Friday, 14 November 2014 11:26

Eldercare Transitions: Starting the Conversation

By Clare Colamaria | Families Today

When I meet with families, it is typically the children of the senior loved ones who are requesting to consult with me. Why?

There are several reasons the children contact me and not the seniors themselves. One reason may be that their parent or parents are unaware that their lifestyle and state of mind and/or body are declining; two, they are aware of their declines but do not want to burden their children with worry or more work; three they do not want change regardless of their situation or circumstances or it could be something altogether not touched upon.

In any case, I can empathize with all of the above; however, decline is inevitable. So, unless we have planned and prepared for changes in long term care, we will get caught in a crisis and thrown off guard, which too is inevitable.

Many times my clients are in the position of witnessing the decline of their parent who truly could use assistance, guidance or a safer environment from the lifestyle they are accustomed to. But for one reason or another they just aren’t sure how to start the conversation without making their loved ones feel defensive about losing their independence or threatened that their children are taking over control of their life.

I would say nine out of 10 times the children ask me how they should start this touchy conversation. Now I want to remind you that I am not a psychologist; however, I see this every day as a consultant and advisor. I also have a real soft spot for seniors. If I were in their position, I would wish to be treated with honesty, compassion and respect.

The sooner you involve your parents in the process the better. Let’s face it, how many of us enjoy talking about old age, declines of physical and mental capacities, long term care and end of life planning?

Perhaps your family is very private about their personal business and has never had tough conversations regarding such personal matters. But it needs addressing sooner rather than later as long as it’s not too late.

Like most important decisions in life, it is a process which takes time and careful planning. It is always best to be well-informed and have facts to support your concerns and opinions before engaging your parents in the conversation. In order to do this, it is best to consult with an expert on proper resources and guidance.

It is also wise to include your immediate family members from the start. This may be challenging for many and may take a few attempts, but it helps everyone understand one another’s concerns and you will be better able to map out a plan that everyone is involved in and on board with.

It is also very important to involve your parents in these conversations as long as their mental capacity is able to reason and make important decisions. If they are not, these conversations will most likely cause added anxiety and resistance.

Here are key considerations to help you frame your approach to this challenging subject as found on


Consider your Personal Point of View

•Begin with yourself, the adult child, and be honest. Why do you want to have these conversations? What do you want for yourself and for your parents? What are your fears or concerns? What would be your best-case scenario? What do you want to happen?

•Be empathetic. Put yourself in your parents’ shoes. Ask them how they are doing. Ask them if they’re still able to do the things they want. Let them know you care about how they are and what they want.

•Be a good listener. Sometimes you are afraid to hear what parents are feeling because it also makes you face getting older. Let them talk and let them know you hear them.

•The idea that a role reversal takes place in the relationship between you and your parents is neither true nor helpful. That should never happen. A shift in your relationship may occur as you guide these conversations, but you should not consider yourself the disciplinarian or that you “know what is best.”

Before you Start Talking

•Involve everyone in the family who should be part of the conversation and include your parents at every step.

•Resist any temptation to jump ahead and put a plan together yourself.

•Remember when you think about HOW to have your conversation to frame it around the five most important considerations for aging seniors: security, freedom, peace of mind, friends and choices. How can your parent’s best achieve these things?

•Think about asking questions to find out whether or not your concerns are the same as your parents. Let them know what you have identified and ask if they ever think of those same concerns or if they have identified others.

•Ask yourself if your desired outcomes are the same as theirs. Have they considered the same things you have, or are they thinking in a different direction?

•Consider putting together a script or an outline so you have something to follow and don’t forget important points. You don’t need to have it in front of you, but it will help you organize your thoughts.

•If you still feel nervous or afraid of getting started, run your ideas past a professional. This can be a social worker at a local agency or senior center. It might be a therapist or someone at your church or local hospital. Identify who your parents trust and respect. These can also be excellent individuals with whom to consult.

•It helps to have conversations when you are not rushed; when there is time for small talk. Plan to talk in a quiet place where your parents won’t have trouble hearing you; where they can feel calm and focus on the conversation.

•Always show respect and support for the fact that these are THEIR DECISIONS and THEIR LIVES.

Getting the Conversation Started

•Ask your parents how you can work together.

•Stress that there are not necessarily “right” or “wrong” options or ideas. It’s most helpful to consider a number of things as good options when starting to have these conversations.

•It helps to start with small, casual conversations to plant seeds. Use phrases like, “Let’s just talk about you,” or “I’ve noticed some things take a lot more energy these days. What are the important things you really want to do? What are your priorities? Is there a way we can make it easier for you to do those things?”

•It has also worked for some adult children to open the conversation by saying how much you admire the way your parents have handled retirement and ask their advice on what has worked well for them so that you can emulate it. This can naturally lead into a discussion about “What kind of planning comes next?”

•Others have started conversations by talking about yourself and your kids and how you communicate with one another. Adult children may already be communicating with their kids on their next steps and their wishes surrounding those circumstances.

•Use something neutral such as a relevant event in the news or a recent incident or anecdote about an aging family member or friend to get the conversation going. This can be an opening to mention, “We’ve never talked about these kinds of things. I don’t want to pry, but it would bring me a lot of peace of mind to know there is a plan if we need one.”

•Build upon these more casual conversations to lead into larger decision-making conversations later.


Clare Colamaria is an Eldercare Consultant and Founder of A Senior Choice, LLC. Clare helps families decipher the many different options involved in care transitions. Clare is a placement specialist, library of in home care resources and Crisis Manager. Please call her directly at (518) 424-2527 or visit her website at Allow Clare to help you make the right choices!

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