How to Talk to Your Parents About Assisted Living

In 2021, the American Community Survey estimated there were 55 million Americans aged 65 and older. With so many adults reaching the age of 65, 1 in 5 U.S. residents will be of retirement age by 2030. If you have an aging parent, grandparent, or other loved one, they’ll likely need some form of senior care in the future, and now is the time to start discussing their desires and options. These conversations can be difficult but necessary.

Lisa Owens, a registered nurse with years of experience as a senior care provider, explains, “It’s not unusual for a person to be resistant to discussing senior care. Oftentimes, there is grief associated with losing one’s independence, and in general, throughout the aging process.” Some older adults also feel that they’ve lost their sense of purpose, especially if they have trouble performing activities of daily living. Instead of caring for others as they have done before, they suddenly rely on children, grandchildren, and other caregivers for assistance with everyday life tasks.

This guide will help you determine when to talk to your parents about senior care. It also includes tips for approaching these tough conversations with respect and tact.

When Should You Talk To Your Parents About Assisted Living?

Dr. Michelle Feng, Ph.D., a licensed psychologist with specialty training in geriatric psychology and medicine and Chief Clinical Officer at Executive Mental Health, recommends having an open conversation as early as possible before physical and cognitive changes make it difficult for your parent to perform activities of daily living without assistance. She explains, “Ideally you should initiate the conversation before something occurs so that you have some roadmap which isn’t created in the middle of a crisis. The conversation doesn’t have to happen in a scary way: It helps when the adult child connects it with a positive event in their own lives (buying a house, having grandchildren, making a move, doing their own will). In this sense, it’s just another conversation about life put into context.” 

While planning your conversation, watch for these signs that your parents need help.

Increased Forgetfulness

As people age, changes in the brain make it more difficult to remember things. Forgetfulness is also a symptom of some medical and psychological conditions. It’s time to discuss senior care when a parent’s forgetfulness gets out of hand. Losing keys is one thing; forgetting to turn off the stove is another. If your parent’s forgetfulness risks their safety, start exploring senior care options immediately.

Signs of Isolation, Loneliness, and Depression

The National Institute on Aging states that although depression is not a normal part of aging, it is relatively prevalent among seniors. As people age, they often experience significant life changes in a short period of time, such as retirement, developing chronic health conditions, or having to give up hobbies they enjoy due to mobility challenges.

Depression symptoms in older adults may not always be obvious. Therefore, watch for moodiness, fatigue, insomnia, and sudden changes in behavior. Furthermore, heart disease, chronic medical conditions, and the medications they use for treatment can worsen depression symptoms. While assisted living won’t always help cases of clinical depression, if the depression is stemming from isolation and loneliness, moving to a community can help alleviate those stressors. 

Recent Falls, Injuries or Other Incidents in the Home

More than 3 million adults aged 65 and older visit the emergency room for injuries sustained in falls every year. Fall-related injuries also account for around 800,000 hospitalizations each year. If you’re concerned about an aging parent, watch for signs of recent falls, such as broken bones, bruises and head injuries. You may also notice that your parent cuts back on regular activities due to a fear of falling again.

Some medical conditions make older adults even more vulnerable to falls, including vitamin D deficiency, vision problems and health issues that cause a loss of balance or weakness in the lower body. Pay close attention to signs of falls if you know your parent has one of these conditions.

Noticeable, Sudden Weight Loss

Older people tend to need fewer calories as they age due to decreased physical activity levels, but noticeable, sudden weight loss may be a cause for concern. If your parent loses a lot of weight rapidly, it could be a sign of gastrointestinal disease, cancer or a psychiatric disorder.

Noticeable Lack of Hygiene

Physical and mental health problems can make it difficult for an older person to keep up with daily hygiene activities, including bathing, shampooing hair, brushing teeth, and changing clothes. Watch for signs of poor hygiene, such as body odor, bad breath, tangled hair, or ragged nails. When you visit, look for unwashed dishes, spoiled food, insect activity, and other signs that your parents cannot keep up with regular housekeeping activities.

