Q: My brother has Parkinson’s disease and I have asked him several times if  he would want to be resuscitated if he were to suffer a heart attack or other medical emergency. He has continually answered yes. We only have each other, there is no other family. I feel like I am giving up on my brother and maybe he won’t get better but at least he will be with me if he is resuscitated. Recently, my brother’s health changed and he needs more care. He has 24/7 help after a recent hospitalization. It would be very hard for me to say no resuscitation. What happens if I continue to say yes to resuscitation?

A: Your brother has chosen you to make decisions on his behalf if he is unable to speak for himself. That is the role of the health care agent. Your role is to follow your brother’s wishes. It is not always easy to do, especially when you feel his decisions are wrong. Sit down with your brother and tell him you are conflicted and the emotional pain it is causing you. It will help him understand where you are coming from and you may better understand his views. If you feel you will not be able to follow your brother’s wishes, then you may want to consider giving that role to someone else. If your brother is having trouble breathing or he develops any cardiac problems, he may need to be placed on a respirator. A tube is placed down his throat and a machine takes over for his breathing. In some situations, it gives his body time to heal and being on a respirator is short term. In other situations, your brother would be placed on the respirator and attempts to remove him from the machine become impossible. Your brother will no longer be able to breath on his own. This could be due to his level of disease and other medical diagnoses. In Massachusetts there are special hospitals that are able to provide care for someone who is connected to a respirator. Your brother would be moved to the hospital that can provide his long-term care.

Q: My mother is now paying for an assisted living apartment, but still lives in her own home with in-home care. She has been doing this for six weeks. She finds every excuse not to stay overnight at the assisted living facility. I have spoken with the assisted living administrators and they have asked my mother what it will take to have her stay and become part of the community. I have had many conversations with my mother about it and yet nothing changes. My mother has the financial means to keep up both places. What should I do? Does my mother need more time to decide?

A: This is complicated. On one level, your mother wants to make the move yet on the other side she is clearly not ready or scared that change is not going to be easy. A couple of ideas: maybe your mother would try spending a weekend at the assisted living apartment. If she has no real complaints, then maybe she can try spending two weekends. There may be nothing you can do to force the decision. It just may take more time.

What does the assisted living offer that your mother does not have at home and what does home have that the assisted living does not offer? If there is more of a reason that home works then in the end your mother may decide to cancel the assisted living or vice versa. She signed the lease on the assisted living for a reason and was hoping they would provide something. Either they have not been able to provide what your mother thought they could or your mother just does not want to move out of her home. Sometimes it takes time to shake things out or an event such as change in health, caregivers not providing services in the home, etc. Another option is for your mother to speak with a clinical social worker who may help ease her mind.

Linda Sullivan RN, CMC, and Debbie Gitner, LCSW, C-SWCM, are geriatric care managers and aging life care professionals. Together they started a business called ElderCare Resource Services, a company that assists, advocates and helps families through the medical maze of options for their family member. Contact them at 508-879-7008; toll free at 866-280-2308 or visit www.eldercareresourceservices.com.