One of the toughest conversations you will likely ever have with your parents is the discussion about assisted care.
No one wants to move into assisted living; the necessity of a move brings with it a great deal of natural fear that must be addressed. According to Dr. Donna Cohen, a psychologist who wrote the elder care guide The Loss of Self: A Family Resource for the Care of Alzheimer's Disease and Related Disorders, pride can be a strong barrier to an aging parent's acceptance of care.
"Many older people see themselves as proud survivors," she wrote. "They think, 'I've been through good times and bad, so I'll be fine on my own.' Plus, they don't believe their children understand the physical and emotional toll of age-related declines."
An older parent naturally fears a loss of control over his or her personal affairs. And some aging parents might even feel ashamed, because they feel like they have become "burdens" on their children.
Strategies for Bridging the Subject of Long-term Care
Many children feel uncomfortable discussing long-term care with their parents. They might feel a sense of sadness about their parents' decline or wish to avoid arguments. Some figure they can "cross that bridge when they get there." But rather than avoiding discord, these caregivers set themselves up for more unnecessary difficulty.
Instead, the best strategy for dealing with the transitioning of an elderly parent to assisted living is to be proactive. Ideally, you would begin having discussions about your older parent's long-term care before the need arises. And you should be involving your parent in the decision-making process about future care from the get-go.
Never blindside an elderly loved one with the suggestion that he or she may need to move into a retirement home.
Ask Open-ended Questions and Actively Listen to Responses
Barbara Kane, co-author of Coping with Your Difficult Older Parent: A Guide for Stressed-Out Children, suggests that asking questions and trying to determine the root cause of resistance can help you figure out the most mutually-acceptable course of action.
"Is it about a lack of privacy, fears about the cost of care, losing independence or having a stranger in the house?" she asks. To build trust, Kane says, you must empathize with your parent and validate his or her feelings, instead of dismissing them out of hand.
If fear of losing her independence is one of the primary causes of arguments with your aging mother, you can alleviate her concerns by asking her up front what her desires are for the inevitable time she becomes unable to care for herself. Talk about what decisions regarding her medical care she would like to make now— before she loses the ability to do so— via an advance care directive or living will.
If your father's sense of pride makes him feel ashamed of the cares he will place upon you, engage him in talking openly about it. Ask him what he would prefer to happen, and sound out his willingness to either accept in-home nursing care from a third party care provider, or to look into moving into a retirement community. Try visiting retirement communities together and making a list of his preferences. Then, when the need for more care arises, he will feel like he was the one who was ultimately in control of the decision to seek additional care.
Involve an Impartial Third Party
It can help an older loved one to become more open to accepting care if there are other voices advising him or her to do so. "Sometimes it's easier for a parent to talk to a professional rather than a family member," Cohen wrote.
Having regular extended family meetings, or soliciting advice from trusted professional like a geriatric psychologist, doctor, or minister, can provide an elderly parent with an impartial perspective that he or she will find more difficult to argue with.
Ask your parents to join you in seeking others' opinions. If your parents are the ones asking questions of others, they will be more likely to accept the answers.
You might be able to avoid conflict by asking questions that guide your parent to the decision you know should be made. If your mother is forgetting to take her medicines, or is becoming unable to feed herself, ask her to imagine how you would feel if she allowed her health to decline just because she was unwilling to accept help. If you are honest with her about your fears and feelings, you may find her more becoming more receptive.
But if your parent is absolutely steadfast in resisting assisted care, don't beat yourself up about it. As long as they are not endangering themselves or others, you should let them make their own choices.
"You can't be at your parent's side all the time," Cohen writes. "Bad things can happen, and you can't prevent them. You need to accept limits on what you can accomplish and not feel guilty."
Caring for elderly parents isn't easy
Making decisions about their future care isn't easy, either. But by involving your parents directly in the decision-making process, actively listening to them and sharing your feelings openly with them, you will find that transition to long-term care may be easier than you thought it would be.