The Graceful Exit: How Caregivers Can Help Loved Ones Leave a Job or Surrender Car Keys

Add more checks and balances

Caroline Burns says that the situation with her father was eye opening. “We certainly learned what not to do,” she says. “The silver lining is that [now] we have things in place with our children for my husband and me. I’ve told my kids that if they see things, observe personality changes, forgetfulness or confusion, they need to say something. We’ve both agreed to get tested and that we need to be having a continual conversation.” 

“One piece of advice is to look at the people who are around your loved one,” advises Caroline.“You need to be able to have an open conversation with them and be attentive to what’s going on when you aren’t there in person. More checks and balances would have been important. And of course, our society needs more awareness and understanding.”

Plan and accommodate for functional limitations

Christine Seel Ritchie, M.D., 61, research director of Palliative Care and Geriatric Medicine Massachusetts General Hospital sees one of the challenges for caregivers on the front lines is that their observations are often dismissed by the medical community. “Many medical personnel don’t talk to older adults or their care partners about how critical it is to name other people in the medical record who can advocate or provide collateral information when things are becoming confusing to us,” she says. “We need to give caregivers and individuals the tools and skills to serve in that role, navigate a different space, and drive hard conversations as everyone ages.”

Ritchie imagines one step might be to offer to couples counseling as they approach this new stage in life. “There’s going to be a certain aspect of navigating loss and adapting to change as a couple. It’s a little like advance care planning for end of life, but in this case, it is planning for functional limitations and how to accommodate them.”

Set guardrails and stick to them

Ritchie stresses that it is important start this conversation early. “When there’s cognitive decline, the partner impacted needs to be able to say, “I’m counting on you to help me think through how to adapt, and I want you to talk to me if you see little things.” 

Ritchie worries that as family and traditional community systems become more fragmented, it may become harder to identify trusted people with whom we are willing to talk about the future. “We need to constantly work at building new friendships and new sources of connection. I know it’s highly likely that as a female I’ll outlive my spouse and others. I need to be thinking about enriching my community network now.” 

When Ritchie’s own father, a cancer surgeon, was diagnosed with Lewy Body Dementia, the family was concerned about his driving. “We sent him for an evaluation and he sweet-talked the person into allowing him to drive,” she said. “We told him how much we loved him and that we were making the recommendation because we were worried about his welfare and others.” Her father disagreed but honored the request because they’d had an agreement. “It’s important to frame the discussion in such a way that you want to prevent your loved one from hurting others, in whatever manifestation that might be.” 

Flagging issues inside the workplace

With a portion of the workforce working longer and later in life, different health challenges can occur in the workplace. “Cognitive decline has emerged as a complicated and deeply personal issue that some companies face,” says Peter Church, 52, chief people & culture officer at Point32 Health in Canton, Massachusetts. “While every situation is different, the culture of a company and the steps you take can make all the difference. By focusing on solutions and fostering an environment of trust, companies can support employees facing cognitive challenges while preserving a positive, inclusive workplace that ensures both individual well-being and organizational resilience.”

Church counsels that while it’s delicate, it’s appropriate to have a tough conversation with an employee that could begin with, “We’ve noticed a few occasions where certain things may have been missed. Are you doing OK?”

He explains that the company needs to ensure resources are in place and approach the situation with empathy, care and respect. In one workplace instance, he offered an employee a solution (in partnership with the spouse) to support the transition to early retirement by having the employee do “knowledge transfer,” and create documentation of their work and work history for others.

Staying involved eases the transition

Forester’s grandparents were both physicians and worked until they passed away. He’s watched his 85-year-old physician father navigate the transition to retirement by following a small number of longstanding patients, while donating his time to share life lessons with other residents at his senior living facility.

In his own place of work, Forester feels fortunate to have a series of senior mentors who help and advise him for free and for “fun.”  They are retired, yet extraordinarily active, sitting on boards, coaching, writing, doing what they want to do at the level that works for them. “There’s a lot we can do to still have a meaningful day-to-day [life],” he adds. 

 *Names have been changed to protect privacy