The Conversation: Talking to Your Parents About Care

Broaching the topic of potentially bringing on outside assistance with an aging parent or loved one can be an emotional and difficult process. Often, adult children feel guilty for not being able to fulfill the role of primary caregiver without help and aging parents show resistance at the thought of a stranger entering their homes. However, the profoundly positive impact that a professional caregiver can have on the lives of aging adults and the quality of life of their children makes this a topic worth addressing.

When initiating this type of family discussion it is important to choose your words carefully—the goal is to have a dialogue, not to dictate the solution that you believe is best for your parent. While in-home care may not be right for everyone, given that an overwhelming majority of older adults wish to age in place in their homes, it should be considered as an option. Consider these tips:

• Observe and research. Perhaps you notice that your loved one has recently had trouble climbing the stairs or has vision problems that have resulted in unsafe driving practices (e.g., drifting into other lanes, not obeying road signs). It is important to observe where limitations might be so that you can provide specific examples when expressing your concerns. Be open when discussing your fears are and give your loved an opportunity to digest this information.
• Evaluate receptiveness and show that you are a resource. Probe lightly during a visit or phone conversation (e.g. “When was your last doctor’s appointment? What did he/she say?”; “Did you drive to the mall today? How’s the car?”). If your parent is receptive to your questions, ask how you can be helpful. You want to be respectful and establish yourself as a resource. Avoid phrases like, “That’s not good. We’ll have to do X.” or “It’s definitely time to bring in a caregiver or move you to a facility.”
• Set the tone. Let conversation flow naturally. Ideally, your parent will bring up the topic of assistance, but in most cases you’ll have to start the dialogue. You can do so directly (e.g., “It was scary when you almost tripped on the steps this morning. Is that happening often?”), or indirectly (e.g., “Lisa’s parents just hired a caregiver to come in three times a week—her mom is thrilled to have help with housekeeping and cooking and now she can spend more time gardening and playing with the grandchildren.”). You want to communicate your concerns, but avoid taking a critical or rigid stance, as this will likely end the dialogue.
• Be receptive. Does your loved one prefer to age at home? What are his or her concerns about aging? What is most important to him or her? Practice empathetic listening to show you support your loved one’s opinions. If your parent is not open to discussion around additional assistance, try to get to the root of the resistance (e.g., cost, invasion of privacy, loss of independence, fear of theft) and ease his or her concerns (e.g. “There are many agencies that conduct thorough background checks on caregivers so we can be sure that they are trustworthy.”; “Caregivers will not take away your independence by doing everything for you, but instead will only offer help when needed.”).
• Consider bringing in a third party. If your loved one is totally resistant to the options you have put forth, sometimes it can be helpful to bring in a neutral third party. If your parent has always sought counsel from a priest or rabbi, for example, consider asking if that person could initiative a conversation and suggest options. You might even consider asking a home care agency to mediate your family meeting. Jesse Walters of Home Care Assistance in Danville, California explains, “We know how difficult this process can be so we routinely facilitate discussions around in-home care with families with no obligations; both the parents and adult children come to view us as a trusted source of support and information.”

Perhaps you’re only able to introduce the possibility of home care and your parent needs time to think about it. Respect your loved one’s choice and give him or her time to digest all of the information you talked about—you want the final decision to be collaborative and best for all parties involved.

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