Start the Conversation
Look for an opening. You might come up with an ice breaker or opening to raise the topic of future care, such as:
- “I’m starting to think about estate planning, do you have any advice?”
- “I just read an article about gathering all your important papers. Sometime can you show me where yours are and what you’d like us to do just in case?”
- “As time goes on, do you think you will want to stay in this house? It might be difficult with all the stairs.”
- “You mentioned your eyes are bothering you. Is that causing problems with reading or driving?
Try not to anticipate what your parents might say or how they will react. Just get the conversation started. It will likely take place over time. Be open. Express your love and concern — and, most importantly, listen.
Respect your parent’s wishes. Every caregiving plan must center on the wishes of the person receiving the care. A plan should never be made without the participation, knowledge, and consent of your loved one. A person with a cognitive impairment should participate as much as possible. Once you’ve brought up the subject, bring in a few other trusted family members to be part of the process and have a nuts-and-bolts conversation. Before meeting, you and the other family members should consider...
- Who is the best person to start or lead the conversation with your loved one?
- What are your own feelings and outlook on the situation?
- What are your goals or what is the best thing you think might happen as a result of the conversation?
- What are you prepared to do and not do?
- What is the most difficult thing for you about having this conversation about the person you care about?
It’s important to have a point person to keep the process going and make sure people understand what’s been decided. In most families, one person assumes the primary role because he or she lives nearby, has a close relationship with the parent, or simply is a take-charge person. Expect that there may be conflicts and don’t be afraid to talk them out. Better now, than in a time of crisis.
Size up the situation. Figuring out what your loved one’s priorities are — where they want to live and the nature of the care needed — will help you determine the next steps. It can lead you to find resources ahead of time. Parents may be hesitant to share the details of their finances or health, but approach them with respect and explain your intentions.
Review finances. Money can be a particularly sensitive subject, but it’s often at the heart of many decisions you’ll make with your parents about housing, health care and other expenses. One thing that caregivers often find surprising is that unless your parents have long-term care insurance, most health insurance, including Medicare, pay for little, if any, of the cost of help with daily activities such as bathing, dressing or eating. Ask them to review their bank accounts, investments, insurance coverage, and other loans with you. Determine with your parents whether they have funds or assets that can be used to cover potential care needs.
Counter resistance. Your mother might say, “I just don’t want to talk about it.” Sometimes parents are private by nature or one spouse might be protective of the other’s limitations. It’s also hard to admit they need help, especially from their own children—who they taught to drive and balance a checkbook.
Be sensitive to the possible reasons behind their push back—but don’t give up. It’s hard for your parents to discuss what they may see as being a burden on their children. If your first conversation doesn’t go well,try again. Start small, discussing just one aspect of your concerns.
Concern for their safety. If your parents shut you out and you think they truly need help, ask a trusted family friend, doctor or faith leader to approach them about your unease. If you feel your parents are at immediate risk or unsafe in their living situation, you may need to contact adult protective services or the police to get involved. This extreme situation underscores the importance of planning early to avoid a forced intervention.