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.

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Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio