As our parents get older, it is often difficult to speak with them about issues they will confront in the aging process. The most important thing is to start the conversation early. Begin the dialogue when your parents are in good health. Do not wait until they develop a serious illness or are unable to make decisions for themselves. Here are some tips to help with the dialogue.
Enlist other family members to participate in the discussions. First, find out what their opinions are before you start the conversation with your parents. It is best to present a united front, so try to reach a consensus before you include your parents in the discussion.
Use good communication skills. Do not offer advice, but present your parents with options. Listen to their needs. Ask open-ended questions to better assess their views and enhance the discussion. • Understand your parents’ need to control their own lives. A sense of losing control is very frightening. Parents have a right to make decisions, but often you need to balance their need for independence with safety issues.
If you and your parents disagree, allow their wishes to prevail until their health or safety is an issue.
Address competency to drive before it becomes too late. This is a huge issue for the elderly because it affects their independence and their sense of control. If you have concerns that your parents are not safe to drive, it is often better for the family physician to address this issue, to avoid your parents blaming you if they are not allowed to drive anymore. There are ways to assess driving ability using simulators which provide objective data that the physician can use. Be forewarned that even with objective data, your parents will struggle with giving up their car. This is an extremely sensitive issue.
Ask your parents details about their finances. While this may be a difficult topic to discuss, it is important to know about insurance policies, trust documents, tax returns, bank records, investments, etc. Find out where they keep their paper work and organize the papers if necessary.
Ask about living wills and health care proxies. Understand your parents’ wishes concerning their medical care. It is important to have this in place before there is a medical crisis.
Gather information for your parents about their Medicare benefits. Medicare does not usually cover long-term care, so it is helpful to explore whether long-term care insurance is appropriate.
Identify community resources. Find out what services are available for your parents should they decide to stay in their home as they age.
Re-evaluate the situation on a regular basis. Your parents’ needs can change rapidly.
If you are having trouble with these conversations, consider involving a third party such a family physician, financial planner, attorney, or geriatric care manager. Most importantly, always treat your parents with love and respect and let them know you will be there for them as they age and confront any difficulty.
SUSAN LOCKE is Healthnetwork Foundation’s medical director.