Creating Successful Conversations With Seniors About At-Home Care

As the adult child of a senior, at some point you will likely find the caregiving roles changed and come face-to-face with the awkward moment when you must explore the idea of finding at-home care for your parent.

It is not unusual to encounter resistance to this idea, resistance that can delay or even halt progress, leaving everyone frustrated. Understanding the reasons for resistance and the dynamics at play in this conversation, including how to actually raise the subject, can mean the difference between a fruitful discussion and a highly emotional failure.

The Dynamics of the Situation

Before initiating a conversation about home care, recognize that accepting care is scary for anyone. Seniors in particular may become more anxious when considering new situations or people. They may fear losing control or worry about the burden of being left alone to manage a caregiver whom they do not know. Many seniors also find the concept of potentially depleting financial resources daunting.

Moreover, seniors' mental states may be weakened, impairing cognitive abilities. It is important to be aware of this and understand this might be what is driving a senior's negative reaction—not stubbornness as it may appear.

On the flip side, consider that your own judgment may be tainted by fear, impatience, a desire to control or a lack of objectivity.

Finally, recognize that the perceived urgency of the situation is subjective and may require reassessment. Our experience has shown that more than 80 percent of urgent situations result from an adult child's misperception. Stepping back to evaluate whether finding home care help immediately is indeed crucial, whether part-time rather than full-time care would sufficiently meet current needs and whether the senior is—or is not—facing a life or death situation can help you gauge the urgency level and ensure that any conversation about care focuses on what's truly necessary. Seeking feedback from more objective third parties at this juncture, such as a professional geriatric care manager, other family members, trusted advisors or physicians, can also prove extremely valuable.

Broaching the Subject

How the subject of at-home care is brought up can make the difference between the ultimate success or failure of the conversation. Being aware of the dynamics above is key to a productive exchange. In addition, the following points can help allay fears and keep the conversation on track:

• Pace the conversation. Begin with small steps and keep an open mind about the senior's needs. If he or she is resistant to the topic, resolve to revisit it another day. An initial negative reaction is not unusual and may be temporary.
• Choose language carefully. Focus on the senior's immediate, personal needs. Choose warm, supportive language rather than speaking in more clinical terms (avoiding words like "assessment" and "evaluation," for example). Steer clear of language that might imply a loss of capacity or control.
• Emphasize the "do it for me" angle. This involves explaining that care would ease your own burden. In this case, a senior parent might feel reassured that accepting care is also a way of taking care of you, the adult child.
• Rather than issuing directives, ask the senior to participate in the thought process by having them paint a picture of how he or she sees somebody helping at home.
• Offer to help introduce and orient the new caregiver to the senior's household, including explaining daily routines, food preferences, how appliances work, where to shop, etc. This will help allay the senior's concerns about the burden of being left alone to manage a caregiver.
• If faced with resistance about costs, re-focus the discussion on the value of prevention, explaining how "front-end investing" in care can help save dollars later down the road.
• Anticipate questions that might arise and be willing to listen and respond thoughtfully.

Using these pointers and remaining sensitive to the underlying dynamics, our own care managers have successfully worked with many seniors and adult children to successfully raise this difficult topic and end up with the best possible care arrangements for the seniors and their families.