185 Commonwealth Road
(Route 30)
Wayland, MA 01778


[This post has been revised since it was initially posted.  I apologize to my in-laws for using our visit and conversations with them as a basis for the points I was making about having difficult conversations with parents.  At the very least I should have run it by them before posting it.  Again, I apologize to them; I meant no offense.]

Having a conversation with elderly parents about growing old safely and happily is no easy task.  The pitfalls are numerous.  It can turn a parent-child relationship on its head.  It can lead to arguments about what is wanted versus what is needed.  It can lead to confusion and hurt feelings.  It can cause rifts and competition between siblings.  In short, a fruitful conversation can be difficult to be a part of and even more difficult to start.

So how do we start one?  With the easier stuff.  After-death issues are simpler than long-term care issues because if they don’t want to participate in the planning they don’t really have to and there will be no second guessing.  So starting there may help.  Some other ideas to consider:

  1. Divide and conquer.  “What will you do if dad (mom) dies first?” this question gives you more of a chance to discuss the issue with each of them separately and talking with one at a time makes it a simpler conversation.  Sometimes one parent disapproves of what the other will choose to do which is not necessarily a bad thing since it effectively gets that parent into the conversation.
  2. As Victoria once told me about addressing family conflicts, “the conversation is never over.”  The goal is not to reach a complete plan with a single conversation. Aim to develop a framework for discussing it during the next visit or phone call.
  3. Avoid a sense of urgency.  Whether there is an actual urgency or not, older adults get anxious and suspicious when pressed to give an answer promptly.
  4. Be patient and keep it light.  Humor goes a long way and even if they get away without having made a choice it is likely that you got them thinking about a particular issue.
  5. Be persistent and practical.  Some parents, especially those living far away, are unwilling to share the names of their attorney or financial planner or primary care physician because they do not want you checking up on them.  Find reasons why they need to share.  Consider asking them to have these people call you so the dynamic of the request and the conversation is less threatening.
  6. Always maintain the appropriate level of parental respect.  This is different for everyone; some parents enjoy the give and take of teasing, others do not.
  7. Remind them that the goal of the conversation is to let you be prepared to help them live the rest of their lives the way they want to.  It is about facilitating their ability to have the choices they have always enjoyed.

This is not a complete list but I hope it provides some ideas for you to develop a strategy to start the conversation.  These recommendations are intended to help with parents who are avoiding the conversation out of a sense of denial and not because of dementia or other psychological reasons.  Further, they may not apply directly to families where the relationships between siblings is an issue or where there are serious financial concerns.  In those cases mediators or social workers may be needed to facilitate the conversation.