An 80-year-old woman cares for her husband after a stroke. He dies, and she is depressed and grieving. One day, she falls and breaks her leg, requiring a hospital stay and rehab. Her adult children struggle to decide her next step. She had never discussed her preferences with them. They decide to sell her home and have her move in with the oldest daughter. She knows her children mean well. But the mother is blindsided by this decision and saddened by the loss of her home and possessions. It is hard for her to adjust to a noisy house full of teenagers. No one is happy in this situation.
Having the Tough Conversation
It’s difficult to talk to parents about their finances and healthcare plans. But this is a conversation best held before a crisis hits. That way, older parents can communicate their preferences and make decisions while they are healthy and lucid. How do you start planning long-term care for a parent despite the discomfort? Let them know you want to understand their intentions to be sure you respect their wishes if their health declines.
First, the Fun
If your parents are newly retired, find out their plans for this phase of life. Do they intend to work part-time, travel, downsize to a smaller home, move to a warm climate, take ballroom dancing? Understanding their intentions will help you make decisions on their behalf.
Start with a Story
One way to open the planning conversation is with an anecdote about a friend who required long-term care. That is, they needed ongoing assistance with activities of daily living, such as bathing, dressing and eating. Mention how that person’s preparation (or not) affected their loved ones. Ask your parents what they would want to happen in that situation. Who would coordinate their care? How would their spouse be protected? What role would they like you to play? What resources do they have to cover their needs? Be sure they understand you are not trying to control their lives or take advantage of them. You intend to follow their wishes.
If your parents have experience with caregiving, they have likely planned for a long-term care event. Find out if they have long-term care insurance which covers the cost of care at home, in assisted living or in a nursing home.
Often, family members pitch in to care for a loved one in the early stages of memory loss. In this case, adult children must coordinate a parent’s care. Making a care plan with siblings often leads to conflict. Financial disputes, differing expectations and uneven caregiving participation can cause disagreements. To address these issues, invite a facilitator from a senior living community to your family meeting.
Complete a Living Will
Your parents must designate someone to communicate their desires to health care professionals if they cannot speak for themselves. For this, they complete an advance directive, or living will.
Look at Living Situations
If your parents are healthy and active, they are probably comfortable remaining in their home. But if they have memory loss or health issues, planning long-term care for your parents means reviewing caregiving options. A candid talk about finances is part of this conversation. Find out how your parents feel about care choices, including:
- Homemaker visits to the home: this helps people who need assistance with basic activities, like dressing, meal preparation, or light housekeeping. Someone who lives with family or is relatively independent benefits from this option. However, a person with memory loss who forgets to turn off appliances needs more supervision than these visits provide.
- Live with relatives: children of older adults often feel caring for their parents is the kindest alternative. But caregiving is an exhausting and overwhelming job. If the caregiver works during the day, the older adult is isolated and bored during those hours.
- Attend adult day care: allows for socialization and gets the older adult out of the house. It also makes it easier for caregivers to work or run errands.
- Move to an assisted living center: in these communities, older adults live in private apartments and access many support services. These include housekeeping, laundry and meals served in an on-site dining room. Residents also participate in a variety of social, creative and educational activities. Some centers have memory care services.
- Reside in a nursing home: older adults with more serious health needs require more care. These centers have medical staff available to address residents’ health needs.
Making a Long-Term Care Plan for a Parent
Planning for a long-term care need is an awkward topic for parents and adult children. But framing it as making choices for your future and assigning responsibilities is far more positive. Start the long-term care planning conversation with your parents by discussing their dreams for retirement. Follow up with questions about how you can help them maintain independence if their health declines.
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