If you dread approaching the sensitive subject with your parents about senior housing and care you are most certainly not alone. For most of us this conversation is right up there with having “The Talk” with our teens about the birds and the bees – awkward and uncomfortable. Equipping yourself with a strategy and clarifying your parents’ goals and preferences will help relieve anxiety for all involved. Encourage your siblings to be involved in the discussion. This will ensure that everyone understands your parents’ desires and needs, and will keep peace in the family, as well as lessen guilt when those tough decisions have to be made.

Practice Good Listening Skills
Recognize that your goal is to assist your parents in exploring their situation and options – not to force an agenda or opinion of your own. Think ahead and prepare for your reactions. Avoid getting frustrated if your parents are not receptive initially to the discussion. The caretaker role reversal which so often begins to take place between adult children and their aging parents can feel stressful for both parties. It’s helpful to keep in mind that your parents are still adults and treating them as you would any other adult will go a long way in keeping the relationship comfortable.

People are more relaxed when they feel they are being heard and understood. As you listen carefully to their concerns you will then be able to hear and dispel some of their fears, such as the loss of independence or freedom. Ask non-threatening, open-ended questions such as “What concerns you most about moving into an assisted living community dad?” Emphasize the positive aspects of minimizing many responsibilities and gaining the freedom to do other things. When you resist the temptation to make decisions for them you can take the long way through discussion and allow them to come to decisions themselves.

Educate Yourself
There are two things you need to educate yourself about:
First, educate yourself on the types of care options available to seniors. Understand what home care provides, what a retirement or an assisted living community offers, etc. For many elderly persons, their only knowledge of long term care options is a nursing home.

Second, if you are not aware of your parent’s financial situation, this would be an appropriate time to find out. Ask about monthly pensions, social security amounts, savings accounts and investments, any long term care policies or whole life insurance that may be converted to cash. Find out if either of your parents served in the military during a period of war time. (There may be benefits available to help pay for long term care.) Although this discussion is again uncomfortable, this information is needed should you have to find long term care options quickly at some time.

It is also vitally important that your parent has a “Durable Power of Attorney” (POA) established prior to becoming incapacitated. This will allow whomever they choose as their POA to make decisions on their behalf, and can specify if those decisions include medical, financial decisions, or both. They (and all of us), also need an “Advanced Directive” specifying what their wishes are for care should they become too ill or hurt to express their wishes. Many fear a loss of freedom if they assign someone as their POA, but a POA can specify that it takes place immediately – or at the time the person becomes incapacitated.

Set the Tone
To begin your discussion, choose an appropriate time and place which respects your parents’ feelings and privacy. Be aware of your own stress levels and choose a time when they will be lowest. The key is to approach the subject with a goal of honest, direct communication. Ask for permission to discuss the topic. For example, “Can we talk about what is important to you should either of you require care or assistance in the future?” If someone they know has recently experienced a crisis of this type, it is the ideal time to bring this topic up. Provide “what if” examples, such as “What is important to you if you could no longer live at home?” “What if you could no longer care for yourself?”

Don’t Make Promises
Please, for your sake and your parents’ sake, do not make promises such as “You can just come and live with us and we will take care of you”, or “I will never put you in a nursing home”. Care needs and circumstances can change, and you may have made the promise with the very best of intentions only to find that this is no longer the best solution. Unfulfilled promises can create such great anxiety, and guilt and potential conflict in a family.

Setting the Stage
These conversations aren’t initially easy and can be challenging. Your loving and honest direct communication with your parents will set the stage for future open conversations. This is an opportunity to become closer to your parents as you move through this life journey together.