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How to Talk about Tough Topics

| November 02, 2018
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It’s easy to procrastinate and make excuses to avoid talking with your aging parent (or other loved one) about essential life choices and end-of-life issues. Even if your loved one is in failing health, you may still avoid talking about or planning for the future. Sure, there’s some fear involved. After all, you don’t need a crystal ball to know that it will be a painful conversation. 

But, the truth of the matter is that your loved one’s health may deteriorate further. Or, he or she may lose the ability to function independently. Rather than avoiding the issue, why not consider for a moment what it might be like to walk in your loved one’s shoes? 

Maybe, your loved one is thinking: Who will help me when I’m no longer able to drive? How could my living arrangements change if I’m no longer able to cook or bathe without help? What if my spouse dies? What about my estate? Will I be able to pay for my care? 

These are important issues that are best addressed before your loved one’s ability to live, think, or function independently is in any way compromised. Talking now, openly and honestly, can alleviate stress and worry for you and your loved one. Even if your loved one is in good health and you think it’s too early to broach such topics, think again. Tomorrow, next week, or next year could suddenly be too late. 

So, where do you begin? 

Depending on the circumstances, consider who might be the most appropriate person to talk with your loved one. Is there a family member or relative with whom your loved one is particularly close? Would your family doctor, your priest or rabbi, or your trusted financial advisor be more appropriate? Maybe, the best person for the job is you. 

As with so many experiences in life, the first step is often the most difficult. How you begin the conversation will depend on a number of variables, such as your loved one’s personality, age, health status, cognitive function, and religious beliefs. If you don’t know how to break the ice, consider the following strategies that have worked well for others. 

  • Ask questions about your loved one’s childhood or fondest memories. As the conversation progresses, ask about the future. What are your loved one’s hopes and greatest fears? Does your loved one feel prepared for the future? If not, what can be done to provide reassurance? 
  • Watch a movie together that deals with aging, death, illness, loss, letting go, etc. Movies can often serve as catalysts for talking about tough topics. A biography of a favorite celebrity, especially one who is aging gracefully or dealing with a reduced level of functioning due to illness or aging, may be just what you need to open the lines of communication. 
  • Be gentle and compassionate. Ask open-ended questions: How are you doing? What are your needs? How might those needs change? What are your expectations for the future? 
  • Sit quietly and listen attentively. Even if your loved one is ill, forgetful, or repetitive, listen to what he or she is saying. Sometimes a smile, a hug, or even a shared laugh over a fond memory can steer the conversation in the desired direction. 
  • Don’t force anything. Your loved one may feel the need to discuss other things, and that’s okay. It’s a start. Building trust and providing comfort and reassurance is a good starting point. 

While you don’t need to show up with a checklist of questions, it may be helpful to jot down some notes to steer the conversation toward important points that need to be addressed. Consider the following questions and their relevance to your loved one’s circumstances: 

  • Does your loved one prefer to stay at home? Could home modifications, such as a ramp, personal emergency response system, or assistive device, allow your loved one to remain at home longer? 
  • Does your loved one have a preference regarding medical care facilities if staying in the home is no longer an option? Many assisted living facilities have long waiting lists, so it’s important to discuss such preferences early to increase future options. 
  • Does your loved one have an up-to-date will? What about a durable power of attorney that grants a designated individual the authority to make financial and legal decisions? Does your loved one have a living will detailing preferences for end-of-life care? Does your loved one have a power of attorney for healthcare decisions? Can you obtain copies of all important documents? 
  • What if your loved one becomes widowed? How would circumstances change? 
  • What about the cost of care? Long-term care at an assisted living facility or in a nursing home can quickly deplete hard-earned savings. Talk to your loved one about long-term care insurance, family and retirement income planning, and asset protection. 

Yes, these are tough topics. But, talking sooner rather than later can help ensure that your loved one’s needs will be met and that life will be lived according to his or her preferences. Denial and procrastination only stall the inevitable and serve no one. Honest and direct communication, on the other hand, can bring you and your loved one closer and minimize fear and anxiety for you both.

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