Discussions with Aging Loved Ones Sometimes Difficult but Important

Sep 24, 2014

Older Couple
Credit Garry Knight / Flickr

Living the way you want to live as you become elderly requires some planning.  If you don’t make decisions before you can no longer make them on your own, someone else will make them for you. 

Chris Blaine, owner of Home Instead Senior Care, believes it’s never too early for kids and their aging parents to discuss the future.  He recommends having those discussions when the child is about 40 and the parents are around 70.

"That way you can really insure that their wishes are going to be carried out.  Oftentimes what happens is there's a crisis, and that's what actually spurs conversations, but by then it's too late.  So, if you can proactively have those conversations,  hopefully you can avoid discontent or, you know, lawsuits and things like that," he said.

Topics to cover, he says, include how someone wants to age:  do they want to stay at home or are they comfortable going to a facility?  And you should discuss finances.

"How are you going to pay for your care as you age?  Driving is a big topic--at what point are you going to stop driving?  There's also things that should be talked about--health, end of life wishes," he said.

Having an advance directive, he says, is important so you can be sure your wishes are carried out.

An advance directive consists of a durable power of attorney—a designated person who makes health decisions for you if you become incapacitated or who makes sure your wishes are carried out—and a directive of care or living will, according to Mercy ethicist Dr. Robert Saylor.  He says a good advance directive gives healthcare workers the goals the person would like for them to obtain. 

"What's important to them, how they define their life.  What is their values?  What is important to them with regards to family and physical ability, etc.  If I cannot get them to that with a reasonable expectation, then I shouldn't be doing those things that are just prolonging the inevitable," he said.

Saylor believes everyone should have an advance directive—no matter your age—and they should be drawn up when a person is able to sit down and talk to their family about what they want.  The worst time to draw one up, he says, is in the midst of a serious illness or injury.

"In which they almost feel rushed into doing something like that and making those decisions, but doing it with a family and letting the person express their wishes to the family actually is the greatest gift they can give their family.  That way the family doesn't feel and and have to go through the struggle of making those decisions.  They know what their loved one wanted," he said.

According to Saylor, both Mercy and CoxHealth Systems have people on staff to help with advance directives.

Bringing up topics like advance directives can be difficult, whether it’s the child taking the initiative or the parent. 

That’s why Home Instead developed an action plan for aging that can be found at 4070talk.com.  It offers tools and resources to help get conservations about aging started and covers a variety of topics such as aging and finances, aging and driving and overcoming hurdles often in the way of communicating about aging issues.

Blaine says conversations can be difficult to start, especially if it’s the child that’s initiating them.

"Even though you're an adult, you're oftentimes in a child role vs. an adult role when it comes to your parents,  and so sometimes that's why those conversations are hard to start," he said.

But he says there are ways to start a conversation that can make it easier—such as discussion basic information.

"I mean the big thing--if you can just sit down and say, 'you know what?  If something were to happen to you, Mom or Dad, I don't really know where to start.  I don't know what your wishes are.  I don't even know who all your doctors are, if you have long-term care insurance, what medications you take.  Can we sit down and can we get some of those things documented so that we have them in a file folder and if there's an emergency myself or my siblings we know exactly where to go so we have that information?'  Because that's going to be a launching point, and then through those conversations a lot of times a barrier's kind of broke down and you can talk about some of the more difficult things like driving and finances and some of the more in-depth things.  But I think families, when they do have these conversations, they find it to be beneficial because there's not this elephant in the room and there's not this wonder of, from an adult/child standpoint, what am I going to do when I get that phone call?"

Having conversations early, Blaine says, can help make it easier for people to have their wishes fulfilled down the road.

According to Blaine, if an aging parent is determined to stay at home in the future rather than go to a long-term care facility, there are some things that can be done early to make that happen.

"They need to look at their current living situation and determine where they live--if that home is going to allow them to age in place or are there modifications that should be made to make it easier--things such as a walk-in shower, grab bars, proper lighting, making sure that things are as easy to get to and on one level as possible, even things such as cabinets and closets and things like that--being able to reach things and get to things," he said.

Blaine says staying at home, even if someone is hired to come in and help out, is often a much more affordable option than long-term care. 

But there’s always the chance that a care facility will be needed, and Blaine says long-term care insurance can help prevent financial worries later on.  However, the younger you are when you purchase it, the more affordable it is.

If long-term care is needed, there’s a great resource through the Southwest Missouri Office on Aging.  The organization has put together “The Long-Term Care Guide,” which offers information such as what local independent living, assisted living, memory care assisted living and skilled nursing facilities are in the Springfield area.   It answers questions such as what is long term care?  Will the state take your home if you go into a nursing home?  And is it a good idea for mom and dad to move in with adult children?  There’s also information about home and vehicle modification, the Medicare Prescription Drug Benefit, funds from a reverse mortgage, help with rent, long-distance caregiving and more. 

This afternoon at 4:30 as our SOC series continues, we’ll tell you how exercise can keep a person feeling younger even as they age.