Let's Have That Talk About Assisted Living

Downsizing & Moving

When it comes time to have the “conversation,” or talk with your parents about assisted living, it can feel daunting, to say the least. This can be difficult for a variety of reasons, ranging from emotional to financial and everything in between. How will mom or dad respond? Are they going to think you are trying to take away their independence? How can you communicate your concerns to them without making them defensive or angry?

While the majority of older Americans are attracted to the idea of “aging in place,” the reality is that a full seventy percent of seniors aged 65 and over will need some form of long-term care in their lifetimes, according to the U.S. Department of Health and Human Services. You may also have noticed changes that prompt your desire to have this conversation – a chronic or declining health condition, repeated falls, a lack of proximity or availability of family members, increasing difficulty managing everyday activities such as taking medications on time, grooming, eating regularly, or handling chores.

It’s human nature to avoid talking about things that make us uncomfortable, so how do you have this conversation? Here are eight guidelines that may help facilitate and ease the conversation:

  • Have Empathy. Go into the discussion as a listener, not the talker, and allow your parent to guide you. By actively listening, focusing on their message, and putting your emotions aside, you can gain better insight into their main concerns. Also, consider that your parents may already be receptive to this change and merely want to use this forum to be heard. Because so many seniors have spent their lives being the ones in charge, especially in charge of you, this perceived role reversal may feel like a threat or loss. By inviting them into the conversation and truly listening, you can empower them to feel like a participant as opposed to a pawn.
  • Ask about their Fears or Worries. Perhaps your parents are afraid you won’t visit as often once they are “shuffled away” to an assisted living facility. Maybe they fear the grandchildren won’t visit as often or they’ll be forgotten about. Reassure them that you will continue to visit and be part of their lives – in fact, it will be even better when you can all focus on the fun instead of the work that needs attention. Perhaps they fear having to rid themselves of their favorite possessions. Encourage your parents that they don’t have to give everything away and can keep the meaningful items. As we age, we don’t lose the desire to do things for ourselves; In fact, this desire can actually grow stronger when it's threatened. You can support your loved ones’ ongoing independence by seeking out ways to help them adjust to age-related changes without sacrificing their way of life.
  • Don’t Make Assumptions. Initiate the conversation by leading with your own long-term care wishes, or share an article or story about someone faced with a long-term care decision. In doing this, you present your findings as something you read or have been thinking about for yourself, which prompted you to ask your parent if they have wishes or desires for themselves. Don’t assume you are both on the same page. According to the results of a poll from The Associated Press-NORC Center for Public Affairs Research as reported by PBS, very few American families are having conversations about long-term care which creates a lack of understanding between parents and adult children.
  • Include Others in the Conversation. Assessing which option will best suit your loved one's needs can get tricky when various family members bring different perspectives to the table. Perhaps you and your siblings will have different beliefs about the level of care needed. If you are the main decision maker and prefer not to involve siblings, it’s still important to seek out professionals, such as the family doctor, or others who might support your decisions. This can help in the conversation with your parents, and it can provide support for you.
  • Keep it Light. The last thing you want to do is approach your parents from an emotional point of view, expecting the worst and feeling ready for combat. Instead, lighten up! Follow your loved one's lead and calmly let it guide the conversation. Opening the conversation with a joke or using your parents’ sense of humor as a guide is a great way to approach the subject and set a tone of relaxed exploration of the topic.
  • Tour Local Assisted Living Communities. Once you’ve had the discussion and mom or dad are ready, plan a fun day to tour communities. Your parents may have taken you on a college tour years before, and the same fun can be had on your community tours! Make an afternoon of it, take breaks, and space the tours out so it doesn’t feel overwhelming. You will immediately see that many assisted living facilities are more like retirement communities than nursing homes and this may help relieve some fears. From musical presentations and poker nights to bingo and dancing, many communities offer seniors a host of social interactions. Ask to stay for a meal and taste the cuisine. Try to really get a feel of the environment, the residents, staff and offerings.
  • Consider Location. Families today are more geographically dispersed than ever. While we often think about long-term care in terms of the “when,” the “where” is an equally important consideration. Deciding on a location and choosing the right community in that location can depend on a number of factors including cost, proximity to medical facilities, proximity to family, features, amenities and health care services.
  • Be Prepared. If we had access to a script that could smooth away all the challenges and bumps in the road, then moments like these would be easy and predictable. The closest thing to a script is preparation. Be ready to offer information on:
    • Assisted living communities in your neighborhood
    • How the senior care services can make life easier for both of you and meet your loved one's changing needs
    • What assisted living is and is not. There are many misconceptions. Take the time to address each of them such as “it’s not a nursing home.”
    • How you will continue to be involved and support them

Conversations about age-related changes are never easy. Acknowledging and engaging your parents, along with these tips, may lead to a smoother discussion. Remember, you are the listener in the conversation, not the talker. Allow your parent(s) the space to consider their options and give yourself the grace to allow everyone to come along at their own pace.