Talking with our elderly loved ones about how and where they would choose to live their remaining years can be more than awkward. It can be frightening. For many, it’s not as much the fear of the elders’ reactions to our words as it is an effort to preserve our own denial.
If we don’t voice the fact that our parents are aging and may eventually need assistance, and then, yes, die — it won’t happen. This is a version of covering our eyes when we were small and saying “you can’t see me.”
True, some adult children know that their parents will not take kindly to such a discussion, thus definitely making it harder, but fear not — this is a conversation that we must have with our older adults.
Having been through this, I’ll provide some suggestions that can make this discussion, or better yet, series of discussions, easier. However, before we move to general suggestions, let me present you with one fundamental rule — the one that underlies everything that you do or say:
Never, never, never forget the fact that your parents are now, and will always be, your parents. You are now, and will always be, their child. Even making financial, health, and housing decisions for them doesn’t change that dynamic. Even providing the most intimate physical care for them doesn’t change that dynamic. Keep as your mantra: “These are my parents ever and always,” and you will most likely usher your parents through their last years with minimal anger and hurt feelings, and maximum love.
Keeping that fundamental rule in mind, how do you move forward?
Consider how often you see your parents
Ideally, family members see one another often enough that they can become comfortable discussing issues that come up naturally as parents grow older. When this is the case, adult children are likely to hear when close friends of their parents have moved to assisted living, or have become ill. They may even hear stories where their parents’ friends didn’t assign powers of attorney for healthcare and their finances so that when one or both became very ill, their children are left trying to care for their parents with their hands legally tied.
These natural conversations can bring about good-natured discussions where the aging parents muse about how they want to age and what they might face. Unfortunately, for some, the conversations don’t evolve so naturally.
Perhaps adult children are separated from their parents by distance, by temperament, by family history, or all of the above. What then? You are still the adult child and you will, except in the most extreme cases, likely be involved in some way as your parents age. Therefore, it would be smart to find time to visit more often and use some of that precious time, hopefully after you’ve closed some of the feeling of distance that may have developed, to discuss what they want you to do to help them move forward as they age.
Involve siblings if you have them
It will help your future relations with your siblings if you discuss your parents’ situation with them and plan how to share these discussions. If they see your parents more often than you do, ask if they have noticed any changes in your parents that would indicate that this discussion is an emergency, or if you can all begin the conversation in a natural manner, and spread it over time.
If you have to go it alone, you should still assess your parents’ situation with as much clarity as you can. Do they seem to be struggling to maintain their home, or do they enjoy living there so much that some tweaks could keep them happy for a long time to come? Are there memory issues, such as forgetting to pay bills, happening regularly or are they doing just fine in that area? The better your parents are doing when you bring up these issues the easier these talks will be, so start as early as possible. Is their 50s too soon? Maybe. Maybe not. It depends on the family and your parents’ general health. Their 60s, even if they are “young” 60s? Definitely. You need to be getting some kind of feel for what they would like as they age.
Be kind, be compassionate, and be respectful
Even if you see issues that tell you changes are going to be necessary before long, don’t storm into their lives and start telling them what they need to do. Remember the one, unbreakable rule: They are your parents. Be kind and go about this talk with compassion and respect. Your parents are facing the inevitable changes that come with age and no doubt carry underlying fear about the future.
Even if you are facing a near crisis, that rarely rules out all choices for the elder. People with memory issues can be gently provided with two simple choices such as either hiring in-home help or moving to assisted living. People with good minds but poor physical health can be presented with more complicated solutions, such as offering to hire in-home help for now while you take them around to look at assisted living and other options. This will help them decide what most appeals to them for their future.
Quality of life for your elders is your goal, and to accomplish that goal their wishes must be considered. If their wishes don’t mesh with the practicalities of life, then you can do your best to provide the next best option on their list, but do try to let their wishes guide you.
Do your homework
It will be easier to help your elders decide what is best for them if you become educated in what their community has to offer. Pick up brochures on home remodeling for aging homeowners. Gather brochures on retirement centers that can provide additional care as needs increase. If possible, talk with people who have used either or both of these options, or other options that may be available in your parents’ community. Then, approach your parents respectfully, even if that means starting off with a joke. You know your parents, so use that to your advantage.
Early on, ask them what is most important to them, independence or safety. You aren’t, of course, going to try to rule one out as exclusive to the other, but you need to ask. Some people would far rather take a few more chances with safety for the pleasure of independence, while others prefer the secure feeling of more care. This could be one of the most telling pieces of information that your parents can provide.
Show them the brochures you’ve collected. Tell them what you’ve learned about home remodeling if that appeals to them or assisted living if that seems more their style. Don’t push them. Leave the brochures on the table and move on to other topics.
Tell them that if they prefer remodeling their home enough to accommodate any aging issues they have, in-home help can be hired to handle some of their care needs. Cleaning and outside chores will eventually need to be hired out, as well. These costs can be balanced with retirement home solutions as you discuss options.
If they say “thanks but no thanks” about discussing these issues, don’t worry about it. Let it rest. Then bring it up at another time. If you aren’t used to seeing your parents often, you will likely have to change that over time unless there is someone else to take over this situation. Remember unless this is a crisis, they deserve time to think about possible options that you’ve suggested.
Listen with your heart to what they say as well as what they don’t say, and respond or store it for later knowing that this is hard for them. Be kind.
If you are faced with an emergency, or just seem to be getting nowhere with your elders, aging life care specialists (the new name for geriatric care managers) can be helpful in guiding you. They cost money but they know how to handle tricky situations.
If you haven’t talked about powers of attorney for healthcare and finances, this is the time to do that. A helpful guide can be found at the Conversation Project. They also have a conversation starter kit that you can download.
The biggest hurdle is opening the conversation. Once this is done, in most cases you can substitute a dreaded marathon discussion for a natural series of fairly pleasant chats. If your parents’ health indicates that their needs are more time sensitive, then you’ll have to push harder, but even then, if you remember your mantra — these are your parents, not your children — and talk to them with respect and compassion, you’ll do fine. Just bite the bullet and do it.
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Carol Bradley Bursack is a veteran family caregiver who spent more than two decades caring for a total of seven elders. She is a newspaper columnist and the author of Minding Our Elders: Caregivers Share Their Personal Stories. Bradley Bursack is also a contributor to several books on caregiving and dementia, and is passionate about preserving the dignity of elders. Her website is www.mindingourelders.com. Follow Carol on Twitter @mindingourelder and on Facebook at Minding Our Elders.