Article: Talking to Parents About Aging

It's never too late to discuss with your parents what they want in the event their health situation changes unless it's after something happens. Don't wait to until you're in crisis mode to talk to your parents. Emotional stress levels will be high enough. Don't add to them.

It is likely that you currently see your parents as being fiercely independent. As a result, you may find that it is very difficult to initiate a conversation on the possibility of needs occurring in the future. Before starting the conversation, there are a few points that you should have at your disposal and a few considerations that should be made.

Long-term care can be expensive.

The cost is based on the type of care you need, how long you need it, where you get it, and what type of medical professional provides it.

The average cost of a stay in a nursing home in Texas can be as much as $5,000 a month. Skilled care provided at home can cost about $4,000 a month.

A national median rate per day cost for long-term care in a nursing home is $225 for a semi-private room and $253 for a private room. This typically covers room, board, meals, housekeeping, laundry, life enrichment activities, and transportation.

When speaking with your loved one, express these costs to them to give them an idea of just how much of an expense long-term care is, when needed.

Next, you should let your loved one know that you want to know what they want and expect when it comes to long-term care. Let them know that you want to make sure that you know this now so that you can ensure that their wishes are met if/when the time comes.

Finally, when speaking about the subject, do not TELL your loved one what is going to happen or how it is going to happen. Instead, approach the subject with the attitude of being open and receptive. Remember, to listen.

Research has shown that, as people age, they prefer to continue living independently, preferably in their own homes and 'age in place'.

While adult children often worry about their parents' situation, it can be difficult to know if parents really need, or want, help from their children.

Talking with your parents a head of time and understanding what they want, allows for the opportunity to honor their wishes, especially if it's not possible for them to communicate at the time due to a stroke or other debilitating illness.

If there are other siblings involved who perhaps have other thoughts and opinions about the situation, there is no room for discussion, as your parents have made their decision(s) clear to everyone.

You could also consider hiring the services provided by a Geriatric Care Manager.

The following suggests ways to speak with your parents about their health, finances, and day-to-day lifestyle.

For your parents' welfare and your peace of mind it's important to have family conversations about staying at home before problems arise. An AARP survey found that parents feel better about having this discussion when things are going well, as part of planning for their future.

Initiating the Conversation

For many adult children, finding the right way to bring up the subject of independent living is a major stumbling block. Experts in communication and aging suggest some ways to break the ice.

Let your parents know what you need. Example: "What kind of help would you want if you were not able to do everything yourself and you wanted to continue to live safely in your home."

Share your own emotions about your parents' changing situation and encourage them to do the same. Example: "I know you have always prided yourself on being independent. I imagine it's very difficult to ask for help. Is that right?"

Raise the issues indirectly. Relate it to someone else's experience or something you have read about or seen on television. Example: "I know you're taking pills for your arthritis, heart, and cholesterol. How do you keep track of which pills to take when? Would it help if you had one of those medication organizers you can buy in the drugstore?"

Watch for openings. Example: "You mentioned having problems with your eyesight. How does it affect what you normally do, like reading or driving?"

Give your parents a list of questions or concerns you have. This could be about their current and future situations. Schedule a time to sit and talk about your concerns. (Consider your own relationship with your parents when attempting this.)

Dealing With Resistance

Respect your parents' feelings when they make it clear that they want to avoid a subject. You may want to try again at another time, using a different approach.

Involve Others

This might be a third person that your parents respect, such as a doctor or clergy, or other family members. You might want to hold a family meeting at which everyone discusses concerns and develops a specific, mutually acceptable plan to resolve them. Investigate community resources. There are often community resources readily available to help older people remain independent, such as transportation services or home care. Check them out. If it's clear to you that your parents do need assistance, you'll be ready to share options with them.

Focus on Key Points

The first topic to address is your parents' own perceptions about their current needs, concerns, and worries for the future, as well as their hopes and goals. There are some major issues that can affect an older parent's ability to remain independent. Asking appropriate questions can help you avoid making assumptions about parents' preferences.

Is Remaining at Home Possiblity?

Ask them...is your home still appropriate for your needs? Can you still manage stairs or are you better off on one floor? Does your home have safety hazards that need to be removed? Could simple modifications make it easier for you or more convenient? Should you think about living somewhere else?

Do They Need Help?

Ask them...do you need help with household chores, such as cleaning, fixing meals, or taking care of the house or yard? Does trouble seeing interfere with your daily activities? Can you easily hear a knock at the door or the telephone ringing?

Can you get to your doctor appointments? Is driving the car getting difficult? Do you have reliable transportation for shopping, medical visits, religious services, and visiting with family and friends? If it's obvious assistance is needed you could always consider arranging for in-home care.

Health Issues

Ask them...what health problems do you have? Are your prescriptions current? Have you been to the doctor lately? What did he or she say about your health? Did the doctor review all your medications to be sure there are no possible bad reactions? Are you having any problems taking your medications? Could you use some help remembering what pills to take and when to take them? Can you pay for the medicines the doctor tells you to take?

Finances

This topic is a particularly tricky area for adult children and their parents to discuss. You may want to be less direct than the following questions, depending on your comfort level.

Ask them...what are your current and likely future bills? Can you pay for what you need? Do you need help getting government or pension benefits? Are your Social Security and pension checks deposited directly in the bank? Is all your financial information in one place? What about getting extra income from the equity in your house?

Have you thought about how you might need money in the future to help you do everyday activities you might not be able to do yourself? Do you have any bills you can't pay?

How Will They Pay for Health Care?

What kind of health insurance do you have? Medicare? Medicaid or other insurance?
Has it paid your health care bills so far?
Do you have long-term care insurance?
Have you paid the insurance premiums and are they up to date?
Would you like help filling out forms like insurance claims?
Have you been told that Medicare or your Medigap insurance won't cover some medical tests or procedures that the doctor has ordered?
Do you have questions about Medicare or Medicaid?
While you probably won't want to discuss all these matters in one conversation, they are issues to keep in mind and to raise as your parents' situation changes. You might also want to ask your parents what issues concern them the most.

Keeping the Conversation Positive

Avoid role reversal. Talking to parents and helping them meet their needs doesn't mean you are "parenting" them. The most productive interactions come when parents and older children are equal in the relationship.

Be prepared to let your parents make their own life choices, even if you don't agree with them. Your parents have the right to make their own decisions (as long as they are not impaired with Alzheimer's disease or other dementia).

The Bottom Line...

As people age, they prefer to continue living independently preferably in their own homes. Talk to your parents about their situation so you can determine whether they need or want your help. Consider emphasizing the issue if your parents' health or safety is at risk.

This must be a personal decision, recognizing your parents' right to be in charge of their own lives. Act firmly, but with compassion if you decide you cannot avoid intervening. Such as...."Mom, Dad, we can't ignore this any longer. We have to deal with it."

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Talking to Your Parents