Elder Care 101 – Where Do You Start?


It’s never easy to tell your parents they need a caregiver. But some simple steps can help you get the message across effectively.


You’ve probably had your share of difficult conversations with your parents over the years—remember back when you were a teen, and had to tell dad you dented his new car? But one conversation may be trickiest of all: talking to your parents about their need for some help. It’s a topic that stirs deep emotions—no aging parent likes to acknowledge they’re struggling with everyday tasks. And no adult child likes to see their parents risk their safety by refusing to accept assistance.


While there’s no perfect or easy way to start talking about the kind of care your folks might need, both now and in the future, some simple strategies can make the conversation go more smoothly. Keep in mind that “care” shouldn’t be implemented when mom or dad are already in a bad situation, such as after a fall. Care should be to improve their quality of life and keep their home the place they know and love it to be. Here’s what we’ve learned over the years along with the insight we’ve gotten from other professionals in the industry.

  • Start early. Ideally, “talk about caregiving arrangements before your parents actually need help,” says Amy Goyer, Family and Caregiving expert at the American Association of Retired Persons (AARP). Even if you don’t think they currently need a caregiver, stop and assess the situation objectively: Is mom or dad slowing down a bit? Are chores like housekeeping and cooking becoming increasingly tough for them, or, if you have a parent who lives alone, does he seem like he could use some companionship? To keep the conversation with your parents from getting too emotional, “use something else as a jumping-off point,” Goyer suggests. For instance, if one of their pals moves to a senior community, ask your folks, “Do you think you’ll want to relocate to place like that, or would you prefer to stay in your own house?”

  • When they pushback, educate them on the risks. If your parent insists he or she will never need care, don’t argue, advises Marlene Vance, an administrator at Braemar at Wallkill, an assisted living facility in Wallkill, NY. “Say, ‘I hope that’s the case, but in reality you never know what life may bring. It would be great to give me an idea of what you’d like, so I can do my best to honor that,’” she recommends. Don’t wait until there’s a crisis! Add that you’re concerned about hazards of being alone such as falling. According to the Centers for Disease Control, 2.5 million older adults are treated in emergency rooms each year for falls, and more than 700,000 seniors end up hospitalized from falling-related injuries. These accidents can cause problems like a broken wrist, arm, ankle or hip, or even head trauma, significantly cutting down on quality of life as well as life expectancy.

  • Observe and Explain. If you’ve never spoken about care with your parents, and they now seem to need it, approach the subject in a planned way, says Miriam Scholl, L.C.S.W., owner of Westchester Eldercare Consultants, LLC. First, make specific mental (or actual) notes about the current shortfalls in your loved one’s living situation: Is Dad losing weight because he has trouble cooking? Is Mom no longer able to drive at night? Explain your concerns. Also be prepared with solutions, which takes a little advance research. “Maybe there’s a great service nearby that can send over a part-time caregiver, or your parents’ town has a discount taxi service,” says Goyer. Or perhaps a neighbor would be happy to take out your parents’ recycling for them, if they’re no long able to do it themselves.

  • Make the goals clear. The goal here is to improve your parents’ quality of life, not just to fix a problem after some mishap occurs. “Tell your parents you’re trying to keep them as independent as possible for as long as possible,” recommends Goyer. This may cut down on their defensiveness. “Don’t automatically assume your folks have to move out of their home because they’re currently having trouble navigating it,” Goyer adds. “Maybe moving the washer and dryer to the same floor as their bedroom would make it easier to do laundry, for instance, or the bathroom could be modified—little fixes can help a lot.” The truth is that having someone in the home to watch after your parents will prevent a lot of potential risks and preserve their quality of life.

  • Start Slowly and Involve Them. Unless a parent is in danger, it’s fine to implement caregiving gradually, says Scholl. At Lifeworx, we find that many clients start with just a few hours of light housekeeping weekly, to get Mom or Dad used to the idea of someone in their home. “Try to arrange for you or a family member to be on hand for those times, Scholl adds. “That way, you can coach the caregiver,” she explains. Your effort will probably pay off: “Even though a parent may initially say he doesn’t want a caregiver, once there is one, the parent often experiences an enormous sense of relief,” says Vance. Pay attention to your folks’ ideas. Solicit their feedback on any and all arrangements being made on their behalf, and be prepared to tweak them as needed, Vance stresses. Would they prefer the caregiver to come at different hours? Do they like to open their own mail with no help from anyone else? What would really WOW them and make them happy? Respecting their desires as much as possible will help preserve their dignity.

  • Step in with a secret subsidy if you can. Often, parents refuse care because they feel it’s too expensive, Scholl notes. If your parent already has dementia and can’t easily be reasoned with, try stretching the truth a little. “You can say ‘Oh, this caregiver isn’t costing anything, she’s covered under your insurance,’” Scholl says. Even a savvier parent won’t know it if you subsidize the cost of the caregiver yourself, especially if you handle your parent’s finances, she adds. “You can pay a portion of the care on your own, and simply tell your parent the caregiver costs a bit less than she really does,” Scholl explains.

  • Bring a third person to the table. Sometimes, an objective party can get the caregiving message across less emotionally. Ask your parent’s physician or friend if she’d be willing to join the discussion, for example. It would be great if one of your parents’ friends has some help at home and can talk about all the benefits with them. You can also consult a geriatric care manager—someone whose specialty is meeting with seniors and making recommendations about their caregiving needs.

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