Is it time to have “The Talk” with your aging parents?
Tips, advice and a checklist to talk to your aging parents about their health changes.
When Peg Bell retired recently, she didn’t expect she’d immediately get a new job: taking care of her 83-year-old mom, Norma.
Norma had lived alone on the family farm since her husband died in 1991. At least twice a month, Peg drove 3 hours from her home to Norma’s farm to help around the house. During each visit she paid close attention to Norma’s physical and mental changes.
Over the past couple of years, Norma had fallen repeatedly. “Who would find her – and how quickly would they find her – if Mom fell and really got hurt?” Peg wondered. “What if she fell outside in the winter?”
Norma’s assorted medications made her forgetful, dizzy and lethargic. She drove less and less, arranging for her groceries to be delivered to her home; she had long ago hired out housekeeping and yard work. Driving to church became difficult, which was one of Norma’s primary social outlets.
Peg knew it was time to have The Talk with her mom: Could Norma realistically stay on the farm, or was it time to consider moving to an assisted living community?
Look for the signs.
According to a 2015 caregiving report conducted by AARP, more than 32 million Americans provided care to an adult older than 50. And while every caregiver just wants to make sure their loved one is safe and well cared for, there’s no one way to have a conversation that ensures a positive outcome.
So how do you know it’s time to have the care talk with your aging parents? First, you need to look for signs your aging parent may need help.
One thing you can do is observe whether it appears your parent requires help with their activities of daily living (ADLs). Typically, ADLs are defined as 6 routine activities people do every day without assistance. For clarification, long-term care insurance commonly uses these ADLs to determine if care is needed; typically, if an individual is unable to perform at least 2 of the 6 ADLs, long-term care insurance benefits, if you have them, will kick in.
Here’s that helpful ADL checklist:
1. [] Bathing – Is your parent able to shower or take a bath without assistance? Can they brush their teeth, comb their own hair or shave?
[] Yes [] No [] Sometimes
2. [] Dressing – Is your parent able to get dressed on their own without struggling with zippers, buttons, etc.?
[] Yes [] No [] Sometimes
3. [] Toileting – is your parent able to get onto and off of a toilet without help?
[] Yes [] No [] Sometimes
4. [] Maintaining continence – can they control their bladder and bowels?
[] Yes [] No [] Sometimes
5. [] Eating – can your parent feed themselves? Not that this doesn’t include whether they’re able to prepare their own food — it’s only measuring whether they can feed themselves without help.
[] Yes [] No [] Sometimes
6. [] Mobility – Is your parent able to move from seated to standing, get in and out of bed, and walk independently from one location to another? It’s generally OK if they need to use a cane or walker for assistance; you’re simply looking at their general ability to transfer from one spot (their bed, a couch) to another.
[] Yes [] No [] Sometimes
If you’ve checked “no” or “sometimes” under at least 2 of the 6 ADLs, your parent may need more help performing normal tasks in their day-to-day lives. Here are some other changes to look out for:
A change in their weight
This may indicate they’re not eating well or are having difficulty cooking their meals. It may also mean they’re not able to drive to the grocery store. Ask them about their meals, and check the pantry and fridge for old food or less food than usual.
Cuts, scrapes and bruises
These may signal a recent fall. Watch to see if they hold onto furniture for balance, or have trouble climbing stairs or moving around. Ask if they’ve had a fall.
Unkempt appearance or surroundings
A change in their personal appearance may indicate problems with dressing, bathing or grooming – 2 of the 6 ADLs.
An uncharacteristically messy or disorganized home could mean they’re not managing their housekeeping tasks like washing the dishes, doing the laundry or taking out the trash.
Scratches or dents in their car
These may be evidence of impaired driving ability. Blurred vision, confusion and drowsiness while driving causes crashes, near-misses and fender benders – even while parking. Take note if they’re asking you to drive them more or if they’re staying home because driving is too much trouble.
Expired medications or unfilled prescriptions
Are they having trouble remembering to take their medications, or are they mixing them up? Are they taking their medicine at the appropriate times of day as prescribed? Check in with their doctor to see if they’re staying on track. Older adults may take many medications; often, those medications cause adverse side effects or cause drug interactions. Be sure to share a list of all your parent’s medications with their personal physician to reduce or eliminate the chance of drug interactions.
