Time To Talk

A Guide To Having “The Conversation” About Assisted Care With A Loved One

As we grow older, we become less capable. As an abstract concept, we all recognize this as a fact of life. But when applied to ourselves and our parents, the concept is too scary to contemplate. By recognizing that they are getting older and less capable, we are recognizing our own mortality. And so, we let our parents’ home situation slowly deteriorate until living alone becomes life-threatening or untenable.
Caring for an elder adult is a huge undertaking, one that, if possible, you should not do on your own. Everyone who will be helping in the future to care for your loved one should be involved from the beginning. All the caregivers should gather together beforehand to rehearse what they are going to say and discuss what responsibilities each person is willing to sustain. Refer to the provided checklist to ensure you consider all of your parent’s needs (for legal issues, see “Available Avenues” in the July 2013 issue). Practice how to offer suggestions and solutions to your loved one in a positive light. When the time comes to sit down and have “the conversation,” everyone should already know what problems might arise and have a plan ready for how to diffuse them.

Sometimes family dynamics create additional problems. Unresolved issues and entrenched family roles can make it impossible for siblings to reach an agreement. If such is the case, get someone else to mediate, preferably a geriatric professional (see “Geriatric Care Managers” in the Feb/Mar 2014 issue). This can also help when a parent is unwilling to listen to their children.

When you do sit down to have a conversation with your loved one about his or her long-term elder care, it should not be an ambush. Remember, this is not an “intervention”; this is a “conversation.” As such, you should inform them beforehand about what you plan to do. Don’t be ambiguous about the time, but keep your message simple: “Peggy and Jim and I would like to come over and chat about your health and your future plans. How is Friday at noon?” Avoid an argument or drawn-out discussion beforehand by saying, “I hear what you’re saying, but let’s talk about that on Friday when we can all get together.”

Also, listen to what your parent has to say. While you want to be prepared, you also want to leave room for adjustment. Unless there is a safety or welfare risk, your parent’s wishes should be paramount. Ask your parent’s opinion about every item being discussed, and respect that opinion once it is given.

You can delay the inevitable, but time will catch up to all of us. It is much easier to have “the conversation” with your parents when they’ve reached retirement age and are still able to get about on their own. If you wait until they have lost some of their abilities or perhaps dementia has set in, you might be unable to get the power of attorney you need to make decisions for them.

Editor’s Note: This is the final installment of Advice on Eldercare, a yearlong series of articles dealing with caring for aging parents and relatives.

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