Avoiding a Crisis: How to Start the Conversation

January 12, 2017

Mature woman (60s) helping elderly mother (90s).

It is Monday and Mary is at work ready to start her day. As she is settling in, her office line rings and it is Peggy, her mom’s neighbor next door. Peggy is concerned about Mary’s mom because she stopped by for a visit this morning and noticed several issues. Mary’s mom appeared un-showered, mail was collecting on the counter, dirty dishes were in the sink, and the stove was left on. When Peggy tried to talk with Mary’s mom she assured her that everything was fine and she was simply a little slower this morning. Peggy immediately contacted Mary because she is worried about the safety and well-being of her mom; however, she is unsure how to help.

The phone call from your Mom’s neighbor about her strange behavior has become your “wake up call.”  The thoughts begin to flood your mind trying to remember when your Mom’s demeanor began to change. You remember the phone calls were getting shorter, Mom couldn’t remember details, and then her “new” friends who seemed to visit often were a concern.  Yet, she is your parent and you don’t want to interfere in her personal business and she continues to reassure you all is fine.

This scenario has become the exasperation that many families will face evidently as their parent ages. The realization that your parent has cognitive impairment and you have no idea about their abilities, lifestyle, or financial status can be daunting.  Questions to consider: What are their monthly expenses, housing, food, transportation, and health care, compared to income such as – Social Security, Pension, Long Term Care Insurance or 401k/IRA? This is the time when the middle-aged adult must confront the realities of their parent’s health crisis and become involved in the care of their susceptible family member.

The older adult’s desire to remain as independent as possible can be hindered by a mirage of conflicts. This could include economic reality, health status, and ability to care for one’s self. The adult child needs to have a basic knowledge of their aging parent’s ability to remain living independently. This is not an easy concept, unraveling a parent’s financials can be irritating, vexing, and overwhelming especially when one has their own family events.

So how does one start the conversation?  In an ideal world, our loved ones would age successfully and manage their own affairs and lifestyle. Yet in most “worlds” the adult child doesn’t become involved in their elder’s life until a catastrophic event happens. Then the adult children or family member is handling an arduous situation under traumatizing and stressful conditions for everyone. Instead let’s not wait for the crisis, mobilize the family, and work as a team to ensure the elderly can live as independently as possible. The idea is not to control their lifestyle, but to support their goals.

The first question is “where or how does one begin the conversation?” There probably isn’t an ideal time, but timing can be the key. Opportunities could come from news stories such as one about an elder who was a victim of a scam, or stories from friends, co-workers, and other family members who had a recent encounter with their elderly loved one.  Attitude and manner is essential, calm and non-defensive is critical.

How to begin:

  1. Be prepared; focus on the objective, don’t become defensive or accusatory. Write down questions and exact information of changes in loved one’s behavior (if any). Keep in mind the oldest old of seniors never expected to live as long, nor realized the longevity their finances needed to last.
  2. Manage the emotions and avoid personal biases. During the conversation it is understandable that the child-to-parent relationship could illicit past behaviors such as unexpressed anger, frustration, and unresolved issues.   Remember the conversation is not about past unresolved disputes, but to ensure the elder(s) remains safe and cared for. Try to keep the conversation positive and reassuring. Instead of using terms like “I” and “me” – use “we,” “us,” and “team.”
  3. Start the conversation by being upfront, this is the trustworthy and respectful approach. Choose the right location – consider a safe environment with limited distractions- no phones or T.V.  Try to avoid “ambushing” it immediately places everyone in the defense mode.  Avoid re-hashing sensitive topics not related to the main focus
  4. Finally, end on an upbeat tone. Reaffirm what has been discussed and agreed upon. If your loved ones says “No” try not to get angry, discouraged, or defensive. Give your elder time to absorb the words and conversation; example “by doing__________ we are able to keep you living in your home as independently as possible” or “let’s set an appointment with the lawyer to establish a trust, will, or DPOA.” Provide resources and alternatives for your elder.  If a goal is to be “power of attorney” on bank accounts, IRS forms, and/or healthcare speak to these agencies prior and obtain literature if possible and know what all is entailed. Don’t forget small items such as where does family keep “passwords” for internet accounts, who is their insurance agent, accountant, know that different bank entities require their own POA documents to be completed and don’t forget where are the elder’ important documents are kept.    Consider outside professionals:  an “aging life care manager,” an elder law attorney, and a financial manager or fiduciary.  These individuals are valuable in their knowledge and resources.

The conversation is hard for everyone to begin. However, having the comfort and benefit of knowing that an older adults lifestyle is being supported and their wishes maintained, is priceless.

deon-batchelderDeon is a Certified Care Manager and the Clinical Supervisor for Elder Options, Inc. She brings a wealth of knowledge about POLST, Parkinson’s disease, VA benefits, and entitlement and waiver programs to the Elder Options team. Deon’s passion for care management grew from a commitment to advocate and support older adults, disabled, and vulnerable populations.

Aging Life Care Association
Area Agency on Aging
National Academy of Elder Law Attorneys, Inc.
Professional Fiduciary Association of California