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Let's Talk: Difficult Elder Care Conversations

Let's Talk: Difficult Elder Care Conversations

As your loved one ages, making the process as safe and simple as possible may seem like a task too large to tackle all at once but being prepared and having those difficult conversations with the entire family (before it's too late) is critical to the well-being of all involved. Your family's ultimate goal should be to discover what your aging loved one absolutely wants and does not want in terms of living arrangements and care. The following five questions will help you better understand your loved one's needs and create a successful care plan.

1. What matters most about their living situation?

Does your loved one want to remain in a home that has become isolated over time as family and friends have moved away? Can they live safely in their current home, even if family and friends live close by? Discuss whether your loved one would benefit more from the comfort and familiarity of the home environment, or if they would be more enriched by the social interaction of facility living.

2. What practical day-to-day concerns need to be addressed?

Does your loved one have any worries about getting in and out of the tub, shower or bed? What about keeping their balance on the stairs? Keeping up with bills? Preparing meals? Arranging and attending appointments? Doing laundry? Understanding and following doctor's orders? Managing increasingly complex medications? Attending social events? Reassure them that these common issues have easy fixes. This may also be a good time to bring up the issue of driving safety and alternate forms of transportation. Consider asking their primary care physician to step in as an authority to reinforce the message if your loved one should not be driving.

3. What is their health care status?

Especially if your loved one suffers from any minor or major medical issues, is there a coordinating doctor who manages care? Do they have supplemental insurance? Don't forget dental information and specialists, too. Also ask your loved one about their fears concerning specific medical issues. For example, many of us worry unnecessarily that our memory is failing if we can't recall where we put our keys! Discuss permission for you to attend appointments and speak to the doctor the doctor's office will need your loved one's consent.

4. Do you have financial resources and a plan?

What kind of resources are available savings, real estate, vehicles and which ones could be used for care if needed? Money can be a touchy subject for many, and especially may be when your loved one is the parent. Their immediate response might be, "That's none of your business." Let them know that you're not prying; you simply want to abide by their wishes. You can suggest they talk to a trusted third party attorney, geriatric care manager, or financial planner and keep all but the basics private.

Next, it's important to make sure the entire family is on the same page mom, dad, brother, sister, aunts, uncles everyone should be involved.

5. Who is the best person to help and how can we share responsibilities?

Review your loved one's wants and needs, and make a list of what is required. A basic plan helps account for contingencies. Ask each member of the family how they'd be willing to help. Who family members, friends, neighbors can handle various responsibilities? Depending on where family and others live, some tasks to consider may include: house cleaning and cooking, transportation assistance to errands and appointments, and managing finances.

Dealing with Family Dynamics

When taking into account family history, blended families and multiple personalities, coming up with one action plan that everyone agrees on may seem impossible but it's not. If everyone comes together willing to talk honestly, listen openly, understand each individual's viewpoint, and negotiate accordingly, success is within reach. It's important for all to keep composure, leave past issues in the past, and remind each other that the goal of the conversation is to help the shared loved one prepare for any changes so that they can live their life their way not your brother's way, not your aunt's way, not your way.

Make a Plan and Stick to It

As important as a plan may be for your loved one's safety and well-being, a plan is also necessary for the well-being and happiness of the entire family. A plan can stop family members from second-guessing themselves: "Is there anything else I should/could be doing for my loved one?" It can stop unsettling self accusations: "If only I had stopped by the house that day, mom wouldn't have fallen." And, it can establish emotional boundaries for each person involved: "I've shared my opinion, and been a part of the planning for dad's future. I'm doing my part to help."

Working on a plan for your loved one's aging years can be a challenging, emotional process. Sadness, confusion and frustration can be experienced as you acknowledge the passing of time, or find yourself grieving for what never was or will inevitably be. However, embracing the opportunity to learn more about your loved one, and deepening the relationships within your family will bring peace and comfort to all involved.
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