Last Updated: November 19, 2019
Discussing age-related decline, assisted living, health and money with an aging senior parent can be intimidating to parents and adult children alike.
Our experts at A Place For Mom will guide and provide you with tips on topics regarding the age-related decline, dealing with resistant seniors, evaluating your elderly parents’ health, how to start a conversation with your senior parents, having ‘the talk’, and more.
For many families, going home for the holidays is a tradition that allows you to reconnect with your loved ones after months or even years. But sometimes these festive occasions are eye-opening to age-related decline, cognitive impairment, and health or safety issues facing our older loved ones.
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Dad and Mom may have aged more than expected, or suddenly seem to need more assistance with daily tasks. Or maybe, your senior loved ones are doing fine, but you recognize that they are getting older. In either case, it is important to discuss topics and decisions regarding their advanced years and end of life wishes. You may wonder about the challenges of talking to aging parents about changes.1
A Place for Mom works with experts in many different fields who can help provide insight on preparing for the future — from the retirement years and beyond. Our experts help adult children learn how to recognize problems. They also provide advice on how to have tough conversations with parents or other aging family members this holiday season.
According to our experts, there are five must-have conversations you need to have this holiday season with your elderly parents. These are among the topics you should cover:
Dr. Leslie Kernisan, Geriatrician
As we grow older, we all pass milestones with our parents. Some of us grow taller, and at a certain point most of us grow stronger (we finally beat them in one-on-one basketball!). These milestones are a natural part of life and are often cherished memories.
Physical health decline is just as natural. However, you, your aging parents, and your family may find age-related decline difficult to confront. Age-related decline can result in a sort of role reversal that both parents and adult children find hard to deal with. Despite the difficult topic, starting a conversation about health and safety with your elderly parents is vitally important.
Geriatrician, Dr. Leslie Kernisan, gives us a checklist of ‘life tasks’ which could be red flags. This list may help you indicate whether or not your parent needs additional senior care. Dr. Kernisan suggests that, first and foremost, you observe their Activities of Daily Living (ADLs), which include things like the following:
Difficulty in performing these necessities of life is a major issue and a key indicator of the need for geriatric care. But such problems can also be indicative of greater health issues that may need diagnosis or treatment.
Even if your parent’s ADLs seem to be okay, there may still be less obvious issues at hand which can be just as potentially detrimental to a senior’s health and safety. These crucial components of life are known as the Instrumental Activities of Daily Living (IADLs) and include these items:
It’s important to keep an eye on older adults and be sure to ask yourself things like this:
These activities and instruments of daily life are just the beginning. There are further warning signs relating to elder abuse, mental health, physical health, and safety. For more information on these subjects, read Dr. Kernisan’s full interview.
Dr. Melissa Henston, Geriatric Psychologist
Mental health and wellbeing are just as important as physical health and safety. According to Geriatric Psychologist Dr. Melissa Henston, adult children can often spot clues that something is wrong as soon as they pull into the driveway. If the lawn is overgrown or the driveway hasn’t been cleared, those may all be warning signs that your parents or senior family members are struggling.
Once inside the house, you can often tell that something is ‘off’ immediately. Does it smell? Is it messy? Keep an eye out for these warning signs:
If any of these basic warning signs are triggered then you will need to look deeper into the matter. You may want to begin considering full-time geriatric care or assisted living options. For more warning signs and what to do next, read Dr. Henston’s full interview.
Andy Smith, Senior VP of Financial Planning at Financial Engines
Talking about money with your parents (or anyone for that matter) can often be a sensitive subject. However, as your senior parents get older it becomes an increasingly important subject to address.
Many seniors have radically underestimated the cost of retirement. Many find themselves unprepared for the very real costs of medical diagnosis or treatment. As Smith points out, an “average 65-year-old couple thinks they’ll spend around $50K on healthcare costs throughout retirement. In reality, [the] number’s closer to $241K.”
