Journalist Gina Roberts-Grey went to the experts to find out about best practices for talking to aging parents about care. Here’s what she learned.
When you were a kid, you probably sat through “the talk” that had your parents (perhaps awkwardly) explaining the birds and the bees. Decades later, your roles have flip-flopped and now you’re faced with talking to your parents about considering home care options.
Whether the topic is a move to assisted living, incorporating a geriatric care manager or hiring a private individual to provide care in the home, counselor and social worker Karen Whitehead says it’s common for older adults to put up a little (or a lot) of resistance to the subject.
Whitehead says that beginning to discuss this topic before a parent needs care, if possible, is one of the best ways to take the sting out of the topic. “Having discussions about what your loved one would want if they needed assistance with dressing, bathing, meals or if they needed more medical care can be helpful to know where to begin looking for care when the needs arises,” she says. However, often parents and children avoid these conversations because they are uncomfortable.
It might seem like it’s never a right moment to start a conversation about care. But take heart. There are steps and strategies that can reduce the stress surrounding conversations about care and minimize your parent’s resistance to considering it.
Connect to a Past Experience
Ask your parents if they had a loved one who needed more assistance and care than they—or their family—were able to provide. Whitehead suggests asking your parent what the circumstances were, what the resolution was and how they felt about it.
“Tapping into those feelings can shed some light on what may be going on for your parent,” she says. “It’s possible that they felt their loved one was a burden, and they don't want to be a burden to you now that their role has changed.”
It’s also possible your parent experienced guilt about the decision to move a loved one to a care facility and now they’re trying to spare you that distress. Regardless of the circumstances, a conversation about their own personal history might help clear up confusion or shed light on its source.
Take a Walk in Their Shoes
Your loved one may not be able to make too many decisions these days. All that’s left are choices about what to wear, what to eat for lunch--or whether or not to stay in their home.
It’s important to acknowledge your parents' fears regarding the future and their disappointment with not being able to function independently. Let them know you understand how difficult this is.
“Empathize and give them an opportunity to share their sadness and frustration about losing independence and try to connect to their feeling,” suggests Nicole Rochester, M.D., and private patient advocate. “Ask questions about how things are going or how they're feeling about falling more often instead of stating you know they’re unsteady.”
Then imagine how frightening it would be for you to no longer be able to have the same level of physical security you do today or be able to make decisions for yourself.
Choose Your Words Carefully
Whitehead suggests avoiding saying "You need/have to..." or "You should..." She says these phrases “take control away from your parent and will likely put your mom or dad on the defensive.”
Collaboration is also helpful, adds Rochester. “Instead of telling your mom she is forgetful and will burn the house down thus she can no longer live alone, share your concerns and ask collaborative questions like, ‘How can we work together to keep you safe?’” she suggests.
Most adults fear losing independence and control. Using language that respects these fears can often help you tackle difficult conversations around care. Ask your parent, "What would it be like if you had help with ..." to elicit a response that is meaningful and might lead you both to a solution.
Time it Right
It’s tempting to bring up the idea of your parent needing assisted living or more care than the current level in a moment of frustration. However, Whitehead says that conversation is better suited to a time when cooler heads prevail. “It's better to wait until you’re both calm and the situation can be approached with a cool and clear head.”
For instance, don’t seize the moment in the emergency room to tell your father he’s fallen too many times living on his own and has to move to assisted living. “If your immediate reaction to the news of an alarming incident is to say “it's time for assisted living” your parent might fear telling you important details about their health, which could make matters more dangerous,” says Whitehead.
In the heat of the moment, stick to expressing concern. “Ask if that fall or near fall was scary,” says Whitehead. “Then discuss it, and possible care decisions stemming from the incident, at a calmer time.”
Build a Village
It’s tempting to charge into the situation and want to take control in the best interest of your parent. But Whitehead cautions against that urge.
Rather than taking control, she suggests collecting your loved one's opinions and desires and then acting as an advocate to see them fulfilled as close to the intentions as possible.
“If they want to stay in their home, discuss helping them evaluate whether this is feasible instead of shutting it down,” she says. With your parent present (if possible and feasible) talk to area agencies on aging or their physician for a free or low-cost evaluation to help determine the safety of the current living situation and for recommendations on future needs.
And be patient. “This is a marathon, not a sprint,” says Rochester. “Don't try to solve all of the problems in one conversation.” Instead, bite off small chunks, celebrate wins, and revisit the topic when the time feels right.
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