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Tips for Talking to Parents about Long Term Care

Golden LivingCenters | posted November 15, 2014 | Bookmark and Share

Parents want to be larger than life and in control – even when their bodies start to betray them. It’s human nature, and rarely does one want to admit they need help caring for themselves. 
But it happens to us all… eventually. 
Here are some tips to broaching and continuing that tough conversation with mom and dad. 
Start as Early as Possible
Given the sensitive nature of this conversation, the earlier you can broach the subject with your parents, the less likely it will be for there to be confrontation. While a parent has their full mental and physical capacity, begin to discuss the trigger points they would feel would prompt the need to transition their care into an assisted living or skilled nursing facility. 
If you wait until parents exhibit the need for more care, they also will be dealing with the reality of what is happening to them right now. Staying in denial about their physical condition will escalate the conversation, whereas if you can get agreement from them before these behaviors manifest themselves, you can short circuit the process when is becomes necessary later. 
Be on the Same Page
Before you have the conversation with your parents, talk with siblings to get everyone on the same page. If the subject hasn’t been broached before now, tell them you plan to talk to the parents then give them an update afterwards. Ensuring all siblings are on the same page is crucial as one naysayer can give a resistant parent the grounds needed to continue to resist. 
Just like children can play mom against dad when trying to get their way, parents can use these same tactics to get the siblings disagreeing with each other and avoid the painful decision to move into long term care. Taking the time to get all the siblings and extended family on the same page with the same course of action will be key to support the parents’ health and ultimate caregiving needs.  
Assign the Care Team
While all the siblings and extended family needs to be informed about a parent’s condition and transition, who will have the primary responsibility over the parent long term? Who will need to be involved in any major decisions about the parent’s care? Who needs to provide support and what kind of support will they provide? Which family members simply need to be informed but not have any role in the actual decision-making process? 
It helps to clearly define these roles in a shared document that keeps everyone aligned. This will help tremendously when big decisions have to be made later. If a family member is in a support or informed role only, an important part of that role is to keep any negative or contrary opinions to themselves and actually be supportive or just informed. 
Communicate Effectively 
First, decide to have a regular update conversation with your parents every year or more frequently if necessary. Just like the initial conversation will be easier the earlier it takes place, deciding to have a regular conversation about the long term care needs of the parent will help it be more comfortable.
Decide the best method for communicating to the caregiving team and what types of information needs to be communicated and how frequently the team wants to be kept informed. Starting a private Facebook page can work as a way to share memories and pictures, but if the entire care team isn’t on Facebook, you may want to stick with a group email message. If there are urgent matters, collect cell phone numbers and start a group text message if time is of the essence. 
To communicate daily activities, it could help to collect all of those over a period of time and only communicate those on a weekly or bi-weekly basis. When you start an email, it helps to have a clear message about the most crucial matters first and any support requests you need in the beginning of the communication to be as clear as possible. 
Address Legal Matters
In the initial conversation with your parents, talk through the legal documents that will need to be in place. Ensure their will is up to date and that the caregiver who will have the power of attorney has those documents in place. If the caregiver who has power of attorney also will handle the parents’ financial matters, ensure that framework is in place and is transparent. 
Stay Close
One of the biggest fears about moving into a long term care facility is that a parent will be forgotten. When selecting a long term care facility, a parent may want to stay close to their “world” to keep their regular routine in place. This sounds like a good argument at first, but the reality is that as a parent’s condition declines, it will be much more critical that they are closest to their primary family caregiver. Moving them to that area while they are healthy will be much easier than when they need a higher measure of care. 
Be Flexible
Keeping family traditions in tact will be important, but if new rituals need to be in place to accommodate a parent’s new home, be flexible and stay positive about it. Encourage family members to plan travel that helps them visit the parents, and if the parent’s health allows, a sibling or other relative could take them out to the mall, to a movie or to a museum while they are in town. 
Stay Positive
This will be a time of uncertainty for your parents, so staying positive will be important for all of you. While you don’t want to negate their feelings, asking leading questions, such as, “what was your favorite thing about today?” and “what’s one thing you are grateful for today?” can help train them to look for positive aspects in their new world. Practice this same positive routine yourself and expand more on how much you appreciate them. Simply saying, “I love you” can be reinforced with a good positive memory of something important you learned from them or a fun memory that you know will make them laugh. 
Regardless of how you approach this period of time in your lives, it can be a sober reminder how precious and fragile life is. Keep your focus on creating as many memories with your loved ones that you can cherish long after this period ends. 

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