Smith also warns that Social Security is not enough. And while there is no secret formula to retire with enough money to meet all your needs, the best option is to simply save as much as you can for as long as you can before retiring.
Thanks to modern medical advancements, many elderly seniors are living longer than they thought they would. While this is a huge blessing to you and your family, it can also mean that unanticipated financial burdens are placed on you and other family members. Preparing for these potential additional costs means having a conversation about your parents’ financial position, expenses, lifestyle, medical needs, and other sensitive topics.
Approach the conversation with care! Smith advises that you:
It can also help to speak to a professional, but be careful. Stay involved and be wary of unscrupulous advisors who offer unqualified medical advice, or are looking to take advantage of their senior clients. Most importantly, use their feedback as advice for informational purposes only. It’s up to your parents and family members to make any final decisions. Learn what you need to get started, and how to stay safe by reading Smith’s full interview.
Stuart Furman, Esq., Elder Law Attorney
Unfortunately, many seniors are more vulnerable than they were when they were younger. To ensure that their wishes are carried out while also protecting you and your family, you need to discuss legal matters with them candidly.
Everyone, regardless of age, should have both a will and a living will, but this is especially true for older adults.2 They should also have, and you should be aware of, these items:
For more information on how to have a conversation about your elderly parents’ legal matters, what they need to do to protect themselves and their family, and what you can do to help them, read Stuart Furman, Esq.’s full interview.
Dr. Wes Ashford, Neuroscientist, Psychiatrist and expert in Alzheimer’s disease
Some degree of cognitive impairment is one of the unfortunate side effects of advanced age for many adults. Memory loss or other signs of mental decline can be scary and devastating for seniors as well as their adult children, but there are ways to handle it. Dr. Ashford recommends that you keep an eye out for the warning signs this holiday season. Do your parents exhibit any of these things:
Some seniors may try to cover up their memory loss or develop coping mechanisms to mask their difficulty. To catch all the warning signs, adult children are advised to be extra vigilant and pay close attention to their aging parents. For more information about age-related cognitive decline, how to spot it, what to do about it, and how to talk about it, read Dr. Ashford’s full interview here.
For many families this holiday, starting the conversation will be the most difficult part of addressing these issues with an aging parent or other family members. “Typically you need to look for the opening and opportunity, rather than just jumping in,” Dr. Henston recommends. “Don’t try to take control. Try to get a natural conversation going.”
Your parents will always view you first and foremost as their child, this is natural. Dealing with a sudden role reversal is difficult for many parents to handle. In many cases, this attitude, combined with other issues, means that they will be reluctant to listen.
It is important to remember that your parents need you to be an advocate for their health, especially when mental or physical decline starts to impact their ability to advocate for themselves. Although they may be resistant to your help, and while their wishes are important, you need to know how and when to keep pushing. Often, stubbornness and resistance to communication in an aging senior can be a warning sign.
To break through to your aging loved ones, remember that you need to separate your needs from the needs of your parents. Get the rest of the family on board, discuss everything, and remember to be compassionate but firm in explaining what you believe is best. Whether it’s exploring assisted living options, arranging long term care for aging parents or any other senior living topics, your conversation will go better if you take a firm but thoughtful approach.
Advice from a team of experts is one thing, but there’s no better advice than from someone who has experienced these challenges first-hand. Joan Lunden has been in your shoes and knows how difficult it can be to broach these difficult but vitally important subjects. Watch Joan’s video on Facebook, or read the full transcript below for her first-hand advice:
Today, I’m going to discuss a question that came in: “how do you deal with an aging parent who refuses to try or even talk about assisted living?”
This is a common issue for families. It’s emotionally charged, but when that day comes, when it kinda becomes apparent to you, that living in a home alone is going to present a danger to an aging parent, it’s kinda the day that you have to accept you’re going to become “the parent” and I’m not gonna lie, there’s nothing easy about that life transition.
