Start A Long-Term Care Conversation That You Feel Good About
Supporting a loved one as they age comes with challenges. As caregiving and medical needs increase, it can be difficult to navigate conversations that ensure everyone’s needs are met.
“Long-term care conversations can be uncomfortable because they require vulnerability,” says English Rose Admission Direction Marilyn Hartman. “There’s a reflex to avoid these discussions until a crisis forces the issue.” Yet, crisis events put families in high-stakes, emotionally-charged situations. Without advanced planning, it is easy for family tensions to rise and bad feelings to set in. “Doing the work before big decisions need to be made takes the pressure off. It gives families the time to build the right support network and get buy-in from one another,” says Marilyn. “It’s simply never too early to start a conversation about long-term care.”
The question then becomes how to start these conversations and talk about future long-term care in a gentle, loving way that brings the family together. Here are some strategies that can help.
Be Realistic
We all want the people we love to live the longest, happiest, and most fulfilling lives possible. But the fact is, if they live long enough, they will experience the natural progress of aging, which involves decline (physical, cognitive, etc.) and some degree of disease. Loved ones will inevitably require some kind of support to continue living a large, engaging life full of meaning and purpose.
When a loved one’s daily needs start to increase, family members often willingly step in. However, those who take on primary caregiver roles often do not anticipate the time, energy, and expertise it takes to support someone holistically. To live life well, aging parents require not just physical support tasks but social, intellectual, spiritual, and emotional engagement to feel relevant, useful, and happy. Before long, being a primary caregiver means having to expect unexpected emergencies. Without proper planning, family members choose between their health and wellbeing and those of their loved ones. As families scramble to find care coverage, life disruptions, missed work, and care costs begin to mount.
In conversations about care, all parties need to acknowledge, in a loving and compassionate manner, the facts: Additional support will be needed to care for the health and wellbeing of everyone in the family. Being realistic means being open to feelings of vulnerability. Care discussions may make someone who is aging feel that they are becoming irrelevant. A spouse may feel guilty for not being able to care for a loved one fully. A child may feel conflicted that their busy work schedule or family life keeps them from helping more. Feelings and fears are an important dynamic during these conversations and should be empathetically addressed, rather than be the reasons why families avoid the topic of care planning.
Choose Your Words
There is no one way to approach a long-term care discussion. These conversations are very family specific. Sometimes, it’s as easy as, “Honey, we are worried about your safety, so let’s get you some support.” More often, it requires a little subtlety.
For example, as a person ages, it is common for them to slow down. They do fewer things, go to fewer places, and host fewer visitors. But when the desire to stay home leads to isolation and loneliness, telling them that they need to get out more may not be well received. Rather, ask them about the people and activities that used to be a larger part of their life, you can say things like, “I bumped into Frank’s daughter last week at the grocery store. When was the last time you saw him? How’s he doing these days?” Or, “I noticed you haven’t been knitting or cooking as much as you used to. I know how much you like to stay busy. Do you need supplies or help with groceries?” Inquiries like these can be used to broach conversations about what’s keeping them from the people and activities they used to enjoy, which leads to how the introduction of care and support could be helpful.
A soft approach can be beneficial when it comes to living arrangements. It’s much easier to start with conversations about how nice it would be to have more people around than simply stating that you think it’s time they moved into a senior care facility. When a family is not faced with a crisis that requires them to choose a care facility quickly, they have the luxury of collaborating on an exploratory journey that leads to a quality resolution. By developing a framework of curiosity rather than driving to a predetermined specific outcome, family members are encouraged to engage in conversations. They are more likely to feel good about where the journey leads because they have a voice. Phrases like “I’m curious about…” or “I wonder if…” can lead to the next steps. Follow up with “What do you think?” and “Would you like to see for yourself?”
Relationships and feelings linger long after any decisions are made. This is why it is so important for families to embark on an exploration fueled by curiosity, rather than forcing quick decisions in a crisis.
Do Your Homework
The good news is that you are not the first to consider long-term care for a loved one, nor do you have to start your research from scratch. Many brilliant professionals can share first-hand accounts of similar family journeys and help identify the best care and support resources for your unique situation. Think of the homework as an opportunity to build a coalition of people who can help you navigate.
Referencing your research is also a great place to start a care conversation, as it roots the discussion in your direct experience and invites collaboration. Start with something like, “I recently read an article that got me thinking we should ask a few questions and maybe even check out a few places to see what you like and don’t like. Would you be interested in coming with me? We could take a tour and then go for lunch.” Any conversation rooted in collaborative information gathering rather than decision-making takes the pressure off and makes it easier for others to see good intentions and hear what everyone is saying.
Sometimes families enlist professional care consultants to help with the research and facilitate family conversations about long-term care. The benefit of working with a care consultant is that they already have a vast knowledge of available care options. Rather than spending your time doing market research, you help the care consultant learn about your loved one so that they can recommend a handful of well-suited care options tailored to your family’s individual needs and preferences. Partnering with a care consultant is especially helpful when family dynamics benefit from a trusted third-party perspective.
Affirm Love
Finally, remember to communicate that your highest priority is the safety and wellbeing of your loved one and that you are only interested in having a conversation about long-term care because of your love for them. Say things like, “Dad, we notice that Mom is starting to struggle to keep you well and safe. Because we love you and Mom, we want to discuss what kind of support could be helpful for everyone.” Express how being in a relationship with them as a loving child is one of your most valued roles. Affirm that Mom also needs an opportunity to return to her most cherished role as a loving spouse, which she can’t do while being a full-time caregiver.
Some of the biggest fears about accepting support or moving into a community of care revolve around giving up the ability to make independent choices and being separated from family. Reaffirm that your only interest in exploring care options is your love for them. Remind them that exploring is not deciding but a way to ask questions and learn together. Tell your loved one they deserve to be safe and surrounded by the support and care that enables them to live an engaging, meaningful life full of purpose. Reiterate that you are committed to making sure they have a voice, which is why you are having these collaborative discussions early and inviting them to explore options with you. Starting care conversations now, rather than in a crisis, gives your family the best chance to make great care decisions that everyone feels good about.