How to Talk to Your Parent About Moving to Memory Care

Kara Lewis
By Kara LewisDecember 29, 2020
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Memory care offers social opportunities, cognitive engagement, and an enhanced quality of life for seniors with memory loss. People with dementia receiving care from highly trained staff members report fewer symptoms and medical visits than those not receiving such care, according to a 2019 study in the American Journal of Geriatric Psychiatry. In addition, reliable care lowers stress and burnout for family members, the researchers note.

However, to benefit from memory care, seniors and family members must have a conversation about making the transition. “Years ago, families would have a heavy-handed approach, but it’s different now that we’ve learned more about the experience of people living with memory loss,” says David Troxel, former president and CEO of the California Central Coast Alzheimer’s Association. “I encourage adult children to form a partnership with their parent. Be authentic and genuinely express your concerns.”

Follow these steps to improve your chances for a good conversation. 

Step 1: Get support from siblings and family members

Before approaching your parent or aging relative about moving to a memory care facility, contact family members who may be involved in the decision to ensure a united and supportive front. Several key strategies can simplify this process, particularly if adult siblings or other relatives are divided on whether memory care is needed.

Practice active listening

Active listening is a communication tactic grounded in empathy. While it’s easy to be formulating your own response while others are talking — particularly in emotional situations — active listening counters this and encourages conversation participants to stay in the present. According to researchers at the University of California, Berkeley, features of active listening include:

  • Validation. Statements like “I understand this situation is frustrating” or “I can tell this is hard for you” let others know you’re considering their feelings.
  • Paraphrasing and asking for clarification.
    Rewording someone’s statements not only shows you’re paying attention, but it also gives them an opportunity to explain further or redirect misunderstandings. Phrases like “It sounds like…” and “So, what I hear you saying…” can be effective entry points for summarizing a loved one’s points and inviting further discussion.
  • Use “I” statements. This common advice gets repeated for a reason. “I” statements, such as “I feel Mom’s not safe at home,” keep the focus on your feelings, rather than directing anger or judgment at someone else.
  • Ask questions and be curious. Questions can give you a lens into someone else’s viewpoint. Something like, “What concerns you about Mom moving to memory care?” lets the other person share their perspective.

Seek a credible, outside opinion

In situations where families struggle to agree, someone with experience in senior living or senior health can often help lead to a consensus, says Adair Nelson, a Senior Living Advisor with A Place for Mom. In fact, Nelson has served as a mediator in several family discussions throughout her career. Similarly, families might reach out to their parent’s primary care physician, a geriatric care manager, or a neurologist for a professional opinion.

The family needs to have consistent messaging. Keep it conversational. I would focus on socialization, safety, and quality of life issues.

David Troxel, former president and CEO of the California Central Coast Alzheimer’s Association

If your parent has yet to get a neuropsychological exam or it’s been some time since they’ve had one, now’s the time, says Troxel. This helps determine whether or not the family member is displaying symptoms of Alzheimer’s or dementia, as well as how far the disease has progressed. Additionally, doctors will ask caregivers about any changes they’ve observed, as well as use cognitive exam tools like the Mini-Mental State Exam (MMSE) or Montreal Cognitive Assessment (MoCA). In many cases, a thorough doctor’s visit can solidify a decision to move a parent to memory care.

Detail the primary caregiver’s experience

Often, tensions arise between an adult sibling who cares for the parent regularly and other adult siblings. While Alzheimer’s and dementia symptoms may not be easy to observe from one interaction, a senior’s primary caregiver has a more comprehensive view. Troxel, who served as a primary caregiver for his mother for 10 years, recommends caregivers keep a journal and share regular updates over email. This can make other relatives aware of what’s going on with your parent’s condition, as well as help them understand why memory care may be needed.

Step 2: Tour memory care facilities on your own

“I always suggest families tour a few facilities before mentioning it to the parent,” says Nelson. This way, they can reference specific memory care activities and amenities they think their parent or elderly loved one will appreciate. A Place for Mom Senior Living Advisors can schedule in-person and virtual tours with communities throughout the United States.

There’s another key advantage to touring a facility ahead of time: In the event of a sudden fall, injury, or dangerous wandering situation, families can more quickly choose and move their loved one to memory care.

Parents will often say, ‘You’re not shipping me off to a nursing home.’ People have these ideas in their heads that senior living is still like it was 20 to 30 years ago, but it’s changed.

Adair Nelson, Senior Living Advisor at A Place for Mom

To evaluate different communities, families can use this memory care checklist, which includes questions about staff training, amenities, security, and other important memory care features.

After visiting a memory care facility virtually or in-person, the next step depends on what stage of dementia your parent or loved one is experiencing. For seniors with advanced dementia symptoms, having a caregiver choose their community can minimize confusion, says Nelson.

Step 3: Consider who to include in the conversation

 While some older adults may value the opinions of a big group, involving the whole family can make others feel defensive and overwhelmed. As with many components of memory care, the right approach varies. 

  • If your parent has close relationships with multiple adult children, a collaborative family meeting, in-person or virtually, may be the right solution. This allows your loved one to hear from multiple trusted perspectives.
  • If a senior is sensitive about their dementia symptoms, they might prefer a one-on-one talk with their primary family caregiver. This can limit combativeness and resistance.
  • If your elderly loved one is hostile about their dementia diagnosisor denies their symptoms, consider involving their primary care doctor or neurologist. This can lend credibility.
  • If your parent requires memory care due to an emergency, like wandering or safety risks, a one-on-one conversation is the most efficient approach. There may not be time to gather the whole family.

Step 4: Choose the right setting, time, and place

 Once you’ve decided who will participate in the conversation, lay the groundwork to make it successful.

