A recent AARP study found that two-thirds of adult children have never had a conversation about long-term care needs with their parents because they don’t know what information their parents need or where to find it. ElderCarelink.com created a discussion guide entitled "Where Will Our Family Be in Five Years?" to help families who are reluctant to approach this sensitive topic, providing a step-by-step resource for adult children and elders to discuss their needs and concerns. It’s never easy to discuss aging and long-term care with your loved one, but it's far better to know ahead of time how elders want to be treated when their living requirements change. Families can use the brochure to approach topics that they may not feel comfortable broaching themselves.
"As Americans come together for holiday gatherings, we hope many of them will use this opportunity to have an inclusive and caring conversation."
Creating A Living Plan
Many adult children worry about their aging parents and would like to create a living plan based on their parents’ wishes, should various problems occur. Bringing up the topic, however, can be a challenge. If your family is among the many that gather during the holidays, this time of celebration can give you the opportunity to jumpstart a conversation of this kind. By offering tips on how to start a conversation about a loved one’s future, the Eldercarelink will help your family create a living plan that addresses important issues and shared responsibilities.
Of course, you are likely aware that bursting through the door on a holiday eve and thrusting a brochure into your parents' hands as you deliver your holiday hug isn't a good idea. However, tucking a few copies of the brochure into your suitcase could be a good plan. Then after the celebrating is over and everyone is reacquainted and mellow, you can start this important conversation with as little stress as possible. It's very likely that your parents would like to share their wishes with you, but aging and the attendant decline are often difficult topics to approach. Often, all that's really needed is a nudge in the right direction.
Setting the Scene: Conversation Starters
If you are fortunate, all of your siblings are on board, and after the celebrating is done, your family is feeling quite close. The approach you take will depend on your family dynamics; however, you will probably want to keep this conversation as relaxed and low-key as possible.
I've found that mentioning, during a casual conversation, certain people who our elders know may be having health problems, or even people in the news who are aging, can help start conversations. If your dad's best friend recently had a stroke and now needs care, and your Dad is relating this information to you and your siblings, then the stage is already set.
If circumstances don't offer you this natural start, you'll have to find a different approach. You may want to wait until you've all shared a nice meal and are relaxed. Talk about what a great time you've been having and then say, "Mom and Dad, you're the best! I wish we never had to think about you getting older or needing help. But that's not realistic. I found a brochure that gives us suggestions of things to talk about so you can help us help you in ways you want to be helped. Can we look at it together?"
Since most people are aware of some losses as they age, it's likely your parents will at least show some interest. Let everyone view the brochure, and then let your parents start the conversation. Don't interrupt. Respect their time and their thought process.
Sample topics from the brochure for your parents to consider include:
- I want to maintain my independence
- I want to be near my spouse, family, friends and pets
- Daily chores and household responsibilities are getting harder
Your parents will continue down the list. They may say, "I agree with these suggestions, but we're fine, so let's just move on."
That's okay. They will be able to sleep on this and may be more ready to talk next time. Don't push too hard, or they may refuse to talk at all. Just show you care and then change the subject. It's very possible that as your folks read down the list, they will warm to the idea. Your mom may see the point about a spouse having more trouble moving around and say, "That's right, Pop. You've nearly fallen twice in the last few months. I do worry about that." Your dad may see the point about managing medications and say, "I do worry about Mom and her medications. They're getting pretty complicated."
This is a sign that your conversation is going well. Assign a note taker ahead of time, if that seems wise. Listen well, and nod in agreement when they hit a good point. Let them talk with each other. This is a plan, not an emergency response, which is the whole point of having this talk early in the game. You don't want to have to face an emergency without any information.
Now It's Your Turn
Once your parents have had a chance to voice their thoughts, you and your siblings can share your concerns with them. Again, stay respectful, and never give the impression that you want to "take over."
You or one of your siblings could start with the Eldercarelink brochure questions by telling your parents that you worry:
- That they aren't safe enough
- They don't have enough access to friends and social activities
- That Dad's worry over Mom's medications and his other caregiving duties are too much for him
Continue down the list in the brochure with whatever points fit your parent's circumstances. Add any concerns not on the list. After all, you will have read the brochure ahead of time, so you and your siblings have a head start.
If All Goes Well You'll Reach a Common Understanding
If all goes well, you, your siblings and your parents will have had a good chat and maybe even have some concrete plans jotted down. By using the Eldercarelink brochure, you'll likely have reached some common ground. You may at least know what your parents’ priorities are, who they'd like to make health decisions for them if their spouse can't and the kind of care they would like if their health fails.
What If Things Don't Go Well?
Are you thinking, "But you don't know my family?" Remember that the ideal family doesn't exist, so don't think that every family but yours will be able to sit down with their aging parents and have a conversation of this nature go smoothly. Your first discussion with your parents about aging and their wishes may get no farther than handing them a copy of the Eldercarelink brochure with a quick sentence about how you want to know their thoughts on aging and what kinds of care they would want.
That's okay. Consider the seed planted. Once the topic is approached, you've gotten your parents thinking, even if they don't respond very much. They may say, "Let's not talk about this at Christmas." They may say, "We're fine and don't need help." They may say, "Let us think about it."
Whatever happens, it's okay! You've brought the topic up and it won't go away. They will think about it, and hopefully read the brochure. They may even re-start the conversation later, as they experience more problems. If they don't, you'll find a way to start again.
You will have accomplished something, even if you don't feel that you have. The window for you to offer help has at least been opened a crack.