So You Think It’s Time for Assisted Living


5 Tips for Starting “the Conversation”

Several of you have told me you are heading into Thanksgiving weekend planning to have “the talk” with elderly relatives about their living situations. It’s become apparent to you that your parent or relative living alone isn’t a good scenario. You’re worried about isolation, falls, navigating the stairs, driving, and quite frankly the impact their decision to age-in-home has on you. After all you’re the one who will need to help them manage living alone and who will have to rush to their aid in the event of a crisis.

I tried having that conversation with my parents many times over the years. I looked for advice on the Internet but it wasn’t helpful. Too many of the articles I read assumed the conversation would be rational and reasonable. First of all, not my family. Second of all, not this topic.

My mother was open to the idea but my father was not. I thought about moving one parent but not the other, but that wasn’t economically feasible. I threatened to pull my help and support, but we all knew that would never happen. I thought about using guilt to get what I wanted, but that didn’t feel right. I felt like a failure; I thought other adult children were more successful convincing their parents to change their living situations than I was. But I was wrong.

I’ve met plenty of adult children who tried and failed to get their parents to make a change. I’ve met even more who have never broached the topic because they don’t know how. I finally moved my parents during a crisis. My dad was just out of the hospital and my mom was about to start hospice. We all agreed at that point that it made sense to have them near me. Since then, I’ve been investigating just what is the best way to deal with this issue and broach “the conversation.” Here’s what I’ve learned:

Remember, it’s a process. The conversation is actually a series of conversations. Don’t expect to fly in for Thanksgiving, suggest Mom or Dad or your Great Aunt Sally can no longer live independently, and get them to say, “You’re so right. Let’s make a move.” Important issues are rarely resolved through one conversation.

You need to listen. In order to advance the conversation, you need to really listen. Otherwise, you’ll have the same one-sided dialogue over and over. What are your relative’s concerns? What are they open to? The decision is ultimately about their life, not yours. So what are you hearing and how can you address it?

Go for small wins. Maybe your relative gives you a flat out “No” about moving, but are they open to meeting a home health aide? Will they at least tour an assisted living facility? Baby steps are still progress.

Get the facts. If you can enter the conversation with knowledge of your relative’s financial information, do it. The more data you have, the better you’ll be able to address their fears and concerns. Likewise, gather information about what facilities are available, which have openings and how much they cost. Have the facts, but present them as options.

Value autonomy as well as safety. You can raise concerns about safety and you can share why what you are suggesting will ease your burden, but you are dealing with an adult and ultimately the decision is theirs. In his book Being Mortal, Atul Gawande drove home the fact that autonomy is as valid a concern as safety. Read it if you haven’t already. Autonomy is as valid a concern as safety. #eldercare Click To Tweet

Even if you strike out now and are faced with a crisis situation down the road, you’ll be ahead of the game. Every conversation you have on this topic will help your family member get more comfortable addressing how they will manage this stage of their life.

For more on this topic, I recommend, “How to Approach a Tough Conversation” from Tabitha and “How To Have The Conversation With Your Parents About The Transition” from Our Parents.



11 comments on “So You Think It’s Time for Assisted Living”

  1. Carla Reply

    Thank you thank you for this post. I’m profoundly grateful both for your insights and for you normalizing what I am going through.

  2. Haralee Reply

    You are right it isn’t one conversation. Seeds need to be planted and talked about again and again and again. The cost can be a big concern too. I was extremely lucky because my Mother said she wanted to go to assisted living and knew the place. Little did I know they had a waiting list!

  3. Paula Kiger Reply

    GREAT points. My FIL lives with us and we may be facing this (are facing this??). It has many challenges, and your suggestions are good ones. Wishing you the best…

  4. Kim Tackett Reply

    I just spent a week caring for my parents…and yes, it’s a journey. A friend of mine said, so wisely, “the path back to dependence is littered with loss.” I try to remember that as I help them navigate the next steps (albiet, with walkers!)>

    • admin Reply

      Perfect quote Kim. I’ve found I mourn all along the way – each time their health or independence changes, you lose them as they were.

  5. Rena McDaniel Reply

    What a great piece Liz! All of it is so very true! It takes a whole lot of conversations to make any headway at all and we still had to wait until the timing was just right. Luckily, it wasn’t a medical emergency just an expiring lease and outrageous rent hike that she could no longer afford.

  6. Pingback: How to Recognize and Accept When Your Parents Need Help - Working Daughter

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