Can We Talk? How to Open Up the Conversation as Loved Ones Age

As adults, we all want to stay independent as long as possible, in our own homes, living our lives without someone looking over our shoulders. At least, that’s the cultural bias among many Americans.

But the aging process all too often compromises independence. When you’re beginning to struggle on your own due to physical or cognitive impairment, it can be incredibly hard to admit that you need help.

Likewise, as the adult child of an aging, ailing parent, you may find it incredibly hard to open up a conversation with your parent about the need for help. According to a 2009 Pew Research Center survey, only 55 percent of adult children have talked to their parents about what to do if the parents can no longer live on their own.

Sometimes the communication barriers are built up over years of difficult interactions; other times, adult children think they know what their parents want, or they simply don’t want to deal with the possibility of their parents’ decline. Aging parents may be reluctant to share their fears and appear weak to their adult children, or they may fear becoming a “burden.”

The problem is this: Frequently, that reticence to discuss what’s really happening can result in no planning or preparation for the inevitable crisis—a fall, a stove left with the burner on, a medical emergency precipitated by forgetting to take medications, a neglected cold that morphs into pneumonia and a hospital stay.

Here are some tips for how to open up the lines of communication. You may both find it helpful to include a trusted third party, such as clergy, another family member or an elder care professional, to add balance and an objective viewpoint to the conversation:

For Parents

  • Let’s face it: Aging happens. There’s no escaping it, and we all go through it. You and your adult children will benefit from sharing your concerns and planning together, rather than waiting for a crisis to force the issue of your need for additional support.
  • Your children are no longer little kids. They are adults, too. Treat them as partners in this discussion. You can guide the conversation, but don’t dictate.
  • Be honest and realistic about your wishes. Any plans you devise together will only work for you if you are clear about your needs and priorities.
  • Be open about finances, healthcare and legal planning. This can be a very sensitive area, but the only way to create a realistic, workable plan is with all the facts on the table.

For Adult Children

  • Watch for openings, such as your parent’s expression of concern about eyesight, an issue with a friend, worry about ability to drive at night, and so on.
  • Give your parents a list of questions and schedule a meeting. Don’t spring the conversation on them, which can make your parents feel more vulnerable and defensive.
  • Respect your parents’ feelings, but push if you feel that their health or safety are at serious risk.
  • Start from a loving place. Assure your parents that you want to support their independence as long as possible.
  • Ask your parents what they would want if they needed help. Try to draw out their thoughts and feelings about what’s happening as they age.
  • Share your feelings about their aging. This can be one of the hardest pieces, but if you’re able to be honest with your parents, you’ll have a better chance of reaching a good solution—and possibly find a new, closer dimension to your relationship.

What to Talk About

These are the key points to cover:

  1. Safety at Home—any modifications needed to the house or apartment for mobility; who lives nearby and can help in an emergency
  2. Everyday Activities—do they need help with chores, preparing meals, grooming, managing medications
  3. Transportation—is it still safe for them to drive; what alternatives are available
  4. Health—contact information for all physicians, list of current medications, releases to allow medical professionals to speak with designated family members
  5. Finances—information about bank and other accounts, monthly income, other assets
  6. Passwords—all accounts, including computer, email, Facebook, online banking or bill payment, etc.
  7. Health Insurance—location of policies, long term care insurance, other relevant coverage
  8. Estate Planning—key documents include a will, durable power of attorney, healthcare proxy and HIPAA release

For more ideas about having “The Talk,” listen to Deb’s radio interview.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

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