Reading the NY Times today I came across an article that I thought I’d share with you.  It was called “5 Conversations to Have With Your Aging Parents,” by Simar Bajaj.

He wrote of our aging population and how many adult children do not know what is going on with their parents health until a fall or hospital stay occurs.  Aging can be difficult and nothing parents want to “burden” their children with but that actually makes things tougher.  So many families live far from each other and when the children get that call that mom fell or dad had a stroke they often times have no idea what to do.  Siblings may have vastly different ideas of what they think mom and dad would want or what their wishes are.  Guessing is stressful.

One of the experts interviewed for the article said, “It feels like you’re putting them through something hard, but it’s avoiding something that is far, far worse” talking about having THE conversation.

Here is a quick synopsis:

1. Know their base line.  Doctor’s have a quick snapshot in an emergency so you can be the best form of knowledge they have.  Ask about your parents routines but preface it with “Because I care about you and want to make sure I can support you in case of emergency…” Ask how they are doing managing bills and appointments or if they still drive at night, take the stairs or are there things they like to avoid.  Try to have this conversation yearly or after a major health event.
2. Ask them about their medical history.  I took my parents to nearly all of their doctor’s appointments so I knew what was going on. I asked to accompany them by saying I was an extra pair of ears.  I lived close by but many adult children do not. Ask them for a list of the medications they are taking.  Ask for the names of their physicians and their phone numbers.  Do they have any allergies?  This information can be invaluable in an emergency situation. Equally important is to ask if there are any prescriptions they are not taking because of cost, side effects or forgetfulness. Knowing what pharmacy they use is very helpful.  Keep this information on your phone or in a file.
3. Talk about what is important to them.  “It’s not just about what you want at the end of your life, but it’s about what you want your life to be like as you get older,” Dr. Mohta said.  What is their biggest worry? My father made it VERY clear that he didn’t want to be on any life support no matter what.  He specified no feeding tube, no resuscitation, no machines.  It is difficult to adhere to this when faced with the decisions but at least you know their wishes.  It is an emotional and overwhelming time. Have these conversations before you need the answers.
4. Discuss their living environment.  Do they need better lighting? Does their bathroom need grab bars, shower chair or handrails? Do rugs need to be taken up? Long term would they consider assisted living or would they prefer home care or Home health care (two different things.) Would they rather move closer to their loved ones?
5. Name a point person.  If a parent can not speak for themselves you need to have a person to speak for them.  Parents need to explicitly state who is authorized to make medical decisions for them and make sure it is clear to everyone.  It is also helpful to complete a living will and a health care proxy form to formally designate the one point person to make decisions.“It is not about picking a favorite, but about picking the person best positioned for the job.  Consider someone who is nearby or closely involved who knows what the parents want and will follow those wishes even when others disagree.  It could be you or one of your siblings, but it could also be one of their  siblings or a brother or sister,” said Dr. Taldone.

In our family, we had two very different situations. My father passed about five months after entering hospice.  He died at home with all of us with him.  During that time we had discussions about dad’s end of life, his wishes, planned the memorial service and covered everything important to him.  Mom simply said “I’m not living with any of you kids.  I need my own place.”  Needless to say, that was the end of her discussion.  My husband’s father died six months after my dad.  He also died at home after entering hospice.

My mother-in-law and sister-in-law (who has end stage MS) both lived at home with him across the street from us.  For a while they opted to have home care to assist my mother-in-law and Home Health to assist my sister-in-law.  It soon became apparent that wasn’t going to work. My mother-in-law, who is in her 90’s wanted the same person coming to the house every day and that was not possible.

While many home care agencies will have a caregiver that’s mainly assigned to your loved one, life happens, and sometimes another person will have to cover for them. On top of that, their needs became greater and greater. Staying at home just didn’t work for them and ultimately, after several contentious conversations they moved to assisted living.  I really wish we had hashed all of that out earlier.  It would have saved a lot of time and frustration.

Bottom line, HAVE the conversations.  It doesn’t  have to be morbid – just a conversation.  My husband is an attorney.  He compiled all of the documents you would need in an emergency like a living will, Medical Power of Attorney, directives, etc., for each family member and as a family we all signed them together after Sunday dinner.

It wasn’t a sad thing but a necessary thing and everyone knows where copies are and who is in charge of what.  Make sure that you get advice as to any legal formalities required for any of these documents, as each document may require different things (witnesses, notaries, initials, etc.). If you have any questions about any of the above, or need referral to an Elder Lawyer, please reach out to our experts at SLS of California and let them help.  It is a free service and can alleviate a lot of anxiety.