How to Start the Family Caregiving Discussion

Nobody looks forward to discussing finances and elder care with their parents, but every family needs to do it. These tips will help you start the conversation now and get a plan in place before you urgently need it.

Cover the Categories

A caregiving plan should include the four major categories: medical, legal, financial, and personal. Some of these questions can be answered in the first discussion, while others require deeper research or outside opinions.

Medical

Get a professional opinion on the loved one's health and future prognoses; this will significantly affect decisions about the level of care needed now and in the long term. Gather information about health insurance policies, including Medicare and long-term care policies.

Legal

Even though it might seem early, making decisions and signing documents now is critical while your parents or other elders are in a sound state of mind. Most important are a power of attorney and a health care agent. These allow care recipients to choose a representative to act on their behalf in case of mental incapacity. 

Also important is estate planning; this can often be a touchy subject, but there needs to be an up-to-date will, and all accounts and trusts must have correctly titled beneficiaries. Otherwise, final wishes will not be honored, and the courts will distribute the estate according to probate laws.

Financial

Gaining access to your parent's financial life can be a particularly tricky topic to breach. It represents a fundamental change in life and roles for older people that can be hard to face. They may not want to reveal financial details. However, it is crucial to keep at it. No one wants dementia to creep up on their parents or leave them vulnerable to scammers. Aging Parents, a blog and mediation service for elder care, states that the approach is crucial for success. "Put it on yourself…that if something went wrong, you would be completely lost as to how to help them."

Have an open and honest discussion about income and expenses, assets and liabilities. Be sure to find out who the financial professionals in your parents' lives are and how to contact them. Consider taking over bill payments or monitoring the care recipient's accounts. Seniors are particularly susceptible to exploitation. 

No matter how uncomfortable, the care recipients must have a plan to pay for care as they continue to age.

Personal

Remember, this discussion is all about the care recipients. What are their personal preferences? Where do they want to live? Assure your loved ones that they will be able to maintain independence as long as possible and that everyone wants to make the best decisions for them. While some may view it as maudlin, it can be helpful to ask the seniors to write a letter detailing end-of-life wishes and the reasons behind their choices. This is also an excellent time to begin compiling a list of essential documents and their location, as well as accounts, usernames, and passwords.

Navigating Resistance

It's not a question of whether resistance will be a part of this conversation, but just how much and how to deal with it productively. If you anticipate it as part of the normal process of approaching this life change, you need not see it as an obstruction. Just work through it gently and with understanding. The caregiving section of the AARP website offers this advice for getting the conversation rolling in a positive direction:

• Avoid anticipating what your parents might say or how they will react.

Example: "Dad, let's talk about what you want down the road. Let's start with what is important to you."

• Express your love and concern—and, most important, listen.

Example: "Mom, have you thought about what you want to do if you need help?"

• Refer to yourself and your thoughts.

Example: "I know this is hard, and I will have to do the same thing for myself one day."

• Be straightforward about the facts; don't hide negative information.

Example: "When you are driving, I notice your reactions aren't as quick as they used to be. I'm worried."

• Phrase your concerns as questions, avoiding telling your parents what they should do.

Example: "Mom, do you think you might want a hand with some housework?"

• Give your loved ones room to get angry, but remain calm.

Example: "I understand all of this is tough to talk about, but at the same time, we need to discuss."

Finally, remember that a caregiving plan is just that—a plan. It prepares for the future and doesn't necessarily mean anything will happen immediately. It just means you don't want to be caught unprepared.