CONVERSATIONS WITH AGING PARENTSIT'S NEVER TOO SOON TO TALK ABOUT THE FUTURE
By Jen Bradley
It’s sometimes hard to grasp the fact that as we age, so do the ones who have cared for us our entire lives. At what point do the caregivers become the ones needing care? The circle of life is a reality, but that doesn’t mean it’s an easy one to accept or manage.
The frank talks we must have with aging loved ones sometimes can creep up so fast they take our breath away. Family homes must be sold, belongings moved to a new place and changes made in what seems like an instant. Local professionals weigh in on how to make these conversations happen earlier and easier and, in turn, make the outcomes a lot happier.
THE EARLIER THE BETTER
It’s really never too soon to sit down with loved ones and talk about life after retirement and beyond, says Beth Johnson, marketing representative from Oakwood Village. “We encourage families to have this discussion when there is time to plan, research and involve your parent(s) in the decision. Too many families wait until there is a crisis.” Local professionals agree that a crisis is the most stressful time to have difficult conversations about money, living arrangements, additional care and even hospice. Part of this stress comes from a loved one potentially having their input taken out of the equation, for a variety of reasons, such as severe illness. “A crisis changes your options,” explains Krista McCook, the chief operating officer for Mosaic Management Group, which owns and operates 11 Artisan senior living facilities in Wisconsin. “If you can make changes sooner, hopefully a loved one can be in a situation that will help them age well for a longer time.”
Jennifer Klug, regional director of customer relations at Oak Park Place, agrees that maintaining a high quality of life is crucial, and says it’s essential to ask a loved one what life experiences they feel they are missing as they age such as driving in the evening or playing with card clubs. Klug says senior communities offer dinners with neighbors, music and art opportunities, and so many others. She explains many seniors say they experience greater independence in a retirement community than when they were living alone.
Another signal to arrange a talk about what comes next is when a family member notices changes in their loved one, whether physical, mental, social or emotional. Klug says that differences in normal appearance and lack of personal hygiene are warning signs. So are spoiled food in the refrigerator, medications gone untouched or undone laundry. It’s helpful to consider what that person’s “normal” is, she says, and caregivers can often pick up on those signs.
Johnson adds that another indication for help is when one parent is caring for the other, and that responsibility is taking a toll on them physically, mentally or emotionally. “Then it’s time to take action,” she adds. “Likewise if a parent is feeling lonely and isolated, or their mobility is dramatically decreasing, this would be a good time to talk also.”
When the time does come, families will realize that “if” becomes a “when” and “how.” Cheri Milton, Agrace HospiceCare’s community grief specialist, says that in the perfect world, dialogue has been happening all along, planting seeds which will be there at the necessary time. She offers an example of what she calls a courageous son who initiated to his siblings during a family reunion that they needed to talk. Their father had been diagnosed with a terminal condition, and Milton says the family was surprised and thrilled that the patriarch actually did want to discuss things, but was scared to bring it up himself.
“Our loved ones often want to talk about things,” she says. “They know they are getting older, things are changing, maybe they are facing some serious health concerns. Often, everyone is trying to protect everybody else. The son said you could visibly see the relief on his dad’s face.”
WHO TO INCLUDE IN THESE CONVERSATIONS?
It’s important to decide who to involve in family meetings and ongoing conversations about an aging loved one’s care, experts say. When it comes to talking about money, though, Colleen Johnson and Ed Kindschi, senior vice presidents at Johnson Bank Wealth Management and Johnson Bank, respectively, know that things can get complicated.
“All the siblings obviously have a vested interest in whatever remains in the end,” says Kindschi. “But when it comes to paying cost of living increases for mom or compensating a sibling for caregiving, that’s where it gets difficult.”
He says he recently had a discussion with a family on just this topic, and he reiterates that it’s never too early to start the conversation. Kindschi says this is even more imperative if a loved one has memory loss and needs to choose someone to take on financial power of attorney.
McCook agrees, saying that cognitive function in a person with memory care needs will decrease and affect their problem-solving abilities. “It limits their participation in the conversation and you want them to be involved in the plans for their future,” McCook notes.
She also says that family members should be involved to the extent they can and want to be. If a relative lives far away, it might be beneficial to schedule a meeting with siblings and parents (if that time has come) when they are in town. Other times, the long-distance relative may need time for a “reality check” of the situation as it is, not how he or she may think it to be.
“I think that makes a big difference,” McCook says of the time spent in observation. “But everyone should be invited to participate in the discussion, though they may not want to be involved at the same degree.”
And, adds Johnson from Oakwood Village, siblings should also be aware of not “ganging up” on their parents and causing a more challenging situation. Agrace’s Milton agrees. “They may not have real clarity initially because this is not something they ever wanted to think about,” she says in reference to hospice care.
No matter what, all agree that concrete change is dependent on the person’s personality or temperament. Some aging family members may be far more resistant to change than others. McCook adds: “Change is scary. Find out what they are afraid of, and then have a real conversation instead of just saying they need to make a change.”
WHERE TO HAVE THIS CONVERSATION
Location for and timing of these crucial conversations are important. Think of when your best time of day is, and where you are most comfortable. Our loved ones have the same idiosyncrasies and it’s much easier to adapt to theirs when this time comes. Klug recommends planning ahead. “As adult children, this becomes a role reversal and it’s not always easy,” she says, and notes that many adult caregivers are also in the sandwich generation, raising children of their own. “They’re used to telling their kids what to do, but talking to parents can be difficult.”
