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Have you seen the bumper sticker that reads: “Be nice to your children, they’ll pick your nursing home?” Although this saying might seem funny to our young grandchildren or other family members, it’s not so funny to older adults or caregivers. However, when you notice your parents or loved ones need more help than you ever imagined, you need to know how to start the conversation.

There is a long list of red flags that can tip you off when the time has come to have the conversation. A few of them are as follows: A gradual or sudden change in mood or behavior, a decline in health or increased trips to the doctor or emergency room, not enough food or rotting food in the house, a change in personal appearance or increased confusion.

This is the time to call a family meeting. It is important to have everyone involved with your parents at this meeting. Have an agenda and appoint someone to take notes. Ask questions and find out what others might be concerned about. Their responses might surprise you.

After the meeting, pick a spokesperson to lead the conversation with your parents. Explain it is your responsibility as an adult child to see that they are safe and healthy. Be respectful and explain you’re being realistic while being loving and practical, trying to avoid a crisis.

Talk about your feelings. Look for body language and facial expressions – are you hearing your parents? Are you reading them correctly? Encourage them to share their own feelings. Many older adults feel a loss of independence and are worried about their declining health and the emotional changes they are experiencing. Maybe they don’t want to be a burden to their children or caregiver. Be a good listener and be patient. Do your best to hear what they are saying – and not saying. Expect there might be some negativity in the conversation.

Take small steps. Don’t overwhelm them with too much action at once. Tackle one or two small issues such as helping around the house, gathering their important documents or offering assistance with paying their bills. Allow them to participate in the solution to whatever is going on that causes concern.

Once they accept help, do your homework. Knowing available resources is important. In the past I have stressed the importance of knowing your parent’s doctors and other vital information (Social Security number, life insurance, Medicare, bank accounts, financial investments, power of attorney documents). Start a notebook or file with this information.

You can also get expert advice from a professional geriatric care manager who can help you navigate through the system. Collaborating with a geriatric care manager can save you time and provide you with information, recommendations and serve as an advocate for you and your parents. Geriatric care management is privately paid, but also cost efficient when you think of the decreased stress and anxiety, and time away from work or your own family, while at the same time providing a valuable service to the family.

Kathy Weston
Director of Hospice Operations