Why is it so hard to talk to our aging parent about difficult subjects, such as getting older, needing help, or planning for being dependent? Sometimes, we just don't want to face the fact that they are getting older. Or, maybe they don't want to face the fact themselves and are in denial about their own aging process. Who can blame them? No one wants to picture one's self needing help with walking, bathing, toileting or eating.
Bringing up these sensitive topics as a shared conversation about planning for the future, or as seeking input on their wishes for how they want to live the rest of their life, is less confrontational than presenting mom or dad with a ready-made plan. Besides, if you don't know what your parents are thinking, how can you help them plan? Let your parents know the conversation is about them and their wishes for the future.
Resist any temptation to jump ahead and put a plan together yourself. Simply guide the conversation with questions that allow your parents to express their thoughts, feelings, concerns and plans. Reassure them, that as children of aging parents, you are never attempting to switch roles. What is most important to your parents? Remember, when you think about how to have your conversation, to frame it around the most important considerations for aging older adults: security, independence, freedom, peace of mind, family and friends and choices. How can your parent maintain all of these things? But be sure to ask, "What is most important to you?" Ask the question so you can find out whether or not your concerns are the same as your parents.
Here are few topic areas that are important to discuss with your parent:
1. Legal Issues: At the very least your parent should have an up-to-date will, a durable power of attorney for both legal and healthcare decisions, and a living will. You should know where these documents are, and that your parent's physician has a copy of documents relating to healthcare. While most documents can be drawn up on one's own, it's a good idea to see an attorney specializing in elder law who can advise you on your particular situation.
2. Estate Plan: If their plan is to pass property to family members, have they talked to a financial advisor about the best way to do that? How can their assets help provide for their care in case of a decline in health or incapacity? It is important to speak with a professional, and ensure that it is reviewed regularly.
3. Medical Expenses: Medicare doesn't pay for long-term care, and an annual nursing home bill can easily reach $75,000. What is your plan for paying for long-term care, should the need arise? Does your parent have long-term care insurance? Is he or she near the level for Medicaid benefits? Simplify your parent's finances as much as possible through direct deposit and automatic bill pay.
4. Medical Care: Does your parent have one doctor who can coordinate care? It's important to have someone who is the "captain of the ship." Do your parents keep a list of every medication they take? Take a written list of all medications and supplements to every medical appointment.
5. Housing: This can be a tough conversation to have, especially with a healthy parent.Do your parents want to stay in their current home as long as possible? Or are they considering "downsizing" or moving to a senior living community? Discuss what they would prefer if they were to experience a decline in health and need greater assistance with their daily activities. Whatever their choices, help them find options. What home care services are available? What options do they have for assisted living? Be careful not to make any promises you can't keep. While you think it might be fine to have mom live with you, situations change. Caring for someone who needs a lot of medical help can be difficult at best, and at times impossible.
6. Home Modifications: Is your parents' home keeping up with their needs? What repairs and modifications could make their house, apartment or condominium safer and more convenient? From non-slip stair coverings to walk-in shower stalls, find out how to improve their home so they can safely age in place.
7. Wellness: Do your parents have a plan to stay active? Study after study shows that regular physical activity is the most important contributor to healthy aging. No matter what a person's condition, adding exercise is of benefit. Meaningful social interaction is vital to overall health for people of every age. Recent studies show that older adults who socialize, not only with family members, but also with other groups, have better emotional, intellectual and physical health.
8. Home Safety: Many older adults are reluctant to discuss their risk or experiences with falls. But did you know that fall protection is actually an important part of planning for the future? Falls are one of the leading causes of incapacity and one risk factor that we can take proactive steps to avoid. Conduct regular home safety inspections to identify areas of high risk in the home, and make changes where necessary.
9. End-of-Life Care: This is a conversation no one wants to have, but it's so important. If your parent says he would want you to "pull the plug," make sure you know what that means and in what situations it applies. While talking about end-of-life care is hard, it's also rewarding. It can bring a new level of trust and intimacy into your relationship.
These topics are intended to provide a starting point for people who would like to speak to their aging parents about planning for the future. The best advice is to plan carefully and think through such conversations so that they are as positive and productive as possible. Write down what you think needs to be discussed so you don't forget anything. Try not to approach this important opportunity as "The Conversation," but as an ongoing series of conversations. Address one issue at a time rather than trying to resolve everything at once. It is less intimidating that way. If you start small, you are more likely to start. And your parent will be more likely to participate.