I remember going down this road with my mom. She was very resistant to moving out of the condo where I had her living, but she had dementia that was increasing and it was just not possible to leave her there alone. I think that the first thing I want to recommend is getting help. Expert help. I didn’t even know when I started on this path that there is such a thing as a Senior Advisor. So I did it all by myself and drove around and just went and looked at places that I’d seen in my life and I made all the mistakes that you can make.
It wasn’t until I got a Senior Advisor that helped me first assess my mom’s needs, and really come to terms with those. Find out what all my options were, understand the landscape of senior living, and then to even understand the questions that I should be asking, that’s when I finally turned things around. And I made a promise to myself at that point that I was going to do everything I could to help others before they went down this path.
You know, all too often, like me, this all starts when you get “that call” you know, maybe the spouse died, or your parent took a fall, or had a stroke, or just got a diagnosis of dementia or Alzheimer’s, and all of the sudden you have to make all these decisions and find out all the answers in a moment of urgency. It’s way easier if you start ahead of time and have a family conversation. I know that’s not always so easy to do, but it’s so important because you can start to kinda plant the seed not just with your parents but even with siblings. Start to understand what their desires are, what their worries are, help them start understanding what their changing needs are.
And this is not gonna be one conversation, by the way, it will be a series of conversations, but it’s really important to start that process early on. And then I think it’s just really important to educate yourself. Start learning about senior care, go out and visit a couple of facilities, then you can bring your parent into this conversation. Maybe go have lunch at a facility so that they see what life is like there. The big thing is to make them understand that the landscape of senior living has completely changed. It used to be that you know, take the parent out of the home, they go right into a nursing home, then they die. That is not what senior living is about today.
Today there are active communities with hiking trails and swimming pools and gyms and movie theaters and pet grooming. I mean the list goes on and then it goes all the way through to assisted living and memory care and then nursing care and I just think that a lot the resistance and distaste for the idea of a “senior living community” comes from that old idea of what senior living is all about.
So I think first of all you really have to make them understand that it’s not the “old” senior living community. And I think too that they’re afraid of losing their independence. Ironically, if you find the right community, they will be able to have more friends and new activities and kind of a peace of mind that all the chores of life are being taken care of so that they can get on with enjoying life. It’s kind of funny that it’s really the absolute other way around. But, you know, every study tells us today that the biggest predictor of how well a person will age successfully is how engaged they are in life and how many social connections they have. And gerontologists say that isolation, being alone, can be as dangerous to a senior as smoking 8 packs of cigarettes a day.
So it’s important… I think, if I had anything to do over, I would have gotten my mom into an active senior community earlier on. And the final thing is that parents don’t want to be a burden to us. So it’s really important the tone you take. If you convey an idea that, you know, “I’m gonna have to take care of all this responsibility so, let’s have this talk already,” you’re going nowhere. It’s really important that you can inspire in your loved one that you want to be an active participant in making sure that their later years are the best life that they can be. Where they can be not just safe but happy. And I think that that is your starting point.
And, as soon as you’re ready to get this started, I highly recommend that you contact A Place for Mom. I have such respect for A Place for Mom. They will put you together with a Senior Advisor and they will walk you down that path and tell you what your options are, and they can help you then even have that discussion with your siblings and with your parents. So I wish you good luck on your journey!
Getting started with these conversations is easier than you may think, and taking the time to have the conversation will help lead to better outcomes.
For more information, including our caregiver toolkit, financial guides, and more on how to have the tough conversation with aging loved ones, visit our Planning and Advice page.
Do you have any questions about having the “tough conversation” with aging parents? We’d like to hear them in the comments below.
1Fowler, K. (2019, June 19). ADLs and IADLs. Retrieved from https://www.aplaceformom.com/blog/adls-and-iadls/.
2Fowler, K. (2019, October 30). 5 Misconceptions About a Power of Attorney. Retrieved from https://www.aplaceformom.com/blog/4-08-16-misconceptions-about-a-power-of-attorney/.