Difficult Conversations With Aging Parents
Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation, with host Pamela D. Wilson, is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.
Tips For Talking With Elderly Parents
This is Pamela D. Wilson, caregiving expert, speaker, consultant, and guardian of The Caring Generation. The Caring Generation focuses on the conversation of caring. Giving us permission to talk about aging, the challenges of caregiving, and everything in between. It’s no surprise that needing care or becoming a caregiver changes everything. The Caring Generation is here to guide you along the journey to let you know that you’re not alone.
You are in exactly the right place to share stories, learn about caregiving programs and resources to help you and your loved ones plan for what’s ahead. Invite your aging parents, spouses, family, and friends to listen to the show. If you have a question or an idea for a future show, share your idea with me by responding to my social media posts on Facebook, Instagram, Twitter, or Linked In.
Today, we are talking about having difficult conversations with aging parents. Conversations you may not even know you should have until disaster strikes and aging parents are relying on you to care for them in a variety of ways. Simple things like shopping and errands to more complicated issues like taking elderly parents to medical appointments or helping them with intimate tasks like bathing and managing incontinence.
If you are an only child who is a son the topic of caregiving is usually more challenging than if you are a son and have a sister or two in the family who can talk to mom. Even still I know plenty of sons who are the primary caregivers for their mothers who manage conversations about incontinence, wearing Depends, urinary tract infections, and more. You do what you have to do to get by.
Let’s begin with reasons we don’t talk to parents about planning for their future. The first is that as children we expect that our parents have this all planned out. Why would we think otherwise? They are our parents, they raised us and they knew what they were doing—well, maybe not totally. But they did the best they could under the circumstances.
The second reason having different conversations with aging parents doesn’t happen is that we, as their children, are so busy with our lives that most of the time we’re not thinking of what life will be like, 40, 50, or 60 years into the future. We’re trying to get through today, tomorrow, next week, and next month.
The third reason is a lack of life experience with anyone—except maybe grandma or grandpa—who is struggling. As busy adult children either we were too young to see what mom and dad were doing for grandma and grandpa or they didn’t burden us with all of the details about the help provided for grandparents
And last, if we’re honest talking about caregiving, aging, becoming sick, and needing money to pay for care is not a sexy or pleasant topic so society, in general, avoids talking about unhappy things. If you watch television, you might be seeing the commercials about Medicare with Joe Namath and Jimmy Walker. All of these old people on television talking about Medicare coverage.
You have no idea why they’re concerned—it doesn’t involve you. Until you become a caregiver for aging parents, and all of a sudden doctors, hospitals, medical treatments, nursing homes, and money to pay for it all becomes a concern. But even then—you don’t know how to talk about it because you don’t know why it’s important. All you know is that it’s not a happy topic so you avoid it.
Past the age of 65, and sometimes before if chronic diseases exist, paying attention to health can become a full-time job. Parents who have health issues have higher medical expenses. In fact, healthcare expenses, are the third greatest expense for retirees after having a mortgage and transportation expenses.
Let me share some statistics from Milliman, an actuarial company. If you want to see the full report, go to my website, click on the media tab, then The Caring Generation, and look for episode 110—yes there are now over 100 episodes of this podcast for you to listen to and share with aging parents, siblings, friends, and co-workers. This information is from the Milliman Retiree Health Cost Estimates report.
It may shed light on why aging parents can struggle in retirement and come to depend heavily on their children for care personally and financially. All the more reason to begin having difficult conversations with aging parents today no matter how old you or they are.
Statistic #1 “the average monthly Social Security benefit at age 65 to 69 was $1,468.73 for retirees and $871.86 for spouses. Can you guess which spouse receives the higher social security benefit? It’s likely the husband. But do you know why? It’s because women are expected to be caregivers throughout their lifetimes. They have children, care for aging parents, and sometimes a spouse before retirement if not after.
Many women quit their jobs and lose income and contributions to social security and retirement plans that they never make up or regain. And then what happens, the husband needs care and all of the family money is spent on the husband leaving the woman with nothing. Sorry men, but I am pro financial education for women so that they understand what they are giving up and demand some type of compensation if they’re going to quit work.
If you’re wondering what I mean by family compensation, I mean a separate retirement account for the wife in which the husband places contributions. Plus, a long-term care insurance policy. Why should women take care of the family throughout their lifetimes and lose income, only to live in poverty with no one to care for them when older. That’s a difficult conversation to have today in your family.
Here’s another statistic, a healthy and I say healthy 67%-year-old retired couple will spend 33% of their Social Security benefit on healthcare in 2021. So, of those dollar amounts I just mentioned, it was a total of a combined $2,340.59 for a married couple, about $775 of that per month is spent on healthcare. Now, remember this is a healthy couple. Few couples unless they have both been very active exercising all of their lives, and participating in preventative medicine are considered healthy at age 67.
This means that most couples spend more on healthcare that could reach amounts equal to half of their income. These numbers are shocking to most people and they should be. I want you to realize the importance of staying healthy starting in your teens all the way to the end of your life so that you can avoid skyrocketing healthcare expenses and not have to rely on your children to contribute financially to your care.
Because you know what happens then? Your children can’t pay their bills and save for their own retirement. Which means that if you are an aging parent, your care needs and expenses can rob your grandchildren who will have to pay for the care costs of the children caring for you. Think about that. Caregiving is a generational and cultural issue that we must stop passing down from generation to generation. I know you’ve heard me say that before.
This is an important topic for having difficult discussions with aging parents long before health and caregiving needs arise. Have the same conversation in your family with your spouse and your children. The conversation goes like this. ”Mom and dad we want to talk about making sure you are comfortable and cared for when or if health issues happen so that we can continue to work and save money and plan for our retirement.”
How does that sound? In my opinion, it sounds reasonable, non-emotional, not threatening but practical with the intention of creating a plan because you love your elderly parents. This gives you the opportunity to talk to your parents about a plan for what if this happens. What do you want? In a sense a care plan. You may learn through the process that your parents have enough money, but only if nothing goes wrong. If there are no major health issues.
However, if parents already have health issues you may find that there isn’t enough money to pay for their care. Having difficult conversations with aging parents may extend to talking about your parent’s relationship with money. Are they savers or spenders? Do they have a monthly budget that they keep to? Are there things they could be doing differently? What is your relationship with money?
Ask yourself the same questions. As you talk about plans for aging parents think about plans for you and your spouse and what you want in the later years of your life. What does that look like? No doubt these are difficult conversations to have. If you don’t have experience with investing money, I recommend finding a certified financial planner who can advise you so that you are aware of all of the options.
One of the most important things adult children can do for their parents and themselves is to make time to understand all of the options about caregiving—financially, medically, and legally. These are the three prongs of planning that support health and care needs in retirement. I did this for my clients. You don’t have to have a lot of money or be able to save a lot of money to begin working with a certified financial planner. A small amount, $10, $20, $50 a month saved consistently can grow to be a significant amount in time. Everyone has to start somewhere.
I encourage you to begin having difficult conversations with aging parents today about eventual care needs and health issues so that money concerns are on the table and you’re not blindfolded or shocked when parents do need care. If your parents are reluctant to share financial information with you—which they may be—suggest that they see a certified financial planner separately if they don’t already have a relationship with someone.
However, make it clear that the reason this discussion is on the table is that you do not intend to support them financially because of the responsibilities you have to your spouse and your children. The alternative for when parents run out of money is talking about Medicaid. I will include a link in the podcast transcript to an article about Medicaid and why families become angry or panicked because they didn’t realize the importance of planning ahead for the care costs of aging parents.
The earlier you begin having difficult conversations with aging parents the more prepared you will be for when the time comes parents need care and you’ll have a well-thought-out plan in place. We’ll talk more about having difficult conversations with aging parents after this break.
The Caring Generation is not limited by time zone or location—caregivers worldwide can listen any time of day. Visit my website pameladwilson.com to check out my caregiver course online, Taking Care of Elderly Parents: Stay at Home and Beyond, with 30 hours of webinars and other information featuring practical steps for taking care of elderly parents, spouses, and how to make a plan, like how we are talking about today, for aging and health.
Taking the course is like binge-watching a Netflix series where you learn about all the things you never expect that can happen in a very short period of time and you can always go back and watch it again. This is Pamela D Wilson, caregiver expert, consultant, and author on the Caring Generation. Stay with me. I’ll be right back.
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This is Pamela D Wilson, caregiving speaker, expert, and advocate on The Caring Generation program for caregivers and aging adults. Whether you are twenty or 100 years old, you’re in exactly the right place to learn about caregiver support programs, health, well-being, and other resources to help you and your loved ones plan for what’s ahead.
