Like many people who have ageing parents, working out how to sensitively handle your concerns when a parent is encountering age-related decline is one of the hardest things to do.
Let’s face it, conversations around your parents care as they age take courage. They are one of the greatest challenges you will face as a child.
One of the key reasons is because as the child you have been used to your parents having the power and control. These conversations reverse the long-standing power structure which can be uncomfortable. This is especially the case if your ageing parent(s) is having trouble accepting the fact that they need assistance.
The important thing to remember is that the longer you leave having the conversation about them ageing the worse it will be for your parents. Don’t wait! Difficult conversations don’t get easier by delaying them.
Research by William et al (2009) based on elderly persons has shown the rate of decline can be slowed with assistive devices and home modifications. In other words, getting help at home sooner than later can actually mean your parent(s) could stay at home and independent for longer.
There is no ‘one approach’ to having these conversations however Dr Nicky Howe, Southcare CEO and Ontological Coach, has developed some Top Tips that will help you.
How to Prepare for Care and Ageing Conversations
Tip 1 Conversational Intent
Think about what your intent is. There are broadly three key intentions of conversations:
- Conversations for connection and intimacy (relationships with others)
- Conversations for shared understanding (trying to be understood and understand in order to plan)
- Conversations for coordinating action (getting things done through making agreements about who will do what and by when)
So before you begin a conversation, it is important to understand your intent and the areas in which you think your loved one may needs assistance. The broad categories may include:
- Medical safety
- Activities of daily living
- Home safety
- Driving safety, and/or
- Financial safety
Tip 2 Listen
Listen to your loved ones concerns with an open mind and receptive ears; this will allow you to discover their real feelings and understand their care wishes as they age. Discuss the fact that not being able to do some of the daily chores and activities they are used to being capable of is not a sign of weakness or personal failing but a force outside their control. Be empathetic. Talk about how you hope assistance will enable them to remain in their own home and maintain relationships leading a fulfilling life. It is very likely that you will need to have the same conversation many times. If your first attempts are dismissed or dissolve into a shouting match, disengage and try again a few days later.
Tip 3 Start with the Facts
Start by seeking to understand how your loved ones are seeing their own health decline. They may have noticed some decline in how they walk, or they may say they don’t have the strength to do things. They may say they keep forgetting things, or don’t have the energy to do things, they may get out of breath.
Offer them your insights. Maybe you’ve noticed the house is getting cluttered or unclean. You could start this conversation by saying “Mum you have been cleaning this house for over 30 years, why don’t we arrange to get someone in to do the big jobs”.
If you are noticing declines in personal care, it can be helpful to bring them in front of a mirror and ask them if they notice anything different about their clothing or hair. You may ask about their feet and how their shoes are fitting.
Or if safety is a concern, try “It’s becoming more difficult to get up and down the steps. Have you noticed that?” If dad says, “Yes,” you can talk about getting some ramps made and some hand rails. Sometimes this conversation helps make it clear that making the necessary modifications to their home is feasible. Maybe the house is too big and a move might be an option, or maybe there have a two story home and they need to move their bedroom downstairs.
Tip 4 Know the Aged Care Options
Established by the Australian Government the My Aged Care website can help you find information about aged care services and what you need to do to receive them.
There are a ranges of services to help elderly people stay in their home and when it comes to bringing in assistance, suggest your loved one “give it a try.” This alleviates the pressure of making a final decision. Usually, people keep the assistance because they have now made a connection with the support worker. Remind them that having services in place can help prevent injuries and problems that may eventually force them to leave their house. If you do encounter resistance, especially the dismissal that “I can’t afford that,” don’t hesitate to bring money into the discussion.
The Australian Government is quite generous with the allocations of funding they make for Home and Community Care and Home Care Packages (you can find out more on aged care fees and costs here). Talk to your loved ones about the financial support they can apply for. You may want to use an example of how help at home is much cheaper than having to move into residential 24-hour care.
Conversely they may believe they have too many assets to receive help. Means testing is applied and your parents may still be eligible for assistance with a (often small) contribution. It’s worth having an assessment and seeing what’s available, here is how to start the process.
Tip 5 Bringing in a Third Party
You don’t have to approach this alone. Gather a care team together that can include your parents’ physician and lawyer, a pastor, friend or close neighbour. It can be helpful to bring in an outside person who doesn’t have the emotional pitfalls that often come with parent-child relationships. Your parent may feel more comfortable opening up about their ageing to someone other than you.
In some situations, their doctor can be very helpful. If you are noticing memory or depression issues, it is time to get the doctor involved immediately. However, even if that is not the case, taking your parent in for a check-up can lead to some undeniable evidence that assistance is needed. Most people trust their doctor. Just be sure to inform them prior to the appointment of the issues you are observing.
If your parent does not have an advance healthcare directive, this is a good time to discuss those issues with the doctor. Once those wishes are known, you or your parent can contact the family lawyer.
Tip 6 Lots of Conversations
You may find that the more “pressed” your parent feels, the more resistance occurs. Understand that you are not at fault and try not to feel too guilty if your loved one sustains an injury because of care refusal. You can’t always “save” your parents, but if you are aware of their needs, have educated yourself on aged care options that are available and continue to have conversations that empower them to make decisions, things should start to fall into place.
- Remain positive, have patience and continue the conversations in a non-confrontational way
- Keep in mind this is a process, a journey. The first step is to have those tough conversations with your loved ones
- Reach out for help
- Look after yourself