Unexplained Bruises or Injuries

Falls aren’t the only cause of injuries in older adults. In 2020, unintentional poisonings and burns accounted for over 6,000 deaths among adults 65 and older. When visiting your loved one, look for visible signs of burns, such as red skin, scarring, blisters, and peeling skin. If you’re concerned about unintentional poisoning, ask your parents about abdominal pain, nausea, trouble breathing, vomiting, and other possible poisoning symptoms.

Mobility Problems

Arthritis, vision problems, and other medical conditions may make it difficult for older adults to move around. If you’re concerned about mobility loss, watch for signs such as difficulty walking, climbing stairs, and other basic movements.

Frequently Missing Appointments or Social Plans

If your parent have started missing appointments or canceling social plans, the behavior could be a sign of depression or mobility problems. Depression may cause some older adults to isolate themselves, damage their social relationships, and experience feelings of loneliness. Adults with mobility problems may desire to socialize, but their limited mobility and balance make it hard to get out of the house.

Talking To Your Elderly Parent About Other Changes

Talking about aging with an elderly loved one can be intense, multi-faceted, and overwhelming. Understandably, you may be anxious about having some awkward discussions, including everything from your parent’s ability to continue driving to the challenges of estate planning, long-term care, and even end-of-life plans.

Though covering all the different subjects you may face when talking to aging parents is impossible, we’ve highlighted several common topics below to give you valuable insights on tackling these difficult conversations.

Senior Driving

In 2020, car crashes killed 20 older adults and injured almost 540 every day, according to the Centers for Disease Control and Prevention. As people age, they may face challenges that make driving safely more difficult, yet it is closely tied to independence for many seniors, making it a sensitive topic for older parents and their adult children.

For instance, seniors may develop vision impairments, making it hard to see traffic lights, warning signs, pedestrians, cyclists, and other vehicles. Additionally, cognitive decline may impair the ability of older adult drivers to make quick decisions in hazardous driving situations.

With older drivers, their ability to react quickly while driving may decrease due to medical conditions, muscle weakness, and drowsiness caused by medications. These factors can increase the risk of accidents on the road. For example, seniors with muscle weakness in the legs may be slow to slam the brakes to avoid a road hazard or pedestrian. 

If you’re concerned about your parent’s safety, look for signs of unsafe driving habits, such as sudden lane changes, speeding, driving too slowly, tailgating other vehicles and getting into near misses on the road. You should also check your parent’s vehicle for dents, scratches and other damage that could have been caused by a recent accident. If you don’t have many opportunities to ride with your loved one, ask friends and neighbors if they’ve noticed anything concerning about your parent’s driving habits. Finally, if you handle your parent’s finances, watch for a sudden increase in car insurance premiums.

Trusts and Wills

Estate planning is an important aspect of aging, yet only 34% of American adults have a will or a living trust in place. It’s understandable why people may avoid this topic as it involves contemplating one’s mortality or thinking they don’t have sufficient assets to make estate planning necessary.

Therefore, explain to them that without estate planning, a court will decide how their assets will be distributed. An estate plan ensures that their assets are distributed based on their wishes rather than leaving it up to a judge or executor.

Whether your parents need a will or a living trust depends on several factors, such as the value of their assets and whether they want to distribute property before or after their death. A will is a legal document that specifies who will receive property in the event of a person’s death. Meanwhile, a trust is used to distribute a person’s assets before death, immediately after death, or even years into the future. Consult with an experienced estate planning attorney to determine the best option.

Long-Term Care Planning

According to ACSIA Partners, an insurance company based in California, 70% of Americans over 65 will need long-term care at some point in their lives. Women need an average of 3.7 years of care, while men need an average of 2.2 years. Despite the high likelihood that they’ll need long-term care when they get older, many adults don’t plan for their future needs, perhaps because they don’t like to think about losing their independence or developing health problems.

At some point, you may consider having your parents live with you. However, remember that some older adults may experience medical or psychological issues that make it unsafe to reside in a family home without professional assistance. If you anticipate that your parents may require assisted living or a nursing home, planning and starting the process early is advisable.

It’s also important to know that many insurance companies, including Medicare, only pay for long-term care for a set number of days. After that, you have to pay out-of-pocket. Prepare in advance by having the difficult conversation sooner rather than later and securing long-term care coverage or locating a facility before it’s needed.

