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Helping your Parents, Getting Started

It is not uncommon for family members to visit a loved one (often over the holidays) and become concerned about their safety. They and their house may be unkept; you might see a stack of unpaid bills; they might have withdrawn from relationships and activities they once enjoyed; you might notice they have lost weight, or you might see other issues that concern you.

Many age-related issues can cause a person’s capabilities to decline and make living at home unsafe.

  • Physical issues, for example, a lack of muscle mass, balance issues, arthritis, diminished eyesight, and other issues can make living at home dangerous.  Falling is the most common reason people move to senior living communities.
  • Cognitive issues, like dementia, can make living at home unsupervised dangerous, especially when the disease reaches a point when a person cannot complete everyday tasks like cooking, cleaning, and taking care of hygiene habits. In normal aging, people do not lose their ability to complete tasks.  It might take longer to complete, but their capability does not diminish.
  • Loneliness

Since changes in the aging process happen slowly, chances are you noticed signs early, and there is no reason to act immediately.  If your loved one is unsafe, immediately get them into a safe situation. Do this before taking other steps.  Your first solution does not need to be the final one. It just needs to take care of the immediate need for safety and security.

Discover Underlying Issues

Once safety is assured, please work with your loved one’s doctors to discover why they are struggling.  There are many reasons why people’s capabilities become impaired in their later years.  Some causes are reversible, like dehydration or a urinary tract infection, while others, like dementia, are not. It is essential to know the difference.

Loneliness is one of the most significant indicators of decline in older adults.  Lonely people are less physically and cognitively active, and the lack of stimulation leads to declines.

Be prepared for a long process

Just because you are worried about your loved one’s safety does not mean they are worried, and moving from a long-time home is difficult.  Homes contain memories that are hard to let go of.  Because of this, the decision-making process to move to an independent living community takes 12 months on average. It takes four months for assisted living because health issues are more serious.

The decision-making process for memory care is also four months; however, the person moving does not make this decision.  A spouse or legal representative makes it.  For more information on helping a loved one move to memory care, see here.

Communication, The Basics

To help your parents, you must be supportive of their desires.  This can be difficult when you worry about their safety and loneliness. For their sake, you want them to move.   But beware: once you have an agenda, you will begin to push it, whether consciously or not, rather than supporting their agenda.  The results are predictable. This dynamic will cause your parent to dig in and become resistant to you and your ideas, and communication will dry up. This is counterproductive.

To avoid this pitfall, do the following:

  1. Don’t push! It will start a counterproductive cycle.  Instead, listen to your parent(s) and understand their position.  If they want to stay in their home and you think it is not safe, listening does not mean you agree; it just means you are first trying to understand how they see their situation.
  2. Use reflective listening. This means listening to understand. It also means summarizing (reflecting) their thoughts and feelings back to them.  Reflecting proves you are listening and trying to understand them.  No action builds trust better than this.
  3. Don’t start the problem-solving process by looking at senior communities or other options like home health. If you do this too early, it will feel like you are pushing.
  4. Instead, allow your parents to brainstorm what a happy and healthy situation looks like to them, given their current and future needs. “If you had a magic wand, what kind of home and community would you like at this point in your life?”  Talk about the home: how many bedrooms would it have, how big would it be, what features would it have? Talk about the community: what would it offer; would there be regular opportunities to socialize; if so, what kinds of social activities would they enjoy? Is a gym or pool important?  Discuss the importance of having health care services available when help is needed. Etcetera.
  5. Once you and your parents know what good looks like, evaluate options.  Find the one that meets their desires best and that they can afford. Since most people are not wealthy enough to get everything they want, this process will result in your parents getting clearer on what they want as they make result in trade-off decisions (i.e., is a smaller home win a community with social opportunities, meals, and exercise equipment more important that a larger home without them?) and more clarity about what will work best.

Consider these advantages:

  1. Fewer conflicts
  2. Better communication
  3. Being a helpful partner
  4. Your parent(s) being empowered to take control of their situation
  5. Your parents are considering a broader set of options than only those associated with staying in their home.
  6. Your parents and you evaluate the options critically to find the best option for this phase of your life.

Advanced Communication Tips

Making change has been studied in academic fields like psychology, medicine, and organizational change for more than five decades.  Studies confirm that people who make change go through these steps, irrespective of geography and culture:

  1. Denial – when a person does not recognize a need to change, even when others do.
  2. Thinking – when a person weighs the pros and cons to determine what to do.
  3. Planning – when a person investigates how to make the change. This happens once they believe making a change is in their interest.
  4. Action – they are changing.
  5. Relapse -when a person wishes to revert to a former situation or behavior.

Each stage has its own goal that must be accomplished to advance to the next stage. People who go through all the stages are more successful at changing. They have done the necessary work. People who skip steps tend to fail and revert from an advanced stage to an earlier stage.
The table below summarizes the stages of change, the goal at each stage, how you can recognize each stage by how a person talks, and the actions you can take to help them the most.  Avoid taking actions that do not match the stage of change of the person you are trying to help, such as touring senior communities with a person in denial. This will cause friction and be counterproductive.
For people to make change, they must believe their lives will be better and that they can make it.  Exploring whether moving will improve your loved one’s life happens in the first two stages. Exploring if your loved one can make the change occurs in the last two stages.   If they go through a complete process, relapse (moving back home after moving to a senior community) will not happen.

 

Stage of Change Examples of what you will hear Examples of what you can do
Denial “I’m fine…” Reflect on how they feel: “You don’t want to move despite what your doctor says. Everything is fine.”
“I don’t need it…” Provide neutral information so they can educate themselves. “Here is a report on aging I thought you would find interesting….”
“Stop pushing me!” Build awareness: “I can tell you are doing fine. I wonder why your kids are worried?”
Thinking Will consider new information Reflect on their feelings: “Your home works for you pretty well, but at some point, it will be too much…”
We will talk about a possible change in the future, but we are non-committal now. When they complain about their current situation, they reflect the opposite because that is what they want. Ex: “You don’t like not knowing your neighbors; in your next home, it will be important to be in a community where people get together regularly…”
They are willing to acknowledge how their current home does not work well. Visit senior communities to try them. Eat meals, attend events, talk to residents, and stay the night. Senior housing is a lifestyle that must be experienced to appreciate.
Make a pro and con list and review it often.
Planning I am interested but not yet making commitments Acknowledge it sounds like they want to move. Ask them why and if any concerns need to be considered.
Start talking about steps they need to take to move – for example, contacting a realtor about listing their home or asking for a contract to review.
They picked their favorite apartment in the community and talked about how to place furniture. Ask them about moving. Find out what they feel comfortable with and what makes them nervous. Help them with the difficult parts.
Action signed contract/deposit Support through the moving process.
Be positive and encouraging. Fear will increase as the moving date nears.
is moving Please stay in contact until they settle into their new home and make friends.
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