How to Have “The Talk” with Aging Parents About Assisted Living

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Imagine for a moment that you are 82 years old. You have fallen and broken your hip. This is not your first fall and you can’t remember how you fell. After the surgery, you are moved to a skilled nursing facility for intense physical therapy for a few weeks and then you expect to be discharged home.

While you are recuperating from the surgery, your 55 year old son tells you that you are not going home, but instead, you will be moving into an assisted living community. He has arranged for a few things to be moved and he will pick you up tomorrow to take you there.


How are you feeling about this unexpected news? Angry? Sad? Scared? Betrayed?

Unfortunately for many seniors, this can be an all too real situation. Let’s look at some alternate ways the son could handle this delicate situation and get his aging parent to buy into this life changing event.

First, let’s discuss what an aging adult has to give up when they move into an assisted living community. When I taught the Administrator certification course, I would ask my students, “How many of you are actively planning to live in assisted living when you become old?”  In eight years, maybe 20 students raised their hands. Why do we not “plan” for this stage in our lives? As we age, we are not getting healthier or becoming more active. Let’s face it, aging is tough.

So how can we help our aging parents or loved ones when this transition needs to happen?

1. Make the Future an Ongoing Discussion

When you begin to notice an aging parent is starting to decline mentally or physically, you need to start the dialog. “ Mom, we have never really discussed what your wishes are if you become unable to care for yourself.” “Dad, I know this is tough to think about, but what do I do if you can no longer take care of yourself?” Many aging adults might say, “Not now dear”, or “This can wait for a later time.” Of course they do not want to talk about leaving their home that has been “the plan” since they purchased it. Many seniors have their burial plans in place but not their end of living plans. With my loved one, this was a discussion that occurred repeatedly for more than one year.

2. Research Senior Living Options

Start educating yourself on the available options in housing choices, costs and services in the area where your loved one will live. This could be in the city where he or she lives now, but it could also be in a different city near loved ones. Start touring different communities and collect their marketing materials. Unfortunately for many families, they do not think about assisted living until there is an emergency. Very few people like making rash decisions while in the middle of an emergency situation. As you begin to have “the talk”, you bring solid information and not speculation. Also, it is much easier to talk about things that are “in the future” and not happening next week. This gives the person time to start thinking about new possibilities that are not as scary to consider since they are very far into the future.

3. Assisted Living is Not Free

You need to start the discussion of finances sooner rather than later. Did your loved one purchase a Long-Term Care policy? Does the policy cover assisted living? Many do not. Do they have a life insurance policy that has a “life benefit?” This pays dividends to the policy holder instead of paying the beneficiary upon the policy holder’s death. Is the home paid for? Are there any investments? Is the loved one a veteran or the surviving spouse of a veteran? The VA Aid and Attendance Benefit is a benefit that your loved one could be eligible for.

Is there a pension? Retirement account or savings account? his is a difficult discussion for many families as the parents are from a generation that did not discuss finances with their “children” and they find the discussion intrusive. Be patient. Be supportive. Be kind. Be persistent. You also do not want a surprise during a crisis, such as the money cannot be withdrawn without a large penalty or worse, the home is in a reverse mortgage with zero equity.

4. Keep Your Loved One Involved in the Decisions

Everyone wants to have the ability to choose where they live and the type of care they want to receive. Could you imagine moving to a home you did not see before purchasing it? How about moving across the country with no idea about the city that you are moving to? For many seniors, this is how they transition into assisted living. If your loved one is able, take her/him with you to tour communities. Let him/her speak candidly with residents about their experience living in a senior community. Maybe there is a friend who has already made the move, can your loved one visit? In my experience, the residents are the best marketers a community has. If they are happy, they will share their feelings with anyone who will listen.

5. Present Living Options in a Positive Tone

Having a conversation with a loved one can be challenging if the relationship is already strained. Not everyone is blessed with happy and loving families. Being aware that the discussion can trigger different responses is crucial. No one wants to be told he/she has to do something. When speaking about assisted living, use words like community instead of facility. Try words such as  “home like environment” such as a home in a residential area like The Colony (board and care) or a “condo-like” or “apartment living” building such as a Brookdale. Highlight the activity program, menu, and socializing opportunities instead of the personal care. Keep your tone calm and neutral. Depending on the person, some may become angry. Try not to respond with anger, for you will just end up in a shouting match and nothing good will come of it. Anger is usually a response to a feeling of not being heard. How would you want to be approached if you were the one who has to make a life altering move?

6. Help identify the “What If’s”

If both parents are still alive and living together, you will want to have “the talk” about any plans they have for when one partner dies. Of course this is a difficult topic and no one likes to think about a parent passing on, but share that your goal is to understand their plans to help the other spouse. Have they discussed what the surviving spouse will do? Should they downsize or continue to live in the home? Should the home be sold and the remaining parent moves into a community? What happens if one parent has a devastating stroke and needs assistance with care and can no longer live at home? Are there funds available to support both in different settings?

I suggest a conversation similar to, “Mom and dad, you are both ok now, but have you had a discussion about the future when one or both of you are seriously ill or unable to care for yourself or the other?” Ask each of them what they want for their partner if the worst were to happen. Hopefully they would want their loved one to be safe, well cared for and financially stable. Ask for suggestions how you can help to ensure their plans and desires can be met.