December is the month when families gather for holiday festivities and holiday cheer. It’s a time when adult children get together and see first hand that their parents have aged; they see that family life, as they remember it, is an image of the past. With aging parents comes difficult issues that need to be addressed in a serious, non confrontational conversaton before a crisis occurs. How to start and what to say in the conversation is succinctly described by Anne Osmer of WWJ 950 radio:
Finances. Wills. Long-term care. Housing preferences. End-of-life care. Death.
Not exactly cocktail party conversation, right? When it comes to discussing these topics with a parent, they can be downright contentious. Small wonder most people avoid bringing them up.
But bring them up we must, because avoiding these conversations with parents is a recipe for disaster. Stories abound of adult children at a loss when a parent suddenly needs help, or dies. Sorting through someone else’s finances and legal papers is never fun, but it can be a nightmare when you don’t know where to start – all while dealing with the emotional side of the situation. And trying to make decisions for a critically ill parent can be challenging when you don’t have the legal standing to do so.
Planning ahead with a parent for their future – and yours – can avoid headaches and heartache later on. Ideally, you should plan together before any major crisis occurs, such as a bad fall or illness.
“It’s so much easier to have those conversations when there’s not a situation,” said Virginia Morris, author of “How to Care for Aging Parents” and an expert on aging issues. She advises to “open the door” before a crisis occurs, since following up on practical measures after conversations take place can take some time.
Morris said it’s important for children to consider their approach to broaching topics related to planning for an older parent’s future. Don’t be condescending or aggressive. Often siblings will get together and decide what they think is best for mom or dad and present it to them. Bad idea, said Morris. Respect is a key ingredient for a successful outcome. Children should start by simply listening to their parent.
One way to start a conversation is by asking a question: “Gee, Dad, I’m considering long-term care insurance – what do you think? Do you have any” or, “Mom, I’ve been reading a lot of articles lately about planning for later years. I’m going to revise my will and make sure my legal documents are all set. What about you – can we talk about this for you?”
Bringing up topics as shared conversation or as seeking advice is less confrontational than presenting mom or dad with a ready-made plan. Besides, if you don’t know what your parents are thinking, how can you help them plan? Let your parents know the conversation is about them and their wishes for the future.
Dan Taylor, author of “The Parent Care Conversation” and creator of The Parent Care Solution, a process designed to facilitate communication, recommends talking to a parent in terms of expanding or retaining their autonomy as they age. “You cannot talk about the ‘death train,’” he said, a conversation that tends to shut the conversation down. He suggests the question, “Mom, if we could support you in the future, what type of support would you like?”
It’s important to plan for the future now, said Taylor. He believes that going forward responsibility for one’s elder years will rest more on the individual and less on the government. The bottom line: If you want to have a good quality of life as an older person, and ensure the same for your aging parents, plan early.
Some important points to discuss with a parent:
Legal issues are most critical. At the very least your parent should have an up-to-date will, a durable power of attorney for both legal and healthcare decisions, and a living will. You should know where these documents are, and Morris recommends your parent’s doctor have a copy of documents relating to healthcare. While most documents can be drawn up on one’s own, it’s a good idea to see an attorney specializing in elder law who can advise you on your particular situation.
Housing. This can be a tough conversation to have, especially with a healthy parent. Find out where your parent would like to live if she had to leave her current home. Be careful not to make any promises you can’t keep. While you think it might be fine to have mom live with you, situations change. Caring for someone who needs a lot of medical help can be difficult at best, and at times impossible.
Financial. Medicare doesn’t pay for long-term care, and an annual nursing home bill can easily reach $75,000. What is your plan for paying for long-term care, should the need arise? Does your parent have long-term care insurance? Is he or she near the level for Medicaid benefits? These are questions to explore, said Morris. She also advises simplifying your parent’s finances as much as possible through direct deposit and automatic bill pay.
Medical care. Does your parent have one doctor who can coordinate care? It’s important to have someone who is the “captain of the ship,” said Morris. Keep a list of every medication your parent takes and make sure he or she has it at every appointment.
End-of-life care. “This is a conversation no one wants to have, but it’s so important,” said Morris. If your parent says he would want you to “pull the plug,” make sure you know what that means. Is that if he’s on life support and in a coma (a rare situation)? What if he can only receive nourishment via a feeding tube, and is coherent at times? Do you “pull the plug” then? While talking about end-of-life care is hard, it’s also rewarding. “It brings such intimacy,” said Morris. “You will recognize that they are mortal. You don’t put off things. It’s really very powerful.”
What if a parent won’t discuss their future with you? You may want to consider getting a neutral party involved. Taylor trains professionals such as lawyers and financial advisers to be parent care specialists, who can help navigate the maze of issues related to aging.
Taylor tells clients whose parents won’t talk at all, to request that their name be taken off all legal documents. Usually it doesn’t come to that and conversations are productive, he said, but when a child is in the dark it can turn into a very bad situation later on.