsible for different things.
• What role is each person going to play?
• Try to create a schedule that will be the least burdensome for each caregiving team member.
• Establish ways of contacting everyone in case of an emergency. Who is the "first-line of defense" in case of emergency?
• As primary caregiver, you need to articulate your limitations. Do you have a job? Do you need help with meals, doctor's visits, house cleaning, yard work, grocery shopping, bill paying, etc. Be clear, be thorough and be assertive in your requests for help. If you can't do it all, SAY you can't do it all, and be specific about where you need help.
• Discuss emotional support for the caregiver and the loved one. Who needs it? Where will it come from? How often can others spend time with the loved one in a "social" sense — watching TV, playing games, talking, reading to them or whatever gives comfort?
• How will the caregiving and support needs change as the illness progresses? Prepare yourselves for the future.
• End with a list of tasks that need to be done before the next meeting, who will do them and when they will get done. Be specific.
• Summarize the meeting to make sure everyone is on the same page. Schedule the next meeting. Give a written summary to everyone, outlining his or her tasks. E-mail is useful for this.

You won't get everything done in every meeting. But if you schedule regular meetings, they will get more efficient as you go. Teamwork makes caregiving more successful and less stressful for everyone, including your loved one.

Potential Challenges
Families come with a history. Only you know how complex your family's history is. The idea of family meetings may seem impossible, but it's worth a try. You might find that a lot of the difficulties that arise in families will be headed off by having regular meetings where everyone is allowed to speak freely. The first meeting is always the hardest, because no one is used to the idea of having someone they love be sick and need care. Have patience with one another.

Keep the meetings as short as you can and narrowly focused. That's why creating an agenda and timeline are helpful. It keeps the meetings from being overwhelming and also keeps one person from spending all the allotted time with his or her specific issues. Everyone needs to be heard. Everyone needs to be respected. Everyone needs to remember that the goal is the best care possible for your loved one.

You aren't going to solve problems that have been in the family for years in these meetings, but you may be able to overcome them and get on with the caregiving more efficiently. If you do have a lot of family issues, it might be a good idea to invite a trusted minister, social worker or friend to one of the meetings as a "third party" who can be objective about what they see and hear.