How to Start the Family Caregiving Discussion

Historical insight — Originally published June 6, 2023. Preserved as historical content; information may have changed.

Nobody looks forward to discussing finances and elder care with their parents, but every family needs to do it. These tips will help you start the conversation now and get a plan in place before you urgently need it.

Most of us have always thought of our parents as the people who took care of us. We didn’t need to know how much money they earned or when they ate meals. But now, things are changing. Statistics show that currently about one third of the adult U.S. population is providing care for another adult. That number is only going to grow as the population ages and life expectancies increase.

Age takes its toll on everyone. For some, it may come in the form of dementia; for others, impaired vision or hearing. So everyone will need help as they age, including your parents and other elderly loved ones. Having a caregiving plan in place is essential to prevent crises from occurring. In order to create that plan, you should have a discussion with everyone involved, preferably before the care recipient starts declining.

No one can go through caregiving alone. Make sure that siblings and any other family or friends who might be a means of support are included in the discussion. While it might seem easier to have one person make all the decisions, this is not feasible in the long term.

However, it is helpful to have a primary caregiver, or at least someone who will lead the discussion. If sibling dynamics are an issue, consider meeting together before meeting with the parents. Discuss individual views, and what each of you is willing and not willing to do. But remember, the seniors will have the final say.

Don’t insist that this conversation needs to happen in one big session. It might play out over the course of several weeks or even months. Decide what works best for your family. If you feel like your parents may get defensive, brainstorm some natural talking points to springboard the discussion. Otherwise, perhaps scheduling a specific “Family Caregiving Discussion” with all involved is the best way forward. Possibilities are endless, so long as the conversation occurs.

A key part of being prepared is knowing the options available. Look into in-home care services and consider your parents’ health. Do a bit of research about local assisted living facilities and their costs. This will help you make a better, more informed decision.

A caregiving plan needs to include the four areas of medical, legal, financial, and personal issues. Some of these questions can be answered in the first discussion, while others will require doing deeper research or getting outside opinions.

1. Medical

Get a professional opinion on the loved ones’ health and future prognoses. This will greatly affect decisions about the level of care needed now and in the long-term.

Gather information about health insurance policies, including Medicare and any long-term care policies.

1. Legal

Even though it might seem early, it is critical to get decisions made and documents signed now, while your parents or other elders are in a sound state of mind.

Most important are a power of attorney and a health care agent. These allow care recipients to choose a representative who will act on their behalf in case of mental incapacity. Also important is estate planning. This can often be a touchy subject, but there needs to be an up-to-date will and all accounts and trusts need to have correctly titled beneficiaries. Otherwise, final wishes will not be honored and the courts will distribute the estate according to probate laws.

1. Financial

Gaining access to your parents’ financial life can be a particularly tricky topic to breach. It represents a real change of life and roles for older people that can be hard to face. They may not want you in their business. However, no one wants dementia to creep up on their parents, or for them to be left vulnerable to scammers. Aging Parents, a blog and mediation service relating to elder care, states that the approach is crucial for success with this subject. They advise: “Put it on yourself…that if something went wrong, you would be completely lost as to how to help them.”

Have an open and honest discussion about income and expenses, assets and liabilities. Be sure to find out who the financial professionals in your parents’ lives are, and how to contact them. You may need to consider taking over bill payments or monitoring the care recipient’s accounts. Seniors are particularly susceptible to exploitation. No matter how uncomfortable, the care recipients must have a plan to pay for care as they continue to age.

1. Personal

Remember, this discussion is all about the care recipients. What are their personal preferences? Where do they want to live? You need to assure your loved ones that they will be able to maintain independence as long as possible, and that everyone wants to make decisions that are best for them. While some may view it as maudlin, it can be helpful to ask the seniors to write a letter detailing end-of-life wishes and the reasons behind their choices. This is also a good time to begin compiling a list of important documents and where they can be located, as well as accounts and their usernames and passwords.

It’s not a question of whether resistance will be a part of this conversation, but just how much and how to deal with it productively. If you anticipate it as part of the normal process of approaching this change of life, you need not see it as a huge obstruction. Just work through it gently and with understanding of your family member. The caregiving section of the AARP website offers this advice for getting the conversation rolling in a positive direction:

• Try not to anticipate what your parents might say or how they will react.
• Example: “Dad, let’s talk about what you want down the road. Let’s start with what is important to you.”
• Express your love and concern—and, most important, listen.
• Example: “Mom, have you thought about what you want to do if you need more help?”
• Refer to yourself and your thoughts.
• Example: “I know this is hard, and I’m going to have to do the same thing for myself one day.”
• Be straightforward about the facts; don’t hide negative information.
• Example: “When you are driving, I notice your reactions aren’t as quick as they used to be. I’m worried.”
• Phrase your concerns as questions, avoiding telling your parents what they should do.
• Example: “Mom, do you think you might want a hand with some of the housework?”
• Give your loved ones room to get angry, but remain calm.
• Example: “I understand all of this is really hard to talk about, and at the same time, it’s important for us to discuss.”

Finally, remember that a caregiving plan is just that—a plan. It prepares for the future, and doesn’t necessarily mean that anything will happen right away. It just means you don’t want to be caught unprepared.

• Download the original family caregiving guide (PDF)

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