  • Have the conversation in the morning. A talk over breakfast not only makes it more likely older adults will be more mentally sharp, it also minimizes the potential for agitation and anger caused by sundown syndrome.
  • Maintain your family member’s comfort level and privacy. Talk in a place where they feel confident and secure — most often, this means at their home. Whenever possible, it’s best to discuss moving to memory care in person.
  • Use supportive body language and visual cues. As dementia advances, confusion intensifies and physical signaling becomes even more crucial. Provide reassurance throughout the conversation by making eye contact, smiling, and even holding your loved one’s hand.

Step 5: Establish a core line or script

In his many conversations with families moving a parent to memory care, Troxel noticed that each person would use different verbiage when talking to their loved one. Some would position memory care as a temporary solution, while others would say their parent is moving into their lifelong home. Similarly, some family members would empathize with the difficulties of adjusting to a new setting, whereas others would talk about the positive aspects of memory care.

An inconsistent tone can further confuse and aggravate someone dealing with memory loss, says Troxel. “The family needs to have consistent messaging. Keep it conversational. I would focus on socialization, safety, and quality of life issues.”

Following this advice, here are some methods for developing an internal script that each family member can reference.

Focus on the benefits of memory care

For Megan Newlin, a teacher in Charlotte, North Carolina, who worked with Nelson to find memory care for her mother, bringing up safety and staff friendliness made the conversation go smoother. After her mom suffered a series of seizures that affected her memory and mobility, Newlin highlighted how a memory care facility would better meet her needs.

“The way I phrased it was, ‘You’re going to stay somewhere where they’re able to take care of you,’” says Newlin. “She was really happy when I told her about the staff and their compassion.”

Nelson agrees that focusing on these relationships can keep the conversation positive and make memory care a more welcome transition. Similarly, talking about memory care therapies and activities may have the same effect.

I needed my mom to be my mom again, and I needed to be her daughter again, but I was her caregiver. Now that I have someone else who’s taking care of her, I’m able to have that relationship again.

Megan Newlin, a teacher who found memory care for her mother via A Place for Mom

“Parents will often say, ‘You’re not shipping me off to a nursing home.’ People have these ideas in their heads that senior living is still like it was 20 to 30 years ago, but it’s changed,” Nelson explains. “Educate your parent on the types of communities, as well as the programming and structure that they have.”

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Nelson recommends mentioning the following memory care features:

  • Housekeeping
  • Nutritious meals and snacks
  • Clubs, activities, and other opportunities for socialization
  • Supportive and trained staff

Talk about “for now,” not forever

Newlin avoids panic by focusing on the short-term with her mother. “We’ve never told my mom that she’s going to be in memory care for the rest of her life,” she says. “We’ve said, ‘This is where you’re going to go now. They can help you with the things that you need help with.’ As time passes, she brings up coming home a whole lot less.”

Don’t make yourself the bad guy

“As a family member, whenever possible, try not to make yourself the bad guy,” says Troxel. “Say something like, ‘I know you want to live at home, but the doctor insists.’”

In other words, shifting personal responsibility for the decision can help preserve your relationship with your loved one.

What to do when your parent says “no”

So, you’ve presented the benefits of memory care, expressed concern for your parent’s safety, and consulted a doctor or other expert — and your parent still seems hesitant or downright hostile toward the idea of moving to memory care. Unfortunately, this is a common reaction. So common, in fact, that Troxel recommends families start the discussion early and expect a “no” as the parent’s initial response.

Here’s how to deescalate the situation and increase your loved one’s receptiveness.

  • Try to understand the emotion underneath. “None of us really want to leave our houses,” says Troxel. “None of us really want to give up driving.” Empathizing with how scary and unknown a new home or lifestyle may seem to a senior will help you reassure them in any follow-up conversations.
  • Put yourself in your parent’s shoes. A parent with Alzheimer’s or another form of dementia will act differently than they used to. It can be helpful to remember the beliefs, opinions, and values they held before their condition progressed, and use these as a guide when making decisions. “You can say to yourself, ‘Mom is running around town disheveled,” Troxel says. “What would she have said about this 20 years ago if I had asked her about what I should do?’ Friends and family can say, ‘What do we think she would have wanted?’”

In emergency situations where a senior’s safety is at risk, families can stand firm in their decision to move a parent to memory care, leaning on legal tools like power of attorney or guardianship when necessary. These legal designations allow a trusted figure, like an adult child, to make decisions on a senior’s behalf when memory or judgment is impaired.

Find support and let go of guilt

Broaching the topic of memory care with your parent and other family members can bring up complex emotions. Just as it’s important to take care of your loved one, it’s also crucial to prioritize and check in with yourself. Newlin recommends the following strategies, all of which helped her through her mother’s move:

  • Join an online or in-person support group.
  • Talk to a therapist or counselor.
  • Preserve your relationship with your parent or relative — and remind yourself that moving them to memory care is an act of love.

“I needed my mom to be my mom again, and I needed to be her daughter again, but I was her caregiver,” says Newlin. “Now that I have someone else who’s taking care of her, I’m able to have that relationship again. You have to be fair to yourself. Step outside of the situation and ask, ‘What’s the best thing for this person and how can I keep them safe?’ I know my mom is safe now.”


Sources:

Greater Good Science Center. “Active Listening.” 
https://ggia.berkeley.edu/practice/active_listening.

Heintz et al. “Emerging Collaborative Care Models for Dementia Care in the Primary Care Setting: A Narrative Review.” 
https://www.ajgponline.org/article/S1064-7481(19)30460-9/fulltext.

Kara Lewis
Author
Kara Lewis

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