Elderly Parents and Future Care Wishes

How to talk about end of life.

senior talking to nurse

No one enjoys talking with their parents about frightening future possibilities -- that they may at some point no longer be able to live independently, what the care options would be if that happened, how care would be financed, and what the parents' preferences are as to end of life and funeral arrangements.

But having the conversation is necessary so that your parents' preferences may be honored, if possible, and so that your contribution to the decision-making can be based on an understanding of those wishes.

Ideally, the conversation will be ongoing, rather than just occurring one time, and hopefully each time the topic is revisited it will become more comfortable, as you and your parents become more used to discussing the range of future possibilities together.

When having these conversations, remember that it is your parents' lives you are discussing, and that your parents' autonomy and wishes must be respected even if they differ from yours.

How to begin a conversation about future wishes with elderly parents

A good way to begin, says Emily Saltz, LICSW, director of Elder Resources -- a private geriatric care management firm that empowers seniors and their families through difficult transitions -- is by asking your parents what their biggest concerns are for the future.

This topic may evoke thoughts on the past, regrets, or a life assessment. Try to listen uncritically, with empathy. One benefit of this conversation is that having your parents share these thoughts with you can bring you closer.

Discuss your parents' preferences regarding housing options

Once you discuss your parent's biggest concerns, adds Saltz, you can then address their thoughts on housing for the future. While most people prefer to remain in their current home, ask your parents what they would like to do if that were no longer possible.

Sometimes this conversation will elicit your parents' expectations or wishes about moving in with one of their children, or hiring a part-time caregiver to assist with daily tasks, and it is helpful to have these thoughts, if they exist, out on the table.

Ask your parents if they feel financially secure

Saltz recommends asking your parents if they feel financially secure and determining if they understand the cost of services they might need, whether in-home care or assisted living.

It is important for you to have a record of your parents' various insurance policies, such as Medicare, Medigap, prescription coverage plan, and any long term care insurance.

If your parents don't already have a will, durable power of attorney and health care proxy, now is a good time to see an elder care attorney so that they can have their wishes implemented as to asset distribution and care.

Discuss your parents' feelings about their medical care and whether or not they are satisfied with their physicians

Do your parents have any concerns about their medical care? Does they have any reservations about their doctors? Do you need to help them find better ones?

What are your parent's wishes as to medical interventions and end-of-life care?

Discuss your parents' wishes as to death, dying and funerals

Does your parent have any preferences as to funeral and burial?

These conversations may be difficult, but every family member needs to know their parent's wishes. Researching and actually selecting specific services isn't morbid, and can really help when the time comes. Adult children who are feeling intense grief over the death of a parent can know that they are contacting the funeral home of their parent's choice, for example, and can have names and phone numbers available. And elderly parents can be assured that their wishes will be followed even when their adult child is feeling sad and possibly overwhelmed when arranging a funeral.

While initially awkward, having these talks and discussing matters all know they must deal with sooner or later may bring family members closer.

Ronnie Friedland is an editor at Care.com. She has co-edited three books on parenting and interfaith family life.

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