How to Talk to Aging Parents About Their Future: Step-By-Step

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Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

The thing about the future is that it is hard to imagine. It is true that some people think a lot about the future, but most people have a tendency to procrastinate. As a child to aging parents, that is where you come in because sooner or later, you will be involved. 

Jump ahead to these sections:

Planning the future has enormous advantages for both you and your aging parents. The painful process now can give you all peace of mind and a path to follow for the future. Take your time with these discussions but keep your eyes on the goal. Prepare by going through our steps on what to include in your talks.

How Should You Start the Conversation About Your Aging Parent’s Future?

Starting a conversation about your aging parent’s future might be the hardest step of all. How do you broach the subject? What do you include? How do you honor their wishes and respect their fears and anxieties?

We have some suggestions on starting the conversation to open the door to more detailed discussions and decisions.

Acknowledge your parent’s fears

This step doesn’t necessarily have to include an open acknowledgment but more of an understanding of the emotional changes that aging brings.

Consider that the fear of loss of independence, control, and death itself may cause your parents to withdraw or resist these conversations.

Be honest about your concerns

Be honest about your concerns without being fatalistic or catastrophic in your communication. Most adult children begin conversations about the future when they see their parents start to decline physically or need more help in the home.

Talk about specifics and your real worries about what you observe. Be prepared for resistance and denial about your concerns.

Tone is everything

Your tone and attitude are crucial to the success of your conversations. If your parents are starting to feel their independence slip away, foster empowerment. You can accomplish this by using a respectful approach that is collaborative rather than directive.

The more you dictate to them, the more your parents may feel pushed into making decisions. This can lead to resentment on their part.

Have a plan

Having a plan provides structure and reassurance. Know what you want to talk about by having advance directives handy and an agenda prepared ahead of the discussions. For every problem that needs solving, have a potential solution in mind.

Be prepared for several conversations

Future planning is complicated and takes time. Depending on how far along you are in the process with your parents, be prepared for multiple conversations. Try not to pressure but keep the process moving forward. If things get derailed, come back another day.

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How to Talk to Aging Parents About Long-Term Care Planning

Long-term care planning involves lots of moving parts, and these discussions can be overwhelming. A good approach is to break down long-term care planning into sections that reflect growing care needs. In other words, identify specific things that may happen and what services might be required to help.

A major medical event is different from a gradual decline or increasing cognitive impairment. Sometimes just one form of support is needed and other times several. 

Home health care

Home health care can be an easier topic to talk about because insurance pays for it, and your parents could be very cost-conscious. Although certain criteria must be met to qualify for home health care, the service tends to be underutilized and misunderstood. 

Your parents may qualify now for home health care based on their need for nursing and the fact that they are homebound. Present the idea of home health as temporary support to improve functioning and independence. Since it is time-limited (in most cases), there is a good argument to be made that maximizing nursing, physical and occupational therapy, and aide service is a positive step towards independence.

In-home care

In-home care has many advantages, the main one being its flexibility and that it is not based on insurance criteria. The downside and possible point of resistance for your parents is the cost. Unless they have long-term care insurance, in-home care is privately paid.

One way to present the benefit of this support service is to remind your parents that help with bathing, dressing, cooking, and transportation can relieve you of those duties. It also helps your parents remain independent in their home.

Assisted living

Any discussion about long-term care has to include assisted living. These discussions need to be specific and detailed. Have an honest talk about what conditions would necessitate assisted living. 

For most families, finances or the burden of care are the driving forces for considering assisted living. At some point, the cost and management of home care might be too great, and assisted living is a viable option. Discuss the advantages of assisted living and consider visiting some in the area.

Older adults often have erroneous notions of assisted living and are pleasantly surprised when they visit. One touchy but important subject to discuss is the limits to your caregiving ability and availability and when that might be a trigger to consider assisted living.

Rehabilitation

Rehabilitation is inpatient intensive nursing, physical, occupational, speech, and respiratory therapy following a three-night stay in the hospital due to a critical medical event. Medicare pays for rehabilitation, and there are many benefits to opting for this service.

For one, it offers a safe environment for a patient to recover from an accident and illness. Two, it takes some of the caregiver burdens off of you and gives you time to consider and set up in-home services that are necessary when your parent returns home.

Nursing home care

Nursing home care is something most people want to avoid. This topic of discussion can be a good segue into talking about finances (more about that later) and the need to put support in place to prevent nursing home care in the future.

