Dear Sahaj: My parents are in their late 80s. My father is a cancer survivor and has been taking care of my mother, who has mild dementia. She knows who she is and recognizes us, but her short-term memory is gone. My father’s health is going downhill, and he is starting to worry about what will happen if he dies before Mom. I live in a different state, but my brother lives only four miles away and has been trying to figure it out on his own. I will visit them soon. I know my dad will be against us even considering putting mom in an assisted-living facility. I would like to actually have them both in assisted living right now so they could have a better quality of life and get the help they need, instead of running my poor brother ragged. My brother is such a good guy; he doesn’t complain and drops everything, including anything that comes up with his kids, to help my parents.
How can I bring this up with my parents and help them understand that assisted living would be good for everyone and it’s not what they think it is? I can’t even broach the subject without my dad shutting completely down. He won’t listen and gets angry. My brother and I also really need to get a handle on their end-of-life wishes. A real bummer to bring up, but we have no idea what they want, and we don’t even know where — or if — they want to be buried. I would love any advice on how to bring all of this up when I finally travel to see them.
— Worried Daughter
Worried Daughter: I want to take a moment to acknowledge how difficult this is. Recognizing that your parents are aging and may need ongoing care beyond your capacity can be overwhelming. Talking about aging, death and dying is challenging. For many, these topics are clouded with other feelings — like regret and fear — that require processing before rational plans can be made.
Your dad sounds like he is scared to consider an assisted-living facility, and instead of being able to communicate that fear, it manifests as anger. You’ll need to be able to listen and validate what he is feeling rather than trying to only get your point across.
Consider asking him: “I am curious what you think it means to live in an assisted-living community.” This may clarify his fear, allowing you to specifically address it. You want to highlight how this move would allow him to preserve his independence and, frankly, enjoy it.
You and your brother should educate yourselves about the different options — and understand the financial plan for considering them — so you’re equipped with resources and information for during, and after, the conversation with your parents.
Be explicit about your concerns when you talk to your parents. Maybe there are specific struggles you or your brother have observed that can be improved with additional care. Even if it’s not a concern for their safety, it may be a concern for their quality of life. This may sound like: “With additional care, you can focus less on making sure Mom is safe, and more on enjoying this time together.”
Reflect on how your family’s culture impacts this conversation. Maybe there’s a cultural norm for parents to move in with kids, or traditional gender expectations for men to care for themselves and their wives. Your dad may be up against many narratives beyond a fear of losing his independence that you may want to address with him. He may also be struggling with the roles of your parent-child relationship reversing. Framing this move as a way for your parents to support you may help with that.
This will be an ongoing conversation, but here are four additional tips:
- Mentioning that you are planning your own will, or sharing an article on the topic, can give you an inroad to the conversation that feels less personal.
- Hypothetical conversations are less threatening than direct conversations. For example, you can say: “This may not be an imminent issue, but I want to make sure I honor your wishes when the time comes.”
- Be honest about how hard this is for you, too. That you dread thinking about it but want to make sure it’s not harder than it inevitably will be. This may sound like: “This is hard for me to talk about, but I don’t want to make assumptions about what you and Mom will want.”
- AARP has a plethora of resources for family caregivers, including workshops, financial and legal information, and local resources. They even have a free resource line you can call to help you gather information.
You also seem to have guilt for being far away, so have a conversation with your brother to ensure you are on the same page and to learn ways you can share in this responsibility and be of support to him from afar.
Ultimately, you can initiate these conversations with empathy and curiosity, but it’s not your decision. Respect your brother’s choices and trust him to set his own boundaries. And find creative ways to pass on resources and information so your parents are educated on these topics while allowing them (barring real safety concerns) to have agency over their decisions.
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