If you’re not sure how to talk to your children about caregiving issues, or if you’ve tried to talk to your aging parents and that didn’t go so well, let me start the conversation for you. Share The Caring Generation podcasts with family and friends. There are over 100 episodes. This is 110. You can also visit my website pameladwilson.com, Click on How I Help, Then Family Caregivers, Then Eldercare Consultation to schedule a 1:1 eldercare consultation today by telephone or video call.
We’re back with more thoughts about having difficult conversations with aging parents. In the first part of the show, we talked about talking about money. Here’s why talking about money is important. Healthcare costs and other costs of care after retirement depending on your health—good or bad—can drain your bank account. If you as the adult child do not want to become financially responsible for paying for the care of aging parents you will have to learn to say no and to set boundaries.
The more you do the more parents will expect of you. All the while you are an emotional wreck trying to balance work, your spouse, children, and the rest of your life. Caregiver exhaustion and resentment occur when caregivers are not good at initiating difficult conversations with aging parents. Part of the issue is that you don’t know what to talk about or how to present the information. The what to talk about part of having difficult conversations with aging parents involves identifying resources and supports so that you are not the only caregiver for a parent.
Finding support means having difficult conversations with siblings about who can help and how often. Now this means you actually have to have brothers and sisters. If you are an only child or if you are a spouse with no children the situation is slightly different. You have to find the support because there is no family support—and even if you do have family, brothers, and sisters, there is no guarantee that they will be willing to help care for an aging parent. Many of you know this.
Don’t be angry with your siblings, that only destroys you. Move on and find other sources of support. Bringing in outside help has an associated cost unless an aging parent is already on Medicaid or some type of waiver or long-term care program. Medicaid provides a certain number of hours per week of care in the home, it pays for care in some assisted living communities and nursing homes. If your parents are going to run out of money, investigate Medicaid today. Learn everything you can about it. How it works, how to apply, what it pays for.
When you have the information, you can talk to your parents about how they can receive care when they don’t have money to pay for care. On the other hand, if your parents have money, that’s a different conversation. In many cases, you will have to convince your parents to part with their hard-earned money because you’re doing everything for free. You see that’s part of learning to set boundaries with aging parents.
You agree on what you can do, can’t do and the remaining help is provided by paid services. Your parents will probably try to manipulate you by saying they’ll be fine. They don’t need any care. My advice—agree with them and let them fail just like you do with your children who may not listen to you either. Say, mom and dad, that’s great that you don’t feel you need any help. When you decide otherwise, let me know and I’ll help you research some paid services that can help you.
The challenge is that you’re going to feel guilty and if you are the over-controlling type you will have a very difficult time stepping back and trying to stop controlling every part of your parent’s lives. Your parents are adults. They have the right to make choices—even bad ones and then live with the consequences. Which leads us to the next consideration for having difficult conversations with aging parents.
The idea of consequences. Not talking to parents about tough subjects is as harmful for you as the caregiver as it is for your aging parents. For caregivers, not addressing health issues, or safety risks is sure to result in an accident that you will have to deal with. Even if you explain the consequences to a parent and mom or dad fails to listen to your advice you may still have to deal with the consequences. However then, you don’t have to jump back in to help.
This is when you say, mom dad. I love you. We discussed that this might happen. I can’t help you but here is a service that can. By having difficult conversations with aging parents you make your intentions clear and you set a boundary for what happens when. By doing this you make the choice not to be pulled into chaotic, dramatic family situations that tug on your emotions. You also, though, don’t take any satisfaction from your parents being wrong or making a bad decision.
A problem existed, your parents made a choice, and today, you’re living with the consequences. This is part of being an adult and sometimes it really is the pits if you’re the one who made choices that resulted in poor consequences. With regard to your parents, It’s not up to you as the adult child to come to the rescue. You can help but your parents bear the responsibility of making choices.
You can research, identify options, suggest individuals and companies that can help. Your parents must agree to the assistance and move forward to participate. This is where you can become a coordinator and facilitator, not necessarily the “do-er.” Having difficult conversations with aging parents depends on your ability to be kind, patient, honest, and spell out concerns and options.
