Talking with a parent about transitioning to senior living
It’s not always easy to talk with an aging parent or loved one about a need for additional that may lead to a move out of the family home help – whether it’s assisted living, memory care, skilled nursing or even independent living – but ignoring issues won’t make them go away. Doing nothing or delaying the conversation may put a parent’s health, safety or well-being at risk, while possibly escalating their health and your own stress level as a caregiver.
The solution is to do some advance planning – before problems arise or get worse – to make these conversations easier for everyone.
PLANNING THE CONVERSATION
Start early. An AARP survey shows that most older adults feel better about having these discussions when things are going well, as part of planning their future. Too often, families wait to have such discussions until after a parent has had an unexpected health issue or crisis, such as a fall, accident or medical emergency, and is no longer able to take care of themselves. The urgency at this time causes increased stress, confusion and uncertainty when the clock is ticking, care options are limited, and significant decisions have to be made quickly.
Being proactive instead of reactive will help provide calm, thoughtful discussions, and ensure families have a plan in place should a loved one’s health situation change unexpectedly. Planning ahead also enables mom or dad to get on a senior living community’s waiting list, if necessary. Selecting a “continuum of care” community allows adult children choose the best care option for mom or dad for the time being, while planning for additional assistance should the need arise.
Regularly I hear guests and their family members say they should have made the move to assisted living much earlier, not later,” explained Melyssa Cordova, Director of Sales and Marketing at St. Gabriel’s Community, a leading provider of senior care services including independent living, assisted living, basic care, long-term skilled nursing care, short-term rehabilitation, and outpatient therapy in Bismarck. “Having a conversation early and making a move when a loved one is still in good health means he or she can fully enjoy all the benefits a senior community has to offer, including staying active, making new friends, and taking part in a variety of social, recreational and wellness/fitness opportunities. Such benefits have been shown to enhance healthy aging and enable older adults to remain independent and live a better quality of life longer.”
Choosing a senior community such as St. Gabriel’s that offers a ‘continuum of care’ also lets spouses needing different degrees of care stay together and see each other on a daily basis while eliminating transportation issues, which is important for their emotional health and well-being,” said Cordova.
Prepare for the discussion
You might consider scheduling a time for the talk and giving your loved one a list of questions, issues or concerns beforehand. This helps them prepare for the conversation by letting them think about the specific kinds of help they may need or what’s important to them in a new living environment. At the same time, you’re facilitating their important need for some degree of control in their lives. By knowing their wishes, you’ll be better able to help your parent live life the way they want.
Decide the best people to be involved
Usually this includes adult children who live nearby and may already be involved in caring for mom or dad. It may also include a spouse of the aging parent if the couple has different care needs. Limit the number of participants to avoid overwhelming the parent or loved one. You can always update additional family members after the conversation. Often it can be helpful to have someone in addition to adult children be involved in the discussion; mom or dad may be more likely to listen to an independent, unbiased perspective from an outside party, such as a trusted friend, relative, doctor or pastor.
ASKING QUESTIONS THE RIGHT WAY
Once you come together, there are particular communication procedures you might use and signals to watch for – both within yourself and your loved one. Seniors seem to have a radar that is highly tuned in to the signals we send when we’re about to tamper with their control without their permission. We need to signal back that we’re friendly and “on their side.” Keep in mind that you’re “partnering” with your loved one to solve a particular need or issue in their lives, as opposed to “parenting” or taking a one-sided approach that tells them what to do or what is best.
Consider this approach in speech and delivery of your side of the conversation:
Here are some suggestions for dealing with delicate topics:
Approach the subject indirectly:
Mom, I know you’re taking a lot of pills. How do you keep track of them? Would it help if you had someone to remind you when to take your medication?”
John says his dad has given up driving. Have you thought about how you would get around if you could no longer drive?”
Be direct, but non-confrontational:
Mom, I’m worried that you seem to be unsteady on your feet. I’m wondering what we can do to help protect you from falls?"
Dad, if you ever decided it’s not a good idea to live alone, have you thought about where you might want to live?"
Watch for openings:
Uncle Joe, you said you were having problems with your eyesight. Now that you no longer drive, do you have anyone who can take you to your regular doctors’ appointments"
Gramps, after you said last week that you had trouble turning the handles on the water faucets, I wondered how you were managing with the shower?"
Share your own feelings about your loved one’s changing life:
You’ve always been so independent, Dad. I imagine it’s hard for you to ask for help now. But if it were readily available, what kinds of things would you like help with?”
Aunt Jane, I know you must be bored alone in the house all day with me at work. Wouldn’t it be nice to be someplace where you can be around interesting people and have stimulating things to do?"
DEALING WITH RESISTANCE
Be prepared for your loved one to resist any conversation about their diminishing independence and health. They may be offended, telling you to mind your own business, or they may dismiss your concern with reassuring statements, preferring to pretend that life is as normal as it has always been for them.
Moving to an independent or assisted living or skilled nursing community can be one of the best decisions a family can make for an aging parent, particularly when activities of daily living become more than they can handle, social isolation is an issue, or their care needs are more than family members can provide. Starting the conversation early will make your loved one’s transition into their next phase of life easier and more enjoyable for everyone involved.
(The following references were used in preparing this information: Loverde, Joy. The Complete Eldercare Planner. New York: Three Rivers Press, 2000. Solie, David, M.S., P.A. How to Say It: Closing the Communication Gap with Our Elders. New York: Prentice Hall Press, 2004.)