You’ve noticed some changes. Now what?
Once you’ve had some time to evaluate your parent’s situation, here comes the tricky part: initiating and navigating the conversation – which might include whether it’s time to consider an assisted living community.
Peg Bell decided to discuss with her mom the problems she noticed, then discuss the solutions together. By taking this approach, Peg felt her mom would feel more in control of the decisions.
“I became a big suggester,” Peg said. “I knew it wouldn’t work if I tried to force something on Mom. I had to make it seem like it was her decision. But ultimately you have to do what’s best for them. Lean on other family members for help if you have to.”
Norma ultimately decided to look at assisted living options in her hometown; she called each of them, while Peg visited the communities. Peg said her personal visits helped her, for a few reasons:
➔ You’ll be more familiar with the communities and what they offer. “If your parent throws up roadblocks, you can tear down those roadblocks,” she said. “She initially wanted to take her kitty and said she wasn’t moving without her. So we found a pet-friendly community.
➔ You can push all the positives. “Mom said that no matter what, she wanted to keep her car – she didn’t want to rely on anyone else’s schedule if she wanted to go somewhere. So we talked with a couple of residents about what they thought of the community’s transportation, and they all said they loved it. That helped lower her resistance a little.”
➔ You can take a look at the space they’ll move into. Norma wanted a one-bedroom apartment – but she was moving from a two-story, three-bedroom farm house. Peg got a floor plan showing the square footage of the new apartment, then measured all her mom’s furniture. She was able to make many of her mom’s treasured pieces fit perfectly, but there were some compromises. “Mom wanted to take her desktop computer and her 55-inch TV,” Peg said. “We really had to talk about what was realistically going to fit in the new space versus what she had.”
Making the move – and what comes next.
Initially, Norma had thought she’d wait a few months to make her move. But once she visited her new apartment, she told Peg she wanted to move in immediately. Within Norma’s first few weeks there, Peg quickly noticed changes in her mom – all for the good.
“Mom decided to learn how to play dominoes, and before she’d never been interested in playing. And she’s met a lot of new people,” Peg said. “I think our personal relationship has improved a lot. It’s really helped my peace of mind too. She has an emergency call button around her neck, which makes me feel better that she has help right outside her door.”
A few tips about helping your parent settle in.
Peg also offered a few bits of advice:
➔ You may need to get power of attorney to act on your parent’s behalf – because chances are good you’ll need to make medical and financial decisions for them. Having power of attorney also means you can talk to your parent’s doctors, as well as anyone your parent does business with.
➔ Make sure you know where your parent’s important papers are, and that they’re up to date. Do they have a will? Life insurance? Long-term care insurance? A do-not-resuscitate directive? Knowing whether these documents exist – and where you can find them – should be included in your conversations.
➔ Help counteract feelings of unfamiliarity or homesickness. Once your parent has moved into an assisted living community, encourage friends and family to visit. If possible, arrange a family dinner – many communities have private dining rooms and welcome family members to join their loved ones for meals. Surprise them by sending greeting cards to their new address or having flowers delivered. Who doesn’t love receiving mail and a fresh floral arrangement?
One more tip Peg shared: Sometimes you have to remind your parent – and yourself – about the benefits of making the decision to move. “Communities make sure Mom’s on the right medications and that she takes them properly. She’s getting the right care. She’s getting three square meals a day, and it’s good nutrition,” Peg said. “She’s doing activities, and she has a calendar of things she could try. She has lots of opportunities to meet people.
“I haven’t seen Mom smile so much as she does now. She’s really much happier where she is today. She doesn’t want to move back to the farm.”
Rolling Green Village is here if you need us.
If you’re talking to your aging parents about changes in their health and are considering an assisted living community like ours, we’d be happy to tell you more about us. Read testimonials from residents, view our assisted living floor plans and see answers to some frequently asked questions.
If you’d like to visit our community, just give us a call at 864-987-9800, or use our contact form.