Difficult conversations about driving, home care, nursing homes and hospice can be so easy to postpone. But the longer you wait, the harder it becomes.
The earlier you discuss aging issues with your loved ones, the better.
“Do it when they’re healthy and younger,” said Michele Moore Wright of Home Care Assistance of New Mexico.
“About everybody that calls says, ‘I’ve never been through this; I don’t know what to expect,’ ” she said. “We plan for our children and we plan for ourselves, but we don’t understand when our parents are aging.”
“I think what’s hard is a lot of us delay the conversation until there’s a crisis,” added Leslie Montoya, a medical social worker with Legacy Home Health and Hospice. “Then it’s harder to make those decisions. The earlier we talk about it, the easier it is.”
The American Association of Retired Persons offers a newsletter about negotiating these tough issues.
Spend time with your loved one observing and gathering accurate, specific information about your concerns before you even begin a conversation, it states. If you want to talk about driving, ride along first to make valid observations. Worried about their safety at home? Stay with them for a few days to get a real sense of the situation. Is the mail piling up? Are they having trouble navigating stairs? Are they able to prepare healthy meals? Talk with the people who see them regularly and try to be objective.
Caregivers can sometimes weave in conversations about aging after watching a movie about a subject like dementia or a news report about serious injuries or health problems.
“If you see a movie about dementia or somebody’s dying, say, ‘What would we do in that situation,’ ” Moore Wright said. “Don’t get discouraged. If you don’t get anywhere, keep trying.
“You bring it up before you need the conversation.”
Giving up the keys
Driving is a big conversation. Surrendering the car keys means surrendering your independence. Assure your loved one that you or someone else will drive them where they need to go so that they don’t feel stranded.
It helps to put yourself in your loved one’s shoes, Montoya said.
“We’re all going to deteriorate. We’re all going to pass away. Sometimes I think the person bringing it up has the hardest time talking about it.
“Say, ‘I’m worried about you; I don’t want something to happen to you’.”
You could ask them to limit their driving to daytime or at certain times of day, she suggested. Or ask family members to help.
“You don’t want to isolate them in their home,” Montoya added. “You have to be flexible.”
Accompanying your relative to a doctor appointment can offer reinforcement.
When it comes time to talk about nursing homes, say, “I want to make sure you get your needs met,” Montoya said.
Join your relative on the internet to research the options. Some facilities offer meals and medical care.
“We have our social workers meet people where they’re at,” Montoya said.
Bringing up hospice is hard, she added, but at that point, elders have usually had conversations about it with their doctor. They may want to sign a Do Not Resuscitate document.
Ask, “If you had a diagnosis, would you prefer to be at home, do you want to be on life support? Do you want to be kept alive artificially?” Moore Wright said.
It’s not a one-way conversation, so ask how they think they are doing and what adjustments they’ve thought about.
Have compassion for their situation and understand that change is hard for everyone. The unknown can cause fear and discomfort for all of us at any age. It’s normal to want to avoid change, so tell them that you understand their feelings of reluctance, fear, anger or hopelessness, and that you want to help make change easier for them. Sometimes people just need acknowledgment that this is hard to deal with.
Ask your loved ones whether they want a funeral and if they want to be cremated. If they do want a service, what kind? Say, “What do you want to do when the time comes?,” Montoya said. “I really want to honor your wishes.
“How can I support you? Who do I need to call to make the transition as peaceful as possible?”
Give your loved one the opportunity to think and talk.
“It’s their life, not ours.”