By A. Frank Johns
There is a price for not talking.
Family conversations concerning long-term care and end-of-life issues are some of the most difficult. That is why they are so often avoided. Their difficulty makes them so anxiety driven and emotionally draining that many find it easier to never start. Beginning the talk is costly enough. Beginning it correctly is priceless.
The Talk = The Conversation with Aging Family Members About Their Long-Term Care
Even when started correctly, navigating the talk is tricky. Inviting parents and grandparents to talk openly about these issues is no easy task. But families tackling this task are better prepared to address long-term care and end of life issues than those who delay until it is too late.
Baby boomers are aging. “There are more Americans age 65 and older than at any other time in U.S. history,” reported U.S. News after the census reports of 2012.
Top Ten Red Flags That Lead to the Talk
Gradual, but notable loss of vision, hearing, or mobility for which the person will not see a professional;
Sudden unexplained weight loss in short period of time for which the person will not see a professional;
Significant lack of personal hygiene, or leaving the house dirty when usually well kept;
Gradual, but notable forgetfulness, confusion, with longer periods of memory loss;
Strangers, neighbors or long lost relatives becoming the “best friend” or companion, and the parent or grandparent hardly knows their name;
No food in the house, or its rotten and months out of date;
A new boyfriend or girlfriend (often gigolo or gold-digger) declaring “love” and wanting your parent or grandparent to marry them;
For several months mail-order boxes have been showing up and your parent or grandparent does not remember purchasing them (or won’t admit it);
Someone unknown to the family took your parent or grandparent to get some legal papers but your parent or grandparent has no idea what they are and has no copies;
You have been told that your parent or grandparent has been taken out of state to live with a distant relative you have not seen in decades.
Many of these are obvious, and it may be too late for the talk. Many others create the opportunity to start it.
Topics related to aging and eldercare have reached a fevered pitch not just in politics and policies, but also in dining and living rooms across America. Rising health care costs, changing Medicaid and Medicare laws, and a growing variety of senior housing alternatives and long term care options are a few of the issues facing families who have aging parents and elderly grandparents.
If you are joining your family for a reunion or vacation this summer, here are things you should consider to begin "the talk":
Stop, Look, and Listen
Stop and think carefully about the words you will use to begin – invitational, not demanding; courteous, not condescending;
Look at your parents or grandparents physical and mental abilities over a period of several years (go back and see what pictures, letters, audio recordings, medical and care-giving notes tend to reflect); and
Listen (really listen) to your parents or grandparents as they are able to give direct and decisive answers to your request for having the talk. If there are notable declines, the time to put legal protections in place may be running out. However, even for people who are perfectly fine – it is still important not to procrastinate on major legal decisions.
The Opinion of Others – Talk with other family members. Do they have similar concerns? Ask them to help open the conversation and set the groundwork for future talks.
Proper Mindset – Maintain the mindset that it is THEIR best interests for whom your work is critical. Nothing contaminates the discussion quicker than the sense that the “helpers” are acting selfishly and trying to advance their own agenda.
Minimize Sibling Rivalry – Family members don’t always see eye to eye. Discussing the well-being of your parents can conjure memories of childhood conflicts. When possible, leave those conflicts at the door. It is important to keep in mind the bigger goal: what is best for mom and dad.
Blended Families Need Transparency – If your parent or grandparent has remarried and there are children on both sides, start the conversation early on and don’t stop, beginning with the other siblings, and then with your parent or grandparent.
The Referee – As with effective mediation, identify one person most known for level-headed moderation to act as the point-person facilitating the dialogue.
To-Do List – For some, the best technique is keeping a list of all the questions or concerns that require family attention and consensus. Working from a list can help keep everyone on topic and assure nothing goes overlooked.
Engage Your Compassion – Above all else, be sure to turn on your empathy with your parents and siblings. They are your family and your warmth and heart felt concern with and for them is crucial.