Mother and daughter talking on couch

Addressing Tough Conversations with Aging Parents

There’s another dent in Dad’s bumper. A pot was ruined after Mom forgot she was boiling water on the stove. Grandma frequently forgets to take her medications. Grandpa is having trouble taking care of himself.

When is it time to have the talk about the car keys, assisted living, or even just allowing their children to help them more with daily tasks? When do you have those tough conversations with your aging parents?

“It is never too early to begin the conversations and planning for future medical care,” says Diana Kerwin, M.D., chief of geriatrics and physician on the medical staff at Texas Health Dallas. “It is important to know what your parents’ beliefs and desires are, or their vision of how they want to be cared for in the event they develop an illness or a disease that might affect their ability to make decisions.”

Getting involved early, Kerwin says, will make those conversations less tough when the time comes to ask for the car keys or giving up a bit of independence, or to begin discussions about assisted living.

“Get involved early in learning about the care your loved ones need,” she says. “There is no set point, but if an older parent lives alone, he or she will require more complex care and a greater support system because aging makes us frail and vulnerable. The activities of daily living can begin to be a challenge.”

And as parents age, it’s up to those who love them to keep their eyes open for potential warning signs.

“Become an observer of normal behaviors for your parents,” Kerwin says. “When things begin to go amiss, such as bills not being paid or meals and/or medications missed, that’s the time to get more involved in their care.”

According to a survey conducted by Pfizer and Generations United, “Respondents said the hardest conversation to have with aging parents is telling them to stop driving and hand over their car keys—more difficult (39 percent) than talking to parents about their final wishes or wills (both 24 percent).”

Worrying that your parents may be reaching the point where driving is no longer advisable? Experts recommend going with your parents on a drive, using a checklist like this one to pinpoint any concerns—and check for both daytime driving and nighttime. If the checklist reveals that your concerns are valid, talk to your parent about those concerns, and whether curtailing driving during certain hours of the day or night is appropriate, or even about arranging alternative transportation.

“With driving, note any minor accidents or getting lost,” Kerwin adds. “This is a good time to bring in the physician, as losing your independence as a driver is a difficult adjustment.”

Talking to your mom and dad about lifestyle changes revolving around independence can be tough. Kerwin says to keep in mind that approach is everything.

“Remember, the feeling you communicate remains much longer than words,” she says. “Tell them you love them and want to support them so they stay safe.

“Do offer to go to doctors’ appointments, so you understand the current status and concerns of the care provider.”

The AARP’s guide “Prepare to Care” suggests reviewing these questions before sitting down with your parents:

  • Who is the best person to start the conversation with your loved one(s)?
  • What are your biggest concerns and priorities as you help put together a caregiving plan for someone else?
  • What is the best thing you think might happen as a result of this conversation?
  • What is the most difficult thing for you about having this conversation with a person you care about?
  • What are you afraid might happen as a result of this conversation?
  • How do you think your loved one and other family members might react to the conversation? How does your family usually respond when uncomfortable subjects are discussed?
  • How can you explain to your loved one and other family members why it is important to have this conversation?
  • In addition to emotional support, how much financial support are you willing or able to provide if your loved one needs it?

And self-care is important to factor in as well. Kerwin says that as parents age, their children may be able to care for them, but if circumstances don’t allow that, or if you find yourself needing help navigating the world of caring for a parent, help is there.

“Older adults have greater medical needs and require more attentive care,” she says. “If children are able to be the overseers of their parents’ evolving physical and mental health, that is a good option. If not, there are geriatric supports for families to work with to ensure maximum wellness.”

Do you need to have that tough talk with an aging parent? Do you need help coordinating care and finding support? Texas Health has geriatric medicine specialists throughout North Texas.

7 Comments

  • Anita says:

    Many families are faced with aging parents or partners who cannot even afford to think about assisted living as the cost is totally unaffordable. There are also many ex-wives caring for ex husbands who are faced with nursing home care but cannot afford it. I for one am caring for an ex spouse and he does not have Medicare except for Part A due to being a civil servant, he needs to be in a nursing home as he has dementia and is getting very forgetful, I half own the land the home is on so that cannot be sold, I have been caring for him the last 9 years with grandson and we need his pension to pay mortgage and so on, so what is one to do? I have fought to no avail to get his VA benefits restored which they cut off almost two years ago and I am at my wits end with my own health issues and no help.

  • Cavon Muhammad says:

    Thank you for this article as it has really helped me. My aunt is aging and she is in a rehabilitation facility and really really really really really wants to go home. I want her to go home and I really thought that it would be possible but it doesn’t seem as if it is possible. It is overwhelmingly emotional for me and it’s breaking my heart that she might not be able to go home.

  • Bob Ellzey says:

    Thanks for posting this very good article on addressing tough issues with parents. Two more helpful resources with links below:
    1. Book: “When Roles Reverse: A Guide to Parenting Your Parents” by Jim Comer
    https://www.amazon.com/When-Roles-Reverse-Parenting-Parents/dp/1571745009

    2. Texas DPS: If dealing with drivers license issues is too challenging or ineffective, DPS provides a way to contact them anonymously with your concerns and let them intervene.
    https://www.dps.texas.gov/DriverLicense/MedicalRevocation.htm

  • Shirlene Lucy says:

    I missed the seminar today, but would like to know of any more that will be presented in the near future. My mother is 98 years old.

  • Patrick Lee says:

    That was done with my mother several years ago. She lived with my sister for an extended period of time. Mother passed away on July 22, 2017. All of her wishes were granted.

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