How to Talk to Elderly Parents About Assisted Living
Talking to parents about assisted living can be tough. The move to a senior living community is often viewed as a permanent blow to an elder’s independence, and many seniors stubbornly avoid discussing this topic because they’re afraid they’ll be forced out of their homes. Adult children and even spouses tiptoe around the subject because they’re unsure how their loved ones will react.
The truth is that, while moving is a big adjustment, assisted living can actually extend a senior’s independence, improve their social life and provide assistance with activities of daily living (ADLs). According to the National Center for Assisted Living, there are more than 800,000 individuals residing in 28,900 assisted living communities nationwide. Assisted living is becoming an increasingly important part of long-term care planning since it falls squarely in the middle of the elder care spectrum.
Unfortunately, many families postpone this conversation for too long. An accident or medical crisis can suddenly necessitate a higher level of care. Frantically researching senior living options and taking tours is not the way to ensure a facility offers quality care that matches an elder’s needs, preferences and budget.
Broaching the topic of assisted living well before it’s needed can help remove some of the anxiety and uncertainty from the equation, making it easier for all involved. The following tips can foster a healthy, collaborative discussion about long-term care instead of one that is rife with accusations, fear, frustration or anger.
How to Talk to Aging Parents About Moving to Assisted Living
1. Research senior housing options.
Before bringing up the topic, learn about the different types of senior living settings and the levels of care they provide. Senior housing characteristics can differ somewhat from state to state, so be sure to research options in the state where your parent lives or may wish to relocate eventually. For example, in California, assisted living facilities (ALFs) are often referred to as residential care facilities for the elderly (RCFEs). Although pricing varies widely and changes over time, research the average costs for each type of senior housing community. According to Genworth’s 2020 Cost of Care survey, the national median cost of assisted living is $4,300 for a private one-bedroom unit. Contacting local ALFs for pricing information can give you a more accurate picture of long-term care costs in your area. Learn about your parents’ financial situation and their options for funding their care. For example, ask if they have purchased long-term care insurance. If Dad is a veteran, inquire about his military service to see if he could be eligible for veterans benefits to help pay for long-term care. If you bring solid information to the table instead of speculation, everyone will be able to base their decisions on facts and avoid unnecessary surprises. Some elders are tightlipped about their finances, so this piece of the puzzle can be tricky. Gail M. Samaha, an elder care planning consultant and founder of GMS Associates in Scituate, Mass., suggests emphasizing that you need to have an idea of what they can afford in order to be able to provide for their wishes and needs.
2. Make future plans a topic of ongoing discussion.
Broaching this subject early on while elders are still able to live safely in the community gives you the opportunity to discuss the future in a non-threatening, hypothetical way. This way the feeling won’t be, “We HAVE to have the discussion right now,” Samaha says. “Parents are less likely to wind up feeling like their kids are ganging up on them.” Instead, “the talk” can be viewed as an evolving process where everyone’s opinions can be heard, but nothing needs to be acted on immediately. Have the conversation in a casual, comfortable spot, like at the kitchen table. Start by saying, “I know this is hard to talk about, but I want to be sure that I honor your wishes. For me to do that, I need to know exactly what they are. We don’t have to decide anything today, but let’s just start the discussion, so we can keep this in mind and focus on preparing for the future.”
3. Promise to keep seniors involved in decisions.
Everyone wants to be able to choose where they live and the kind of care they receive. Age does not change this preference. If they are healthy enough to do so, ask your parents to join you in touring senior living communities or going to visit friends and relatives who have already made the move. Seeing these settings firsthand, getting a feel for how they function, and speaking with current residents candidly about their experiences will help immensely when it comes to making a decision.
4. Present housing options with positive language and tone.
One way to ensure this conversation goes smoothly is to be careful about how you present it. When speaking about assisted living, use positive, non-threatening words. Refer to assisted living as a “community” rather than a facility. Talk about “condo-style living” rather than “rooms.” Highlight the activities, amenities and social opportunities rather than the personal care. The tone of voice you use can make a big difference, too. Make a conscious effort to speak in a calm, quiet and pleasant tone. Let your parents know it is important to you that they are the ones to make the final decision. This is a two-way conversation, not a lecture, so be sure to be respectful. Listen to and validate their feelings. If they get angry, don’t respond with more anger. The more a person feels they are not being heard, the louder they will speak and the more frustrated they will get. Don’t reply with loud tones, or you will end up in a shouting match, which never ends well.
5. Identify the what-ifs.
If both parents are still alive and together, ask what may need to happen if one of them dies. Should their home be sold? Should the surviving parent downsize or move into a senior community? This facet of “the talk” can be difficult and sad, but it can help you learn about your parents’ wishes for each other and shed some light on what they have already discussed amongst themselves. Express that this is an unpleasant scenario to consider, but share that your goal is to know what they want for one another. Try saying something like, “Mom and Dad, both of you are okay now, but what should we do if that changes?” Ask each of them what they would want for the other person if the worst were to happen. Hopefully, they would want each other to be safe, well-cared for and financially stable. Ask for suggestions on how you can help ensure these things.
6. Recognize why seniors want to stay at home.
Elders may not want or be able to express this, but most know deep down that if they move to senior living, it is likely their final residence. “Even if they can’t articulate that or admit it to themselves, the underlying reason that elders don’t want to move is that they feel they are going there to die,” explains Sheri L. Samotin, founder and president of LifeBridge Solutions, a company that provides family transition planning, caregiver coaching and other services. “Even if they know it’s the right thing and good for them, it’s not easy to acknowledge that you’re at the twilight of your life.” They may be unprepared to have their relationship with you change and fear losing their independence as well. Keeping their concerns in mind during these discussions will help you answer their questions and respond to their objections tactfully. Discuss ways they can continue living in their house longer, such as hiring in-home care or attending adult day programs. Emphasize that a move to assisted living does not mean they’ll no longer have control over their daily life. After settling in, most seniors find that they have more free time for the things they actually enjoy doing because the housekeeping, laundry and meals are taken care of.
7. Research the progression of illness.
If your loved one has been diagnosed with a chronic medical condition, such as Parkinson’s disease, dementia or heart failure, learn about how it will progress. Certain age-related diseases can significantly impact a senior’s ability to stay at home and/or make informed decisions about moving. Share what you’ve learned from their doctor or through your research, and discuss how the services offered by certain long-term care settings could help them in six months, a year, 18 months from now, etc. If a senior has a progressive chronic condition, it’s often necessary for them to move to different settings that provide more intensive care as they decline. Finding the right facility that can meet their current and future health care needs, such as a continuing care retirement community (CCRC) will ensure the elder’s life doesn’t have to be disrupted multiple times as their condition changes.