The Cost of Cowardice: The Danger of Avoiding Difficult Conversations

How Sidestepping Difficult Conversations Endangers Your Aging Parents -- and You
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As our parents age, a tough transition begins. The people who were once our authority figures, the ones who fed us, took care of us, and taught us right from wrong, become people we worry about and may one day need to take care of. It's the ultimate role reversal, and one that most of us have an extremely difficult time making. The result is a communication gap -- a whole series of conversations we should be having with our aging parents, but aren't. Data and insights from the 2014 Usage and Attitudes Survey conducted by Caring.com show there's a host of topics, from financial issues to medical care to long-term living arrangements, that families are failing to discuss. Here are the three most important tough talks you need to have with your aging parents, and why.

Next Up: Open Hearts Behind the Open Pockets

Difficult Conversation 1: Are Your Parents Still Safe to Drive?

Get a group of 40- or 50-somethings together, turn the topic to aging parents, and the issue of driving is likely to be one of the first concerns they mention. And for good reason; there are some scary statistics coming out about aging and driving. According to the Centers for Disease Control (CDC), 500 older drivers are injured in accidents every day. The American Automobile Association (AAA) says senior drivers are second only to teen drivers in having the highest crash death rate per mile driven, which is particularly startling given that seniors drive far fewer miles than teens. And AAA records show that deaths from auto accident are 17 times higher for seniors than for adults 25 to 64, because older adults have more health problems to begin with, making them far more vulnerable.

But how do you tell your parents -- the ones who taught you to drive -- that they shouldn't be behind the wheel? Well, in many cases, it seems, you don't. Older children have more trouble bringing up this issue than they do discussing subjects that on the surface seem like they might be more touchy. An annual survey conducted by Caring.com, the largest website serving children of aging parents, shows that adult children are more willing to talk about dying than driving. Just 56 percent of Caring.com users had raised the subject with their parents. When you are ready to talk about the issue, there's plenty of good information available on how to know when it's time to take away the keys, how to frame the conversation, and what to say.

Difficult Conversation 2: Do Your Parents Have a Will or Trust?

If there's one age-related issue that enormously impacts all generations, it's estate planning. After all, when someone dies without a will or trust, the estate goes through probate -- which means a large percentage of its value is lost in taxes and court fees. (Here is more information on what probate is and why you want to avoid it.)

Not to mention the fact that, if your parents die without estate planning, their assets will be divided among all living relatives, rather than going to the people they wanted to receive them. There are additional issues to consider as well. If your parents have a family home they wish to keep in the family, a trust may be needed to make that transition smooth and problem-free.

Is It Time for Assisted Living?

Given these facts, you would think that estate planning would be a standard topic around the dinner table as family members age. But it's not. According to a national survey conducted by Rocket Lawyer, a legal referral site, 64 percent of Americans are currently without a will or trust. And even among Americans ages 55 to 64 -- for whom the issue presumably should be a priority -- only 51 percent have made a will. Just as important, annual surveys by Caring.com show that only half to 57 percent of adult children have discussed estate planning with their aging parents.

To bring up the issue of estate planning, it can help to have a guide to the available options. If you're not sure if your parents need a will, a trust, or both, consult an attorney -- many offer an initial consultation free of charge. If this is out of reach, at least make sure your parents put their wishes in writing, witnessed by others. There are many books and websites available to help them get started on the process.

Difficult Conversation 3: Do Your Parents Have a Plan for Long-term Care?

It's not easy to bring up the fact that the parents who have cared for you all your life may someday not be able to care for themselves. But it's a reality nonetheless. Americans are living longer every year, and many will age beyond their ability to live independently. Sadly, many older adults have trouble facing the changes and losses in ability that come with aging. While some seniors know their memories aren't as good as they once were or that they're no longer able to keep up with important responsibilities, others may lack awareness that things are slipping through the cracks.

Still, it's not an easy topic to bring up -- and we're not doing so. According to data from a 2014 survey by Caring.com, only 45 percent of adult children have discussed with their aging parents what they plan to do when they can no longer care for themselves. And only 30 percent have discussed how their parents will pay for care as they age.

Then there's the related issue of where your parents will live. For many seniors, their first choice is to remain in their home and age in place, but for many this isn't a realistic option. The home may have safety issues, be too far away from needed services, or be too expensive and difficult to maintain. Yet only 43 percent of families have discussed if and when aging parents should move out of their homes.

Unfortunately, there can be a high price to pay for not getting help when help is needed, says Los Angeles-based geriatric care manager Bunni Dybnis. "We see terrible things happening, like people getting scammed, or failing to take care of serious health problems, or driving when they're not supposed to and don't have insurance." Studies show that one in three adults over the age of 75 has enough cognitive impairment to mishandle or fail to take care of important financial issues, Dybnis says. One misstep in an area like this can cost your parents dearly; failing to make mortgage payments or pay property taxes could lose them their home, for example, while failing to take medications could lead to a heart attack or other serious health problem.

