In the family I grew up in, we talked about almost everything—sex, money, politics, religion—even death. When my father passed away, I realized that my mother would live on for many years without him, and I thought there would be a discussion, but Mom had only one thing to say, “I just don’t want to be a burden on you girls.” None of us wanted to dive into the details.
My mother lived to the age of ninety-four, and whatever burden we felt as she aged came not from her increasing needs, but from our very different views of when and how those needs would be addressed. I wish we had talked about Mom’s future when it was just that—the future. Instead, we all waited until her physical and mental health had deteriorated to the point where something had to be done, and then we scrambled to figure out how to respond to each new crisis.
If I had the chance do it differently, here are some things I would do.
- Watch for opportunities to start the conversation well before aging and the need for caregiving becomes an issue. Mom mentioned her worry about being a burden when she was in her mid-seventies and still active and fully independent. It was the perfect opening to ask what she meant and what she feared. Any life event that signals advancing years—birth of a grandchild, retirement from a job, an unexpected illness—can provide the backdrop for discussing changes that come with age.
- Reframe the issue. My mother thought about growing older as her problem. She thought she had to figure out how to make sure her daughters would not be inconvenienced as she aged. The truth is that parental aging affects the entire family, no matter how large or small a role each person might play. It’s important that everyone have a chance to voice concerns and be in on whatever decisions are made, whether they agree with them or not.
- Get the lay of the land. Stephen Covey said it best: “Seek first to understand, then to be understood.” What is each family member’s vision of the future? What is the likely time horizon for self-sufficiency and when might some kind of help be needed? What do aging parents expect/want from adult children? What are adult children willing and able to do? What community supports are available? (For example, check out the growing number of virtual senior villages at vtvnetwork.org and here at The Caregiver Space.)
- Run through some specific scenarios. In the case of an emergency, who could be there quickly to help—family, friends, neighbors? Do parents need to live closer to their adult children? What are the options if living in the family home becomes a safety issue—modify the home, move into senior housing, move in with one of the children? What are the options if/when parents have to give up driving—senior/public transportation, Uber or another taxi service, neighbors, family? How would the family handle it if one or both parents show signs of declining mental health or early dementia? What if a parent is diagnosed with a serious or terminal illness?
- Identify professionals who can help with difficult conversations. After numerous arguments about whether or not my mother would move from her Florida condominium to a senior apartment five minutes from my sister’s house, I contacted a geriatric care manager (now know as Aging Life Care Experts) who conducted an in-person assessment and offered her advice that, in my mother’s case, living near family was the best option. Mom still didn’t like the idea of moving, but the opinion of a professional carried weight with her. Sometimes a trusted family physician, a clergy person with counseling skills, or an attorney can play the role of facilitator.
- Set one or two primary goals and keep them in mind. The issues that come up with advancing age are myriad and complex. Knowing what matters most—proximity to family, participation in community activities, and/or overall safety—provides a touchstone against which to assess various options. My mother’s primary goal was maximum independence, so discussions about her living situation focused on the type of housing and support services that would allow her to have a place of her own.
- Be persistent, and also patient. Understanding what I call the tightrope of aging is a process involving multiple discussions over time, especially when things don’t go as originally planned.
Communication is key to making advanced age the best that it can be. Talking early and often will help lessen the potential burdens of caregiving for an aging parent.
Melanie P. Merriman, PhD is the author of Holding the Net: Caring for My Mother on the Tightrope of Aging (Green Writers Press), winner of American Book Fest’s 2017 Best Book Award for Autobiography/Memoir. Melanie is a former cell biologist and hospice care consultant.