Kate called me last month asking about assisted living options for her mother. Mom had been living at home by herself and was doing fine (her words when family checked in on her by phone). It wasn’t until there was a family gathering at Mom’s house that they realized things weren’t as “fine” as they thought. The milk was expired and the bread was moldy. Piles of bills and other paperwork covered all the tables, unread newspapers were piling up by the front door and the yard which she took pride in was obviously untended. Everybody could tell Mom had lost weight, her clothes and her house were very dirty and she seemed confused. The family got together and decided she wasn’t safe to be at home any longer and needed to move somewhere where she would get some assistance. We toured several assisted living buildings and found one the family thought was perfect. Next came the question I dreaded “How do we tell Mom she needs to move?”
According to recent Marist research, 80 million Americans are reportedly conversation avoiders, meaning they haven’t talked about any important end-of-life issues with their parents or children. In addition, research by Home Instead Senior Care revealed 70% of family conversations about aging are prompted by an event such as health crisis or other emergency.
Why aren’t families talking? It’s difficult! Research by Home Instead Senior Care indicates a majority of adult children (54%) described their critical conversations with parents as uncomfortable at times, difficult but necessary, emotional with yelling and tears, or difficult and unsuccessful. How do we get the conversations started earlier so it’s not prompted by a crisis?
Home Instead Senior Care has very comprehensive materials on getting the ‘talk’ started and focuses on areas such as driving, health care, relationships and dating, end of life. In an effort to guide Kate, in the example above talking about the future far in advance of the crisis would have helped a lot.
Starting the conversation is the hardest part. Caring phrases can get the conversation going. “I know we want the best for one another. Let’s talk about options that will work for both of us” or “I know you want to remain home for as long as possible. But I want you to be safe. I’d be less worried if we had a plan now in case something happens in the future.” “I know you want to be independent as long as possible, let’s make short, medium and long term plans and define what may trigger implementing each of the plans when necessary.”
During the conversation ask questions such as “What if you could no longer drive, what would you want to do?” “If you’re unable to navigate the stairs in your house what would you do?” “Where would you live if you have to make a change someday?” “Who (or what) do you want to live near?” “What can you afford?” “Do you have long term care insurance that would help pay for care at assisted living?” “What activities are important to you that you want to continue doing if you move in to assisted living?” “What possessions are important to you that you must have if you move to assisted living?” You may want to tour some assisted living communities to see what’s available and choose where to go when the time comes. Document the plan and keep in a safe but accessible place so it’s readily available when needed.
Making decisions, identifying choices and conveying wishes are an important part of the road ahead. Working together to develop the plan helps Mom feel like a part of the decision rather than having the decision made for her. By having the conversation early you’ll both feel more comfortable with the aging process and you’ll avoid having to make decisions during a crisis.