It’s challenging to watch your parents get older—to see the father who taught you to play sports now struggle with stairs or to worry that the mother who once drove you to school should no longer be driving. There will be sadness and anxiety as you realize your parents are changing and won’t always be here.
There also may be incredible frustration. Your mom may resist your efforts to take her keys, even after a fender bender or two. Your father may insist that he can handle those steps just fine despite a recent fall and trip to the hospital. You can see they need more help and support—but how do you tell them that so they’ll listen?
Having conversations about aging with your parents isn’t always easy. UNC Health family medicine physician and geriatrician Karen Halpert, MD, provides some tips.
1. Start early.
Don’t wait until your parent falls or receives a concerning diagnosis to start talking about how they want to spend their final years (which hopefully will be numerous). In an ideal situation, you should start talking with your parent about their goals when they’re healthy and living independently.
“It can be good to start these conversations by just clarifying if they have advance directives, like a healthcare power of attorney or a living will,” Dr. Halpert says. “This conversation is important because you never know when something will happen.”
Approaching the conversation early makes it less about aging and more about preparing for a potential emergency. You’re ensuring all family members know what a loved one wants and that you’re supporting their goals.
“Sometimes parents have long-term insurance plans and goals for their care, but they don’t tell their children because it can be hard to talk about getting sick or old,” Dr. Halpert says.
2. Be present in your parents’ lives.
If someone popped up out of nowhere to tell you it was time to go to a nursing home, you wouldn’t listen. How could that person possibly know when they don’t see you in your own home?
To effectively communicate with your aging parents about your concerns, you need to see or talk to them regularly. If you live close to your parents, that may mean more visits to their home; if you don’t, check in regularly on the phone or by video calls.
“When you’re present, you might notice some of those cracks in the armor, like a house that’s not as clean as it once was or a bill that wasn’t paid on time,” Dr. Halpert says. “You’ll notice when they start going to the doctor more or signs of cognitive impairment.”
Noticing these changes isn’t necessarily a cause for panic, but it can help you to increase support in little ways—maybe you help your parent set up a recurring bill pay or hire someone to help with chores.
While you don’t need to point out every little change or new behavior you see, take note of the things that cause you concern and monitor their development.
“I often hear from aging adults that they don’t want to be a burden to their children or that they know their children are busy,” Dr. Halpert says. “They won’t ask, so you have to show that these things are a priority to you and that you want to be there with them.”
3. Know there will be multiple conversations.
Maybe you’re continuing to notice issues with your parent that indicates the need for something to change—you think it’s time for them to downsize, hire an aide or move into an assisted living facility. Find a time to discuss the issue in a calm way.
“Have the conversation with love and concern for their safety,” Dr. Halpert says. “Give some specific examples of what you’ve seen that has you worried.”
It can be helpful to frame these concerns as “I” statements that are specific (“I’m worried because I noticed you haven’t turned the oven off after dinner several times now”) rather than “you” statements (“You are forgetting everything these days”). Broad, accusatory statements will put your parent on the defensive.
When you do use “you” statements, it should be to remind them of their stated goals, so it’s clear you understand their wishes. For example, you might say, “You told me you want to live in your home as long as possible, so we might need an alarm system or some modifications to make it easier to do your daily activities.”
Once you’re worried, it’s natural to want to implement a solution quickly, but be patient.
“You will not get your mom to move out of her house on the first conversation,” Dr. Halpert says. “It’s a process. Continue to be present and engage over time. The more conversations you have, the easier it will be.”
4. Talk to your parents’ doctors.
Your parents’ doctors also are concerned for your parents’ health and safety as they age, so attending appointments with your parents gives you an opportunity to learn more about how to best support them.
“I love when a family member can come with the patient and speak to other components of their life, because it gives me more information,” Dr. Halpert says. “I balance that with the patient’s willingness to let the loved one be a part of the chat.”
If you can’t attend the appointment, or if your parent doesn’t want you there, Dr. Halpert says you can call the provider’s office to share your concerns. Your parent may choose to grant you proxy access to their medical chart so you can get information directly from the provider.
Your parent may be more willing to listen to their doctor or other outside voices than their child, and the provider can help connect you with community resources.
“If there are home safety concerns, for example, there are physical therapists and occupational therapists who do home safety evaluations and make recommendations,” Dr. Halpert says. “There are programs with driving evaluations—either your loved one gets in a driving simulator or there’s another person there to evaluate and offer advice. If the person shouldn’t drive anymore, they’ll say that.”
That outside objectivity can give you assurance about whether the changes you’re seeing are normal or worrisome, and they might reinforce for your parent that changes are necessary.
Your parent’s healthcare provider may be able to connect them with social workers who can help them navigate programs—from home-delivered meals to physical therapy to community engagement opportunities—and can provide information on home health services or assisted living.
5. Have compassion and patience.
If you’re finding it difficult to talk to your parent about these issues or to get them to listen to your concerns, remember their stubbornness or evasiveness may be due to deeper emotions.
“Have compassion and understand that these are really big changes,” Dr. Halpert says. “It’s really hard to have these huge losses of independence.”
It’s also important to remember that while you may have identified what you’d like for them—an assisted living facility, for example—it may not be possible financially.
“Some people know what they can afford and some don’t, and that’s another hard conversation,” Dr. Halpert says. “Aging in America is tricky, and we don’t always have the resources or systems we need, but we can help someone access what’s available.”
When you find your compassion and patience dwindling, ask for help. Adult children of aging parents are usually balancing their own families and careers as well.
“Don’t do this alone,” Dr. Halpert says. “Rally the team. Ask about agencies, supports and resources that are available. Have regular check-ins with siblings about what’s needed. Be clear when you need a break and ask someone else to help.”
Want to learn more about resources for aging adults? Talk to your doctor or find one near you.