Talking About the Future with an Aging Parent
Talking About the Future with an Aging Parent
I visited with a friend recently, and we shared the problems we face taking care of our moms now that they can no longer care for themselves. Our conversation progressed to the mutual concern we share about younger generations of future caregivers who have seemingly not given much thought to this time in their lives. I’ve heard things like, “I will just put mom in a nursing home when the time comes.” My friend and I agree that this type of thinking can make care decision-making for an aging parent that much harder when, not if, the time comes.
While some cultures expect to have several generations living together, this is not a common practice in the U.S. In fact, families seem to be living further apart than in the past and, as a result, see each other less frequently--especially during the pandemic when people are more cautious about visiting with older family members. This can contribute to gaps in communication, so families must work harder to discuss difficult subjects. Failing to do so can make a health problem or unexpected diagnosis feel like a crisis. In my experience, planning ahead and talking with your parents about what they want before they need help can help you make clear, informed choices on their behalf--not to mention bring you closer together.
Planning for advance care conversations with an aging parent.
Whether your aging parent is healthy or has recently received a life-changing diagnosis, consider these suggestions before approaching them for a conversation about their care needs:
- Identify and join support groups, either in person or virtual, that address your specific concerns.
- Educate yourself on common issues people face in older adulthood and how to prepare for the caregiver role. Here are some books for caregivers to help get you started.
- Talk to others about what they did for their parents and why they made certain decisions.
- Decide that you are flexible in wanting to know what they desire. (After all, they raised you and made decisions based on what was best for you i.e. changing jobs/schools, moving, etc.)
- Figure out ahead of time what topics you want to get their opinion on.
How to have the conversation.
Here are some communication tips and strategies to keep in mind once you’ve decided to talk to them about their wishes:
- Bring up things you see happening to a neighbor or another family member as an entry point for these conversations. Then ask, “If that happened to you, mom, what would you want me to do?”
- Find out if there are decisions your parents have already made about their wills, their own care, and other future medical and financial needs.
- Once a conversation has begun, keep your emotions in check. Be kind and gentle talking when talking with your parents about these subjects.
- Tell them what you’re willing to do should specific care needs arise, and help them identify others, including friends and paid support, who should be involved in their circle of care.
- Ask them whether they would be comfortable living with you or another member of your family if they’re no longer able to live independently.
- Agree to have more discussions as a family and bring up one or two topics at a time.
Example questions to ask your aging parent.
What are some of the questions you need to discuss? This is not a comprehensive list, but consider:
- Where do you want to live if you cannot live alone?
- Where are your important documents stored? (I.e. wills, advance directives, bank statements, etc.)
- Where is the key to the lockbox?
- Who is your power of attorney?
- Who is the executor of your will?
- When do you plan to scale down/give away or sell your heirlooms/etc.?
Understanding an aging parent who won’t (or can't) share their care wishes.
Here are issues that make it harder to have advance care planning conversations and the reasons why your aging parent may act or react in certain ways:
Your parents are only human and may be uncomfortable or fearful talking about getting ill or dying.
Parents have more years of living and experiences than we do. They may have already gone through loss of control or loss of their finances. They may recall some of our foolish mistakes with money, and it makes them fearful of losing control again. They might have saved by scrimping and saving in ways that we don’t understand and are now concerned that handing over their money before death is a mistake. They might imagine someone will spend it instead of paying their expenses.
Parents may still see their grown children as children and are doing their best to stay strong for them.
We appear as children in our parents’ eyes, no matter how old we are. Even when they experience declines in physical and cognitive ability, they may have trouble sacrificing their independence. They may also have difficulty recognizing that we are capable of doing what needs to be done to take care of them.
Complicated histories play a role in how parents perceive their child’s intentions.
The nature of the relationships our parents have kept both inside and outside of the immediate family over the course of their life can affect their sense of trust. Not every family has good relationships. If someone from their past has been abusive or neglectful, for example, these memories are still accessible and may cause them to express themselves in ways that make it challenging for you to care for them--especially for those living with dementia.
If a parent is already in the early stages of an illness like dementia, it may be harder to have a productive discussion.
The more you try to press for information, the more fearful they may become. Furthermore, if a parent has never shared where they keep their will or what they want for their funeral, it will be much harder for them to start this conversation as their memories diminish.
Keep in mind that every care decision will cost money. Senior living options, like assisted living and nursing homes, are costly and can deplete a parent’s savings in a very short time. Medications and treatments for specific conditions can also contribute to ongoing and unexpected out-of-pocket costs. That’s why it’s so crucial to begin talking about these decisions as a family before they need to happen. It is never too early to talk with aging parents about their wishes, but it can be too late.
Adapted from "It Takes Courage to be a Caregiver,” by Cheryl Ginnings, which explores lessons learned from those who have cared for someone with Alzheimer's or dementia. You can contact Cheryl at cheryl[at]cheryl-ginnings.com with any questions you may have.
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