Many people mistakenly think that Medicare pays for nursing home care. Nursing home care is private pay until someone exhausts their financial resources and applies for Medicaid. 

How to Talk to Aging Parents About Advance Care Planning

Advance planning includes all of the long-term care options we discussed above and directly addresses people’s wishes for making decisions about the health care they want to receive if they are facing a medical crisis.

It is human nature to avoid thinking about a crisis that might or might not occur, but avoiding advance care planning can create significant complications later. Start by finding out what paperwork your state requires to get started. You may feel more comfortable meeting with an elder law/estate planning attorney to gather the appropriate documents.

Start with advance directives/medical power of attorney

In some states, the healthcare advance directive includes medical power of attorney. You need them both. Explaining the importance of these documents entails an understanding of what they mean. Your parents may think that telling you what they want concerning their healthcare is enough.

Explain to them that only a legal written document will ensure that their wishes are honored. Also, emphasize that in order to retain control of their healthcare, they will need to specify what they do and don’t want if they can’t speak for themselves. Give specific examples of how this might happen, such as becoming unconscious or becoming incapacitated due to an accident or dementia. 

Also, discuss the importance of healthcare power of attorney. Your parents may not realize that even if you are a blood relative, you will be unable to legally obtain any information about their care without healthcare power of attorney. Not only that, you can’t advocate for their wishes and care without this document.

End-of-life wishes

Who wants to think about the end of their life when they are healthy and doing well? No one. That's what makes this discussion so hard, but you can do it if you approach it in the right way.

It can help to start the conversation by discussing your own personal feelings and decisions. What you want and don’t want at the end of your life and how circumstances might dictate those decisions. Give an example of under what conditions you would want invasive procedures like a feeding or breathing tube.

Open up the discussion in a comforting and accepting way that allows everyone to discuss their feelings without making a decision right then. Allow your parents some time to think about it and come back to talk another day. Suggest they speak with their trusted healthcare providers if they need to.

Discuss burial or cremation choices. Families often assume they know what their parents want, and each parent could want something different. If these decisions are not spelled out, then explain the potential for family conflict over these matters.

Talk about their wishes for funeral plans, and if they don’t have a funeral plan, help them set one up. And don’t forget about organ and tissue donation. 

How to Talk to Aging Parents About Estate or Financial Planning

Oddly enough, sometimes it is harder for parents to talk about their finances than anything else. Some of this is a generational attitude that considers talk about finances inappropriate and crass. Handle the subject of finances and estate planning with care and respect.

Suggest an estate planning attorney

If finances are a touchy subject and your parents are overwhelmed by the process, suggest an estate planning attorney. Sometimes having a professional handle these delicate topics will be more acceptable than involving family members.

Ask about a will

Don’t assume that your parents have a will. Nearly half of adults over the age of 55 don’t have a will. If your parents say they don’t have a will, find out why and try to problem-solve. If cost is an issue, suggest helping with an online will maker. 

Talk about the importance of financial power of attorney

Your parents probably assume that they will have the ability to manage their finances indefinitely. You know this isn’t necessarily true. Incapacity, confusion, fraud, and scams can happen to older adults. When you need to assume some authority over bill paying and other assets, you have to have the legal authority to do so.

One legal mechanism is to suggest a trust where you or another family member can assume financial authority if your parents become unable to manage. Some trusts can be set up, giving you immediate authority if your parents want you to have it, or you can wait until they are ready.

A trust still gives your parents some independence over their financial affairs until help is needed.

Discuss all care options and costs

Financial planning also means considering the costs of care and whether your parent’s estate can pay for care. Cost-of-care discussions can be quite sobering, but it is better to speak now than later when it may be too late. Anticipating expenses creates the framework for careful financial planning and decisions.

Talking to Aging Parents About Their Future

Talking to your aging parents about their future may cause you anxiety, and this is normal. But the stress and uncertainty of not doing so will be worse in the future. Follow our steps to start these meaningful discussions about the future.


Sources:
  1. Germano, Maggie. “Despite Their Priorities, Nearly Half of Americans Over 55 Still Don’t Have a Will.” Forbes. 15 February 2019. forbes.com/sites/maggiegermano/2019/02/15/despite-their-priorities-nearly-half-of-americans-over-55-still-dont-have-a-will.

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