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Talking About "Private Issues" With Parents
Written By : John Jones Jr. 
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Talking with parents about issues involving their health and finances, their feelings about remaining independence, or their thoughts about their final wishes, can be every bit as difficult as that talk you had years ago about the birds and the bees.

Family conversations on such topics make all generations uncomfortable. Yet, they need to occur and often the sooner they do the better. In fact, these talks should take place when things are going well, before there is a crisis and decisions need to be made hastily. Adult children need to listen uncritically and treat their parents with the respect and dignity they deserve.

A recent study found that most elderly parents actually feel better about having these kinds of discussions as part of their planning for the future. Such discussions, they say, help them live life the way they wish.

Here are suggestions on ways for children to handle such conversations:

• Approach the subject indirectly. For example, "I know you're taking lots of pills. How do you keep track of them? Would a pill organizer from the drug store help you?"

• Be direct, but non-confrontational. "You know, Mom, I'm worried that you seem to be unsteady on your feet. I'm wondering how we can help protect you from falls."

• Watch for openings. "Dad, you mentioned having problems with your eyesight. Have you seen the eye doctor lately? Does it seem to affect your driving?"

• Share your feelings. "You've always been so independent, Mom. I imagine it's hard to ask for help. You know you can always ask us for help if you need to, or we can find someone who can."

Here are some other recommendations for children of elderly parents to consider:

• Make a list for your parents with questions or concerns they can prepare prior to the conversation.

• Expect some resistance. Above all: 
- Respect your parents' feelings if they make it clear they want to avoid the subject. Try again at a later time. 
- Push the issue if health or safety is at risk, while recognizing your parents' right to be in charge of their lives. 
- Act firmly, but with compassion. For example, "Dad, we need to deal with this now." 
- Hold a family meeting where everyone discusses concerns and together develops a mutually agreeable plan - giving your parents a sense of involvement and control over their lives. 
- Involve other people your parents respect. This may include a member of the clergy, an attorney, or a close family friend. 
- Look for community resources that can help a parent remain independent, including home care, meal delivery or transportation. For example, most people refer to remain in their current home and today there are options that bridge the spectrum from living totally independently to being in long-term care. Many elderly people, even those with early-stage Alzheimer's, manage to live within the comfort and familiarity of their homes because of the various community services that now exist. Many, for example, prefer live-in care, with a trusted caregiver, over being moved to a nursing home. Senior only independent housing, Continuing Care Retirement Communities (CCRC's) and assisted living all offer housing options.

• Focus on key points and ask your parents for their own thoughts regarding their current needs and concerns and their worries about the future - rather than guessing, which can lead to bad mistakes and hard feelings. Ask about the location of such important documents as insurance policies, wills, health care proxies, living wills, trust documents, tax returns, and investment and banking records.

• Keep it positive and treat them as equals. Even if they make what you consider an unsafe choice, it doesn't necessary mean they are no longer capable of living independently.

• Expect that the discussion will be ongoing rather than a "one shot" deal. Each time the topic is revisited, it should become more comfortable.

• Step back and evaluate. This might include suggesting that your parents talk with a third party - an estate planner, financial expert or attorney - if you think they could use some expert advice.

Physicians and geriatric social workers warn that there are a number of danger signs that indicate that an elderly person needs extra help or an immediate change in their living arrangement. As a result, note any marked change in personality or behavior. However, no major lifestyle changes should be made without discussions with the elderly loved one, other family members, and health professionals.

Once the ice is broken, it will become easier for parent and child to hold discussions. Initiating that talk is often the most difficult part. Don't put it off any longer.

John D. Jones, Jr. is President of Assurance Home Care of Florida and can be reached at

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