McCook says eliminating distractions and prior obligations is important when choosing a time and location. “Don’t do this during a big family function or when you have a bunch of other appointments that day,” she says. “That’s not the time. You should set aside a specific time.”
She recommends talking during normal visiting periods. For example, McCook says she visited her parents every Sunday when they were alive and that would be a good time to broach delicate topics. They were expecting her anyway and it was a comfortable, easy-going physical and mental space for everyone.
Milton agrees wholeheartedly and says that nothing should be done “willy-nilly” in the pressure of a moment. “Schedule a time,” she stresses. “It can sound very administrative and organized, but we know these are very emotional conversations for families.”
HOW TO START
Milton offers some great advice on where to start these tough conversations, especially when they include discussions about hospice care. She suggests caregivers “depersonalize” the situation initially. By this, she means mentioning something interesting you’ve learned about hospice and asking a loved one if they had ever heard that, or talking about a mutual friend whose family member is needing hospice care. “Say something like: ‘Boy, mom, when and if that would ever happen to you, what are your thoughts?”
Johnson, from Oakwood Village, says a good way to approach a difficult conversation is by simply talking to loved ones about their future. “Where do they see themselves living in the next year, three years or five years from now? Have they thought about how and where to get support if they need help?” She says general questions are much easier to start with as they are less intimidating and not asking a parent to make a specific decision.
Klug advises to, above all, listen to a loved one. “Hear how they are feeling,” she recommends. “What are their concerns and what’s important to them? Are they worried about leaving home and why? Is it the markings on the wall where the kids grew each year?” What makes them nostalgic about staying put?
McCook and the financial advisers at Johnson Bank suggest families look to professional resources for help if they feel the conversation may get tricky or their loved ones may have questions right away. “The family might choose to meet with a financial adviser or elder law attorney to start the discussion around finances and health, and begin to set a plan for costs related to care,” says Johnson from Johnson Bank.
Her colleague, Kindschi, agrees. “We’re not making personal care decisions, that’s up to the family,” he reassures, but adds that in tough conversations that third-party can help deflect emotions, offer ideas and insight, as well as take some pressure off individual family members. “This may be the first time that the family is going through something like this, but chances are their adviser has dealt with it and guided other families numerous times.”
WHAT IS THE GOAL?
By and large, the professionals concur, the goal of any initial conversation is information gathering. Johnson, from Oakwood Village, says that loved ones’ preferences and options should be discussed. Where would they like to stay if things change? Do they want to be relocated? How about visiting some senior care facilities in the area just to learn about choices for if/when the time comes?
She adds that in Madison, waiting lists are common. “If a parent is not interested in moving, it’s just sometimes better to get on a waiting list because there is no pressure to move and they are better prepared to if they have seen a few communities and choose one that feels most comfortable.”
Klug says that it’s essential that caregivers let loved ones know they are there to support them, but also see there is a need. She says families need to explain that they will be strong for them through the process, and also reinforce that it’s the right decision. “You truly must support them and understand their needs, wants and desires throughout the multiple conversations.”
McCook agrees, and says that loved ones and caregivers need to work together, and these first conversations are good for fact finding, but a plan should always be in place for what the next step is going to be. Ask them: “What’s working? What isn’t? What are some of the challenges?”
She says that there’s usually something driving this conversation and there may be an immediate need that can be addressed with a short-term plan, with a longer-term solution in mind. She says that a goal of the first conversations is also not to put loved ones on the defense.
She also says that it’s important to empower loved ones during this time, maybe talking about challenges they’ve faced previously in life and how they navigated other transitions. “Tell them they were successful in those situations and maybe they could share why,” she says. “Then ask: ‘What are some things we can do to help you with this transition?”
Johnson adds that if a parent is reluctant to chat about difficult topics, she says it works to say that “they are helping you/ doing you a favor.” For parents who insist they are doing just fine, this might be a way to achieve cooperation, she explains. She also recommends talking to parents at least a year in advance of a potential move. And if the children see their parents regularly, Johnson says this conversation will unfold naturally, over time and with less stress than a crisis situation.
CHANGE STARTS WITH THE FIRST STEP
Klug, of Oak Park Place, says the best way to initiate change is by incremental steps.
“Agree to talk more about it. Agree to take some tours. Agree to have dinner with some residents. Agree to do it as a trial. It needs to make sense to them and they should get to be a big part of the decision.”
In terms of financial decisions, Kindschi and Johnson from Johnson Bank say it’s a good idea to have certain family members have specific responsibilities.
“Everyone should have a backup plan and have someone that is informed of where documents are, where belongings are, who’s in charge should something happen, etc.,” says Johnson.
Milton says she repeats herself over and over again, but it bears repeating once more: “People want to talk about things more than we ever can imagine. Once they do, whether they wanted to or not, 99 percent of the time, everyone involved is so glad they did. It might be hard to jump into, but they are so glad they did.”
Klug has seen the same thing. She also adds that it might have been years since someone lived in an apartment, if at all. “It’s a big change and it’s exciting too,” Klug adds. “We often hear people say they wish they’d done it sooner. I think the hardest part is just making the decision to do it. Once they do, they see all the benefits.”
Johnson concludes with these thoughts: “It’s important for both the parent and child to keep in mind that one of the best reasons to have a conversation is so that a child can help their parent live safely and happily. It’s a wonderful way for everyone to be prepared in case of a health care emergency.” Emotions may be high through any of these conversations, but likely will be even more so when decisions must be made fast. “It’s really never too soon,” she says.