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When’s the Perfect Time to Talk Transition from Independent Living to Assisted Living?

And How to Deal with Aging Parents who Refuse Help.

As a professional that has worked in the Senior Living world my entire career of 37 years, one would think that I would be able to handle any conversation or situation thrown my way, especially when it comes to communication with a loved one about taking next steps in planning their transition from independent living in their home into an assisted living community, right? Well sometimes life has a way of reminding us to take a pause and think through the process, especially when it comes to your own loved ones and what I will call, “The Set-Up” (a.k.a. what not to do) in talking about care for aging parents or loved ones.

My story begins with the aunt of my partner (Eddie) who had a stroke in February. She spent almost a month in the hospital, and subsequently almost a month in rehabilitation prior to being sent home with home healthcare, as well as a Medicare-certified physical therapist, occupational therapist, and speech therapist at home. As many have had to experience over the past 16 months, having a loved one in a health crisis has not been what it was prior to the pandemic. Because of the pandemic no one was allowed to see her – except for her husband, in limited and controlled situations. No one really had any idea of how she was really recovering from her stroke until she arrived home with the cabulance service (non-medical emergency transport service).

In discussion with my partner, her prognosis sounded very grim and really led me to believe that this was a situation that would most likely spiral quickly. So, after weeks of questions and discussions, my partner and his family decided it was time to have a group talk about the situation and identify the best options for their 78-year-old aunt.

Oh, did I mention that her husband was also not in the greatest of health, and they also have a developmentally challenged son living with them in their three-story home? Yes, the plot thickens into a complicated situation that I was pretty confident that I was prepared to address. So what did I do to help my lovely Family navigate this situation?

The Right Way to Discuss the Transition to an Assisted Living Community

Knowing the suggestion of living in an assisted living community can be difficult, I showed up at the house, sat and spoke with my Partner’s Aunt and Uncle. We talked about their family, laughed and had a great visit. I then asked if they would like me to make them something for dinner, just to name it and I would prepare anything their hearts desired.

We then played cards and I told them that I would check in on them in a few days to see if there is anything they would need. They were overjoyed, and by my third visit, I was able to have a true heart-to-heart with them about their concerns around independent living vs assisted living. I then told them that I would be happy to help them navigate assisted living options and choices, as well as identify avenues to help them cover the cost for assisted living options.

Yes, this is really what I should have done, but sometimes when faced with difficult and very personal situations sadly it is not what happened. Here is the real story…

Learn From My Mistakes When Talking to Aging Parents about Changes

Instead of taking more time to talk and put Eddie’s aunt and uncle at ease, I immediately began conducting a risk assessment of each and every potential issue I saw – from how bathing was being completed, to medications being managed. This led to discussions about the in-home care and rehab services that were being delivered to them. Needless to say, the conversation went from bad to worse.

Though I had the best of intentions in my approach to talking about these changes, I failed to take a pause and recognize the panic my partner’s uncle was facing, as he was now the primary caregiver for his wife. The final words out of his mouth were, in fact, “get out of my house!”

A Checklist for Talking to Aging Parents about Changes and How to Deal with Aging Parents Who Refuse Help

So what lesson did I learn that I would like to pass on to anyone reading this and who’s facing decisions on care for aging parents? When it comes to helping a loved one or Family Member of choice make decisions in the aging process, take a pause. Think of how you yourself will feel when the same conversation is facing you.

How we form communication in these long-term care discussions can be pivotal, in that we can either instill trust and discussion, or we can inadvertently create additional anxiety for those we care about. Approaching this conversation without patience can lead to parents who refuse help altogether. Take time to assess and reinforce trust, as from there any dialogue on next steps will be met with less resistance. Talking about care for aging parents isn’t easy.

Here is a brief checklist to assist you:

  1. Take a breath and place yourself in your loved one’s space, the changes that they’re facing and the financial fears they may have.
  2. When you start talking to aging parents about changes, do not start off any conversation about options or what to do next.
  3. Set the table for conversation by reinforcing trust and desire to be helpful.
  4. Assess the situation at hand with your loved one, but do not openly discuss big changes until you sense they’re ready to discuss the larger issues.
  5. Help to identify if all prudent paperwork and legal documentation is in place, (Physicians Orders for Life Sustaining Treatment POLST, Resuscitation documentation DNR/DNI, Power of Attorney paperwork for both Medical and Financial).
  6. Discuss options for coverage of healthcare/ assisted living costs. For example, Is there Long-Term Care Insurance? Are there extra life insurance policies? What ability to cover the cost for assisted living are your loved ones able to take on?
  7. If there are not enough financial resources, who in the Family is prepared to supplement? If that is not an option, then what other options may be available? Is your loved one’s home the sole asset to cover long-term care costs?
  8. Approach the discussion from the standpoint of how to best be of help in ensuring that all of your loved one’s wishes, and needs can be most closely adhered to, and be patient.
  9. Did I mention be patient? It’s worth repeating.
  10. Suggest looking at the options that are identified and help them identify the one that makes them feel most comfortable and at home.

Embarking on any of these discussions can be time-consuming and emotionally exhausting, so it is also important to take care of yourself in the process and realize that you are not the solution for providing care. If your parents or loved ones refuse to have the discussion altogether, keep trying to find the right time to approach the conversation again and remember the checklist above.

Keep in mind decisions on assisted living are not the end of the line, but rather the next adventure in life. In the end at the root of the most successful conversation lies the desire to help provide answers that make your loved one feel safe, comforted, respected, and most importantly – part of the process.

Sincerely – David Haack

Photo: David Haack, Chief Marketing Officer at Cadence Living pictured with his mother.