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Starting The Conversation About Care

Source AARP | A Planning Guide For Families

Many people wait until a crisis occurs before they talk about their values and preferences, wishes for health care or details of their finances. If you wait until a fall, accident or serious diagnosis, big decisions may be driven by assumptions.

A lot of uncertainty can be avoided if you talk with your loved one before something happens. It’s Easy to put off these conversations because they can be difficult. Plus, we’re busy. It never seems like the right time to bring up what we think will likely be an uncomfortable topic. You may be surprised to find your loved one has been meaning to have the talk, too.

Look For An Opening

You might use an article you’ve read or something you saw on the news to raise the topic of future care, such as:

“I’m starting to think about estate planning. Do you have any advice?”

“I just read an article about gathering all your important papers. Sometime can you show me where yours are and what you’d like us to do just in case?”

“As time goes on, do you think you will want to stay in this house? It might be difficult with all the stairs.”

“You mentioned your eyes are bothering you. Is this causing problem with reading or driving?”

Try not to anticipate what your loved one might say or how they will react. Just get the conversation started. It will likely take place over time. Be open. Express your love and concern and, most importantly, listen.

Respect your loved one’s wishes

Every caregiver plan must center on the wishes of the person receiving the care. A plan should never be made without the participation, knowledge and consent of your loved one. A person with a cognitive impairment should participate as much as possible.

Once you’ve started the conversation, you may wish to bring in a few other trusted family members or friends to be part of the process.

Before meeting, you and the other family members should consider…

  • Who is the best person to lead the conversation?
  • What re your own feelings and outlook on the situation?
  • What are your goals or what is the best outcome you think might happen as a result of the conversation?
  • What are you prepared and not prepared to do?
  • What is most difficult for you about having this conversation about the person you care about?

It’s important to have a point person to keep the process moving and make sure people understand what’ been decided. In most families, one person assumes the primary role because he or she lives nearby, has a close relationship, or simply is a take-charge person. Expect that there may be conflicts and don’t be afraid to talk through them. Better now than in a time of crisis.

It is also sometimes helpful to engage the help of an outside facilitator, such as a social worker or minister, to help keep everyone focused, manage potential disagreements and communicate difficult subjects during the meeting.

Size Up The Situation

Figuring out what your loved one’s priorities are – where they want to live and the nature of the care needed – will help you determine the next steps. It can lead you to find resources ahead of time. Your loved one may be hesitant to share the details of their finances or health, but approach them with respect and explain your intentions.

Review Finances

Money can be a particularly sensitive subject, but it’s often at the heart of many decisions you’ll make with your loved one about housing, health care and other expenses. One thing that family caregivers often find surprising is that most health insurance, including Medicare, pays for little, if any, of the costs of care in a nursing home, assisted living residence, or help with daily activities such as bathing, dressing or meals. Ask them to review their bank accounts, investments, insurance coverage and loans. Find out whether they have long-term care insurance and funds or assets that can be used to cover potential care needs.

Counter Resistance

Your loved one might say, “I just don’t want to talk about it.” Some people are private by nature. It’s also hard for some people to admit they need help, especially if it’s from their own children. If your first conversation doesn’t go well, try again. Start small, discussing just one aspect of your concerns. If your loved one shuts you out, ask a trusted family friend, doctor or faith leader to approach them about your unease.


In the journey of family caregiving, start the conversation before a crisis occurs. Heritage Senior Care can help with the process.
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