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About that “Talk” with Your Parents

16 Sep 2019
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You probably heard about the dreaded “talk” with your parents. I’m not talking about the birds and the bees. I’m talking about a whole other animal: your parent’s long term care plans.

Are you concerned about your parents’ care and wellbeing, but afraid of having the “talk” regarding the next stage in the wellness and care that they could need? This next stage could involve many things including home-downsizing, enlisting the help of homecare, or entering an assisted living or a nursing facility. If you aren’t prepared for the “talk,” you might be right! This conversation could end up having you feel like it became an “epic fail.”

You can make the “talk” with them a “win” instead. So let’s start with some tips. First of all, at what age of the elder parent or adult children should this conversation even be introduced? The answer is simple:  there is no age that is “too young.”  In fact, even kids could ask their parents what they think might happen in their later years.  Why not? That’ll get everyone thinking.

On the other extreme, and actually what’s more common, is that this conversation won’t come up until a crisis moment, such as a bad fall from one of your parents, or a broken hip.  At that time your parents will still need to make the same choices, but they will be hurried, perhaps in pain, not as well planned, and several regrettable compromises or even mistakes could ensue.

Let’s look at some reasons why this conversation might take so long to come to light:

  • No one wants to think about “negatives” such as death and taxes, as the adage goes.
  • No one wants to be a burden on their children.
  • No one wants to appear helpless, and the “talk” might make them feel cornered.
  • So many zealously want to hang on to their independence and as such deny the possibility of ever losing it.
  • You or your parents may feel you are still too young to do anything meaningful about such unpleasant inevitabilities.
  • Finances might seem impossible, it’s too painful to think about that.
  • No one wants to lose their status, their furniture, their garden, all the things they’ve worked so hard to obtain.
  • Some fear the idea of assisted living or nursing homes as one step away from death.
So be prepared to come up with some answers to these concerns, which are unique to each family.  But these quick answers below may help:
  • Death and taxes won’t go away by ignoring them, but this isn’t death and taxes.  This could be something positive for you.
  • You could be a bigger burden emotionally, economically, and physically if your health deteriorates and bad things happen like broken hips.
  • By taking the time to talk about this, you aren’t being helpless, you’re actually taking control.
  • You won’t lose control of your life simply because you’re getting some help.  Imagine being in bed all day because you’re afraid to fall, that would be a complete loss of control.
  • Mom, you’re fit today, so take advantage and make some plans while you are on top of your game.
  • You might be able to afford the best care you deserve.  Let’s talk to an elder law attorney or financial advisor to see what they come up with.  In fact, by waiting too long, you could lose a lot of money that you should be using to enjoy life.
  • Dad, no one is saying you’re moving any time soon.  But now that you have some time, maybe you can make a mental list of which furniture you really want to keep or give, and what you can sell instead.  And mom, I know you like gardening.  Let’s find a couple of places where you can keep doing that– it’ll be fun.
  • Mom, Dad, if you’re not prepared, if your condition gets worse, getting help could lengthen your life, and increase your quality of life.

The next step is to try and assess your parents’ safety situation.  This is hard to do, and I don’t believe anyone has a magic answer to predict the optimal moment someone should take action, be it to have home care or move into a facility.  One logical approach would be to grade their ability to be independent.  This would only provide a snapshot of their current situation, but at least you would be provided a more objective means to approach and eventually make a decision.  Maybe your father’s only problem is he doesn’t take his medication faithfully.  But if your mother is having problems with hygiene, missing bill payments, and unable to drive, these problems add up to a clearer picture of losing independence sooner than later.

On the other hand, let’s say your parents are still in their early 70s and are demonstrably independent.  However, they could also have a strong family history of heart trouble, a personal history of smoking, diabetes, are obesity, alcoholism, etc.  These health risk factors could also give the hint that the number of independent years ahead for them is diminished.  In this case, this conversation may be better held now than later.  Still, in either case, no one has a crystal ball for that “uneventful” day.
I placed “uneventful” in quotes to highlight that these “dreaded” days ahead can actually be quite pleasant and welcomed instead.  In my family’s case, although we experienced the crisis moment with our parents before they moved into assisted living, surprisingly our father, who was against the idea, has taken quite well to his new home and is very satisfied.  That’s why one item to offer in your discussion(s) should be the possibility of visiting several assisted living facilities or nursing homes or to interview different home care agencies to see the immense good that they could offer you and your parents while providing more choices.  This gives more control to them, which is especially important for the more resistant parents (such as my father.)
Another strategy is to invite different family members and key influencers, such as your parents’ physicians, to speak to them about this very topic.  However, be prepared to receive their differing points of view.  For example, your sibling who lives far away could double down on considering your parents as still being strong and independent, while you actually know better because you live much closer and see them more often.  Or your physician might see your mother’s forgetfulness as part of stress rather than a manifestation of early dementia.
Once the “talk” with your parents has started, one strong piece of advice is to try to get on their side.  For example, if your parents really value staying at home, agree with them! Approach them with the ball in your court first. You could say “I’m like you, I don’t want to go to a facility.  So, I’ll be proactive.  When I hit 75, first I’ll fix up my home and make it as safe as possible.  I’ll install safety rails in my bathroom and move my furniture so I don’t trip on it, or maybe move into a smaller home or apartment if I feel overwhelmed with a big house.  If I’m still having trouble keeping up, I’ll ask for some help from a home care agency, since my kids probably will still be working. And then if the time comes that I absolutely can’t take care of myself, God forbid,  I’ll still be ready.  For example, the waiting list for some assisted living facilities can be several months.  Great, that will give me time to sell my house and furniture, give things away to my kids, have garage sales, etc.  Before then, I’ll want to hear from my homecare team and children and see if they think I’m fit enough to stay home longer.”  And there you go.  They heard everything you said with Dumbo-sized ears without feeling pressured or being pushed out, because you were specifically speaking of your situation, making it clear to them that you want to respect their decision fully.  While you were actually rooting for them to stay home, you also pointed out some strong reasons for homecare or even assisted living as well, which may make them think twice.
You might need an ice-breaker if you feel uncomfortable bringing up the “talk.”  I’d start by saying someone shared this article with you, or you found it when you were surfing around the net, and simply thought it was interesting.  Then you can ask if they heard of anything on that topic.  That doesn’t mean you have to start the “talk” right there.  Just bring up the same or similar article or news story again when the time is right.  The good thing is at least your foot is already in the door just for bringing it up now.
If your parent continues to refuse to enter into this conversation, sometimes it might be better just to wait  But eventually, the time will be right for him or her.  For example, if your father’s friend is starting to develop some mild dementia and forgets to pay his gas bill, he may let out to your dad that he had a very cold winter day or two because of it.  This can become the mind-changing event your father needed.  Just hearing about things like this from someone outside the family circle could make him more receptive to the “talk.”
One caveat: try to avoid saving the “talk” for Thanksgiving or Christmas or other holidays where your parents are expecting only to enjoy those moments.  In this case, the “talk” could be better postponed as well.

Lastly, try not to reverse roles; you’ll always be their child in your parents’ eyes.  It’s uncomfortable for most to hear one’s child acting as his or her own parent.  Let them know you care, that you see some things that concern you that they might not be aware of, such as having too many bruises and cuts from recent falls that might be happening too often, but that they’ll always be your mom and dad to you.

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