Starting the Parent Care conversation . . .

There are numerous reasons why we don’t want to have this conversation and avoid it at all costs.  It’s awkward . . . it’s emotional . . . it feels presumptuous and uncomfortable . . .  the list goes on and on. However, demographics are clear that the parent care crisis will only increase in the coming years. The best way to prepare is to have a dialogue between adult children (us) and our aging parents about how best to prepare for, and how best to enjoy the rest of their years. It is important for the conversation to address both quality of care, as well as quality of life. So we know we need to have the conversation – but how to start?

During eldercare consultations, I often hear adult children begin the conversation with a decision (Mom needs to go to a nursing home, Dad needs to buy long term care insurance). However, you can’t run before you can walk . . . so this conversation might be a little premature.

Dan Taylor, in his book The Parent Care Conversation suggests that there are actually six conversations that address the fundamental areas that adult children and their aging parents should address:

1. The Big Picture Conversation.   This is the conversation during which adult children discuss with their parents the future that they see for themselves (which could be very different than what the adult children might expect). Some examples to begin this conversation might be:  “Mom and Dad, let’s talk about where you think you want to be 10, 20 years from now and what you think that would look like." This gives you something to work with. For example, if the response is that they see themselves staying in their home, you can begin discussing options for aging in place. Asking questions about the big picture gives you an idea of the future your parents see for themselves, and at that point the family can start working together to help to make some version of that future a reality.
2. The Money Conversation. Very often the money conversation will follow the big picture conversation . . . for obvious reasons. There are numerous reasons why people feel uncomfortable discussing money, however, it is crucial to get a sense of the overall financial picture in order to formulate a long term plan.  Unless you know what resources your parents have and where those resources are, you won’t be able to assist them in protecting and using those resources in a meaningful way.
3. The Property Conversation. Taylor points out that “Miscommunications and misunderstandings occur under the best of circumstances, in even the closest of families. Under the worst of circumstances, such as the death of a parent and the disposition of his or her possessions, miscommunications and misunderstandings can exacerbate an already emotionally charged situation”. Possessions, especially family heirlooms, or those with sentimental value, can exert a powerful hold on families and discussions regarding distribution of those items can quickly escalate. Ideally, a conversation can occur whereby parents can come with a plan for distribution, such as a will, or communicate with all children how items are to be distributed.  Here is an article published by elderlawanswers.com with six ideas for distributing personal property in a fair way.
4. The House conversation. There is a reason the saying goes “A Man’s (and Woman’s) home is his/her castle”.   Home is a symbol for most of us - of both self sufficiency and independence.  As this article indicates, most Americans say that they want to stay in their homes as long as possible.  There are powerful shared memories associated with our homes, and the notion of leaving home is a powerful metaphor for leaving our independent way of life.   It’s often important to keep in mind that the outcome this initial conversation is not to prompt a “stay or go” decision, but to begin to consider what options might be available to them.
5. The Professional Care Conversation. It is quite possible for most people to age in place successfully, provided they have adequate support.  This help is usually in two forms:  informal and formal support. Informal support is that help that comes from family, friends, neighbors, church community, and others.  It can be in the form of preparing meals, providing rides to medical or other appointments, or just an informal visit to ‘check in’, among many others. Formal support is paid assistance that can be provided by in home care agencies or individual care providers. These supports can play a vital role in allowing older adults to age in their homes when they begin to have care needs, either in the form of medical needs (such as physical therapy) or functional needs (such as assistance with bathing).
6. The Legacy Conversation. Taylor points out that “As human beings, we have a deep need to build connections and to establish transitions for ourselves as a way of gaining perspective on how we have lived and what we have achieved along the way.”    Beginning this conversation with our parents is a way to honor our parent’s journey and to recognize it in a way that is meaningful to them.  This conversation might be initiated with the question “How would you like to be remembered?”

Keep in mind that the goal of creating any kind of a care plan for your parents is to decrease anxiety and increase confidence about the future.