No one likes to face choices that aren’t to their liking—not you, me, no one. But there are times when making decisions are necessary due to consequences and other factors that can make the situation worse if you wait. Think of any example in your life where you knew you should have taken action and you didn’t’. Let’s say your car was making a noise and you ignored it for 6 months until it really started causing a problem
You go to the mechanic who says, “hmmm it seems like this should have started going bad about 6 months ago. Didn’t you notice anything?” Back then it would have been a simple $20 repair, today it’s $2,000. That is the gravity of being indecisive and waiting to make decisions when health issues exist for elderly parents, or safety issues, or memory issues, or any other concerns. Something that could be managed, corrected, or fixed isn’t noticed or it’s not viewed as important or time-sensitive.
Over time that small thing becomes so significant that there is no going backward. Let me share a simple example of a parent using a walker or agreeing to home safety improvements like grab bars in the bathroom, a raised toilet seat, or using a shower chair. Parents say, “I don’t want that “stuff in my house.” Well, it’s because they don’t want anyone to think that they need help. But, the consequence of a fall could be minor or major like a broken hip.
Any fall can result in additional medical expenses. Perhaps a hospitalization and then a nursing home stay. After returning home, though, your parent isn’t the same. Mom or dad is physically weaker and more of a fall risk than before the fall when mom or dad refused to use a walker, or have grab bars or other safety equipment installed.
Your parent refused thoughtful advice that could have prevented an accident but it didn’t. Now you are in a very different reality having difficult conversations with aging parents about selling a home and moving to assisted living or a nursing home. That little expense of $20, $100 could have prevented your parents from having to spend $5,000 to $10,000 a month for a care community. In these situations, there is no turning back the clock.
If you are an adult child noticing the little things that indicate a parent needs more help, it’s critical to do something to avoid unnecessary situations where a parent due to a lack of information or recommendations harms themselves. The work to correct the issue is going to fall on you, regardless. Your parents won’t be able to navigate the system or learn the options quickly enough to respond.
It’s going to be up to you. More on this topic is in Podcast Episode 89 My Mother Refuses to Take Care of Herself. Episode 90 How to Stay Out of a Nursing Home, and Episode 93 When You Can No Longer Care for an Elderly Parent. I’ll put links into this podcast transcript for those. The best thing that family caregivers can do for aging parents and everyone in the family is having difficult conversations with aging parents.
If you didn’t care you wouldn’t be going to the effort to research all of the options for aging parents so that they can live in the comfort of their home as long as possible and you can go on with your life providing the amount of support you can but not placing your income, retirement, health, or your future or the future of your children at risk.
If you are in a situation of planning for yourself, aging parents, or a loved one and you’re not sure what to do, what questions you should be asking, what resources are available, schedule a 1:1 eldercare consultation with me. Visit my website PamelaDWilson.com, click on how I help, next family caregivers, and then eldercare consultation. If you are a caregiver frustrated with trying to deal with the healthcare system understand that it may not be you.
The healthcare system is complicated and if you don’t ask for the right thing or use the right terminology you may not receive the type of help and assistance you or a loved one deserves. To give an example of this, I recently spoke to a family member who had used a significant amount of their own money to care for another family member not realizing that under the circumstances they could have applied for a Medicaid waiver and received a great number of services paid for by Medicaid.
If you are a burned-out or exhausted caregiver, don’t give up. Help does exist. Be persistent in contacting local resources until you find someone who can assist you. I’m also hearing from caregivers that trying to obtain services is more difficult because of COVID. I’ll be honest it is. The shortage of workers is affecting every industry especially healthcare. Healthcare and other companies are as frustrated as everybody else about not being able to find employees.
As a result, some businesses are closing which makes it more challenging to find help. Companies are having to raise wages to pay workers, which is great for the workers, but it translates to higher costs to the consumer all around. For those of you caring for loved ones don’t give up. For those of you who are the caregivers, take care of your health. Learn about health issues so that you can prevent them. As we discussed healthcare expenses are a huge cost for retired individuals.
The only way we can change this is by educating our youth about the risks of chronic diseases and by becoming more educated and engaged in preventative healthcare actions ourselves. More education and support for caregivers and aging is on my website pameladwilson.com and on my YouTube and Facebook page with hundreds of videos answering your questions.
Thank you for joining me on The Caring Generation – the only program of its kind connecting caregivers and aging adults worldwide to talk about caregiving, well-being, health, and everything in between. Invite your family and friends, co-workers, and everyone you know to listen each week. I’m Pamela D Wilson, caregiving expert, eldercare consultant, and speaker. I look forward to being with you again soon. God bless you all. Sleep well tonight. Have a fabulous day tomorrow and pleasant journeys until we are here together again.
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