Falls are perhaps the biggest risk of all for older adults living on their own. Many common medications can cause dizziness as a side effect, increasing the likelihood of falling, and the weakness common to aging also leads to falls. If your parent lives alone she may take inappropriate risks, like climbing on a chair to change a light bulb -- or she might simply forget to turn on a light at night. And once an older adult takes a fall, it can trigger a cascade of health consequences from which she may not fully recover.

Once you introduce the subject of a long-term care plan, don't forget to discuss the cost of care as well. Bringing the subject up earlier rather than later increases the chance that long-term care insurance will be within reach. And care planning will greatly influence how your parents save and spend the resources -- including real estate -- they have available. Think of it this way: The longer you wait to discuss your parents' long-term care plan, the greater the chance that they'll wind up living with you. Of course, for some people this is an excellent solution, and one that everyone's happy with. But it's not a decision you want to make because you have no other option.


about 2 years ago, said...

This is no surprising, it is indeed difficult to start a conversation with an aging parents, more so if the topic is not so pleasant like later-life or end-of-life plans and decisions and driving. A study from Pfizer revealed that the hardest conversation to have with parents is telling them to stop driving (39%) than talking to them about final wishes and wills (24%). It may be a normal reaction especially if your parents spent many years driving, taking the keys away from them is like taking away their independence. You have to create alternative list of solutions if you are going to have your parents stop driving, if they don't prefer public transportation, then you can suggest Supplemental Transportation Program. Long-term care is also not a good topic for seniors, most of them are in denial, however, one should not forego planning for it because the cost is not easy to afford, based on www.longtermcareprimer.com/basics/ltc-costs , the cost of long-term care in the US can range anywhere from $40,000-$94,000, and if your parents don't have any plan on how to pay for these expenses, you might be held liable due to the filial law. Start the discussion with your parents while they are still healthy, include other family members and determine their retirement, financial and estate plans, and once they have created a plan, it is important that these plans is put into a legal document - an advance directive or a living will.


about 2 years ago, said...

Hi Anonymous - What I did with my parents when we were going anywhere together, was I just walked to the driver's side door and got in, and put my hand out for the keys. They ended up liking it a lot. Of course this was about 20 years ago that I started that. As of about 5 years ago, they lost their licenses.


about 2 years ago, said...

my mom says she likes to drive,,,,how ever, she is almost 72...she drives really well. the problem is she gets too tired while we r out doing things and driving becomes harder for her and she becomes impatient w/ other drivers being on"her street"...we both joke about the "her street" part but it is hard for me to listen to her complain....when i see the solution as let ur daughter who is younger, stronger and healthier drive...most time she wont let me...sometimes it can get alittle scary for me when we have close calls(almost accidents).any suggestions??


about 2 years ago, said...

Something VERY important that many adult children are afraid to discuss with their parents is a diagnosis of dementia. An excellent doctor who specialized in treating people with dementia said that older people can handle much more than their children realize. When a child does not tell a parent about the parent's dementia diagnosis, it is likely because the child cannot deal with this! People must know about their dementia diagnoses so they understand what is happening to them.


about 2 years ago, said...

Well I am very glad to see this article address the 3 touchiest subjects that adult children need to discuss with parents. I'd be willing to bet that more adult children are more willing to discuss sexual intimacy/viagra/ED with their parents than the 3 subjects above. Sometimes you just have to have DMV help you with the process of driving. That's what my siblings and I had to do. Of course I had to do the actual work with DMV, as they were unwilling to hop in. I filled out the forms to turn them in, helped them with the paperwork. The first time, their old country Dr. filled out the paperwork so they could drive. Once they moved up here, and started going to the Dr. with me joining them, I turned them in again. This time, Dad was turned down and suspended without testing. Mom had to test, and have her Dr. fill out paperwork. Mom failed miserably at the DMV Safety Office - California has Safety Office to deal specially with those turned in for testing. Doing this was difficult, on the one hand, I knew the public was going to be safer, as well as my parents. On the other hand, it made my life even more difficult, as now I had to take them on their errands. Evidently they had gotten lost in town numerous times, as I found maps that the Police Department carry in their squad cars to help people unfamiliar with our town. Very sad. The Trust/Will item I had taken care of about 10 years before they moved up here. I went to get my own done (as a single woman), and basically shamed them into getting one as well. And the last, was covered by me, as they had no long term care insurance. It's OK, they were so frugal all their life, they have enough money to last nearly 30 years where Dad is now (Mom passed 30 month ago). Then of course, there's me to manage the care. That's really what they were counting on anyway!