Challenging Health Issues

Chronic health issues are common during seniors’ retirement years. According to the Centers for Disease Control and Prevention, the following medical conditions are among the most common causes of death for adults aged 65 and older:

• Heart disease
• Cancerous tumors
• Chronic lower respiratory disease
• Cerebrovascular accidents
• Alzheimer’s disease
• Diabetes
• Influenza and pneumonia
• Nephritis (inflammation in part of the kidneys)
• Parkinson’s disease

These conditions result in various physical and mental changes, such as fatigue, confusion, incontinence, difficulty breathing, and limited mobility. Thinking about what will happen when a condition worsens can be difficult, but preparing for significant changes is vital. Here are a few things you can do when handling this sensitive topic:

• Learn as much as possible about the condition, including the signs and symptoms, treatment options, and expected prognosis. Knowing what to expect can help alleviate fear and also help you communicate more effectively with your parent’s health care professionals and caregivers.
• Discuss medication details (e.g., dosages and side effects) and management plans with your loved one to avoid accidental overdosing or missed doses, which can lead to serious medical emergencies.
• Going over your parent’s wishes once their conditions worsen is crucial. Some seniors prefer to  live out the rest of their lives and avoid invasive procedures or medication, while others may be open to exploring all options.
• Talk to your parents about the care they would prefer if they can no longer live independently. Some elderly individuals may require assistance from family members and home health services to remain at home, while others may need 24/7 care at a skilled nursing facility. Discuss your parent’s preferences and be open about the potential costs of care.
• Be mindful of your language when discussing incontinence with a loved one. Suggest absorbent underwear to prevent leaks, and ask if they’ll be interested in trying them out. However, avoid using the word “diaper” and never imply they need to move into a nursing home due to incontinence.

Tips For Talking To Your Parents About Assisted Living

It’s unpleasant to think about losing one’s independence or leaving a long-time home but having meaningful conversations with parents about these topics is crucial. To assist an aging loved one, start by discussing their health, safety, and challenges they may be facing. Starting these conversations early allows parents to be involved in all aspects of planning, ensuring you carry out their wishes regarding medical treatment, long-term care, and financial decisions.

Since these topics are sensitive, your approach when discussing them is crucial. To best serve you and your loved one, we offer tips on approaching these topics.

Do Your Homework Before the Conversation

For a productive conversation, prepare beforehand by speaking with medical professionals or doing online research. Dr. Feng recommends using an article about senior care as a conversation starter.

For example, you could say, “I just read an article on Caring.com about senior care. I want to make sure I understand your wishes so I can honor them. What do you think?” It’s imperative to demonstrate that you’re considering your parent’s best interests and not making decisions on your own.

Be Patient

A productive conversation is not happening if you’re impatient and frustrated. Remember that aging can cause physical and mental changes like forgetfulness and confusion, making it tough for some older adults to have in-depth discussions about their needs.

To remain patient, try putting yourself in your parent’s position. It’s difficult for anyone to lose their independence or deal with health issues. Thus, demonstrating empathy can aid you in persevering through difficult conversations. If you become frustrated, take a break and revisit the discussion when you are calmer.

Let Your Loved One Take the Lead

It is vital to involve seniors in decision-making, even if you have their best interests at heart. This preserves their independence and increases the likelihood of them being receptive to topics such as long-term care and estate planning. Therefore, avoid taking over and make all the decisions on your own.

According to Lisa Owens, RN, giving the person you’re helping as much control as possible is best. Instead of making all the decisions, offer various options and let them choose. Moreover, it’s important to explain that these discussions will help them stay healthy and independent for as long as possible. Preparation is key, so have a plan that promotes good health rather than waiting for issues to arise.

Make It Clear That Their Well-Being Is Your Priority

When you’re ready to have a tough conversation, let your parents know you are concerned with their well-being, not making your life easier. Dr. Feng said, “You can also let them know you care by saying, ‘Mom, Dad, I love you. I want you around for as long as possible. I want to learn about what’s important to you, both now, when we get older, and toward the end of life. I want to make sure I can support your wishes and speak about them if I ever need to.'”

Explain how planning for long-term care can save your parents from selling their long-time home or using up their savings. Long-term care can be costly, with expenses sometimes reaching thousands of dollars per month. Discussing long-term care insurance now can protect both their health and finances for the future.

Frequently Asked Questions

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