An elder care attorney has recently shared a client story with me that got me thinking. His clients, a couple in their early 50’s, needed help convincing the wife’s Mom to move to an assisted living facility. “Crisis” is a word that would describe the situation mildly. Mom, a fiercely independent lady in her 80’s, was in declining health yet refused to acknowledge that she needed help. Her family, although well-meaning, seemed to make matters worse with every conversation. By the time they reached out for help, Mom and the rest of the family were barely on speaking terms. Sound familiar?
Caring for aging family members is affecting the country now more than ever. According to the U.S. Census Bureau, there are 44 million unpaid elder caregivers. As the needs of aging parents grow, many caregivers must broach difficult conversations about assisted care facilities and nursing homes.
Money can make this task easier, but simply hiring a helper or paying for an assisted care facility goes not guarantee that the parent will go along willingly. How can you approach the conversation to get buy-in?
Get talking early.
I recommend that you start the conversation as early as possible. Don’t want until a stroke or a heart attack forces an impossible choice: quit your job and care for Dad, or move him to a facility over the weekend, kicking and screaming. The more time you make for these conversation without the pressure to make an immediate decision, the more open-minded everyone will be about exploring options.
Be sure to consider all financial aspects of elder care. For most families, a combination of Medicare, long term care insurance and personal savings can be used to alleviate the expense and help everyone face the situation with grace.
Be your parents’ vocal advocate.
Second, approach the conversation from the position of being your parents’ advocate. If you attempt to force them into a decision, you will lose their cooperation. Talk about your concern for their well-being. Take the time to understand what independence means to them, and what preferences they have for their care down the line. Many elder parents are reluctant to share their failing health with their children for fear of being a burden, but an open and ongoing conversation can help create trust and openness.
Be ready for some (or much) resistance.
What should you do if your aging parent is resistant to the very idea of elder care or assisted living? If the situation is not dire, back off for the time being. Much of the older generation mistakenly believes that they will be able to care for themselves for the rest of their lives. Be patient. Shifting entrenched positions takes time. If you encounter strong resistance, let the issue go but look for future opportunities to return to the conversation .
Sometimes the situation has to deteriorate before it can get better. It may take a drastic incident before Mom and Dad can stop and realize they need help. Yes, this might mean a fall, a nighttime robbery scare, or getting the utilities turned off because Mom or Dad forgot to pay the bill.
When that happens, adult children should not beat themselves up for not being able to prevent the incident. Instead, they should reinforce the idea of the elder parent’s self-determination. An effective starting sentence might be “I cannot make decisions for you, but it would mean the world to me if we could make these decisions together.”
Get your ducks in a row.
On the subject of making decisions, this is a good time to mention the Power of Attorney. Be sure that the document is in place, and that it addresses who will make decisions related to health care and finances. Getting your aging parents to consider the Will and the Power of Attorney can be a task of its own because it forces them to face their own advanced age. However, without these preparations your family can be thrown into chaos by a diagnosis or a sudden serious health issue. Help your family compile a “master file” of all critical documents, doctors’ contact information, financial statement and bank account details, and as well as personal preferences and wishes.
Finally, be sure that all family members are on the same page. All it takes is one hold-out son or daughter who insists that Mom should stay at home, and the chances of getting the parent to shift from an entrenched position become very slim. Family relationships and dynamics can be complex and emotionally fraught. The conversation goes better if siblings make a conscious effort to leave their baggage by the door and focus on creating the best possible outcome for their aging parents.