At some point, every adult child realizes their parents are getting older, and the future may hold some stressful situations and difficult decisions. Even if that future is—we hope and pray—far off, now is the time to start communicating about what aging parents want for their lives and future care. “The best time to have a fire drill is when there isn’t a fire,” says Kathleen McInnis-Dittrich, the chair of the Older Adults and Families concentration at the Boston College School of Social Work.
Even for those who strive to follow the commandment to “Honor your father and mother,” the prospect of raising difficult questions can be challenging. But planning ahead can ease the burden of an unknown future. “It can be an opportunity for less stress—not more,” agrees Kathy Kuhn, who runs a program for professionals at the Boston University School of Social Work’s Center for Aging and Disability Education and Research. So look for ways to delve into these 5 topics with your aging parents—you’ll be glad you didn’t wait.
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1) Housing Choices
Perhaps the greatest fear among older adults is that their future will involve a move to a nursing home. “Older adults are very concerned about losing control,” says Kuhn. Adult children can help reassure their parents by acknowledging their fears and asking questions like whether parents might like to eventually move to a warmer climate, whether stairs or other challenges in their current home are manageable—and what to do if they are not—and what alternatives they see for themselves if and when they need more extensive care. Remember, says Kuhn, “they’re in charge, it’s their life.”
2) Health Care Decisions
Honest conversations, ideally unfolding over a period of time rather than in one single session, are crucial so adult children can learn what their parents want when it comes to life-extending treatments, do-not-resuscitate orders, and other medical scenarios that are as important to communicate clearly about as they can be distressing to contemplate. AgingWithDignity.org has a “Five Wishes” feature that allows people to write down feelings, instructions, and plans to share with family members—not only the person who is named health care proxy—and physicians. “The more this can be done as a family, the better,” says Kuhn.
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3) Finances
When it comes to finances, the whole family may need some education before they can plan smartly for the future. For example, Kuhn says many families think Medicare will cover long-term care, but it only covers up to 100 days in a nursing home and a limited number of in-home nursing visits. Some parents may not be comfortable disclosing their financial situation to their adult children, so Kuhn advises approaching the topic within a context like, “I read an article about Medicare and learned…” or “Friends at work were talking about financial planning, and I wondered what you think about….”
4) Documents and Estate Planning
Preparing for the future means completing legal documents including a will, health care proxy, and durable powers of attorney for finances and health care. This can be stressful because it means facing—on paper—death and possible debilitating illness. But going through the process before a crisis can help everybody feel the parents’ wishes are clear and appropriately recorded. “It is not easy, but the rewards for having had this discussion is indescribable,” says McInnis-Dittrich, who recently lost her own mother. She recommends CaringInfo.org for tips on starting the conversation.
5) Legacy and Memories
Family occasions like baptisms, anniversaries, birthdays, or holidays are opportunities to start conversations by asking how your parents met, what their childhoods were like, what they hope to be remembered for, and what advice they have for younger members of the family. “I always recommend adult children ask parents to talk about the greatest joys in their lives,” says McInnis-Dittrich. You can also ask if there are things they hope to accomplish during this stage of their lives—and think about what you can do to help them achieve those goals.
