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					                            THE CONVERSATION
                               J. William Crittenden, MPA
                        Senior Care Management Associates LLC

        Have you been anticipating having “the conversation” with your parents? You
know the one I mean. You have perhaps spoken with any available siblings, close
friends, a clergy person or physician, or perhaps a geriatric care manager about “the
conversation”. You have started the conversation dozens of times in your head. “Mom, I
am worried about you,” you begin, or maybe “Dad, I don’t think you should be driving
the car anymore”, or “Hi Mom and Dad, Have you ever thought about moving to a
nursing home?” Yet you fear that right after you speak these words you might feel like
you are rearranging the furniture in your stateroom – on the Titanic. Your fear is that no
matter what, you – or just this conversation – are going down!

        With the burgeoning senior population in this country the prospect of needing to
have a similar conversation with a senior adult is steadily growing greater. The statistics
on needing to have such a conversation are increasing exponentially, with someone in our
country turning 55 years old every seven seconds of every hour of every day and this will
continue to be true for the next 20 years. Or the fact that the age group of 85 years and
over is the fastest growing age cohort in our country today.

         So, here are a few tips both for aging parents and for their children – who are
probably between 50 and 65 years old themselves. What will you do when the time
comes for “the conversation” in your house? First, before the need becomes blatant, start
early by paying attention to any physical, mental or emotional changes in your loved one.
Be aware that the changes you observe may be subtle, almost imperceptible, but
increasingly evident to the senior adult and to their family, such as memory problems that
may create safety issues in the home, or the lack of physical stamina to walk as far as
they once did, or a greater than usual amount of confusion regarding past activities. The
first response is often to overlook or excuse these issues, but should we?

        The word that has become increasingly important for both seniors and their
families is planning. A great percentage of all adults today still do not have a will, a
health care power of attorney, nor have they completed the legal steps in forming an
advance directive. Not only is this a critical issue for seniors, it is clearly an important
part of planning for everyone. Evaluating and purchasing a long term care policy not
only makes financial sense in most instances, a growing number of continuing care
retirement communities are requesting or requiring incoming residents to have such a
policy. Being informed about these issues can often make having “the conversation” go
much more easily.

        One of the most important skills going into “the conversation” is the ability to
listen. Rarely have I had an initial conversation with older adult(s) about these issues and
had them indicate that they have given no thought to their increasing limitations. At
times they have refused to think about their future needs because such thoughts are scary
and unsettling for them. Families must take the time to listen, carefully and lovingly, to
their older family member before they attempt to “sell a solution” that the family has
devised. As these conversations begin, senior adults need to know that their wishes will
be heard and respected in the formation of future plans, or the conversation can take on
the symbolism of the Titanic mentioned earlier. Over several conversations the topics of
finances including who is legally designated to sign on bank or savings accounts, in-
home care vs. assisted living, how the senior adult wants (or can) spend their final days,
and funeral arrangements are among the topics that need to be considered. These are
obviously not easy conversations to have for any member of the family but be assured
that without them some issues that are critically important to the senior family member
will be unheard.

        Finally, all members of the family must be heard and respected in “the
conversation”. Clearly, these can be tough and tender moments. In addition to the joy of
reminiscence, the feelings of fear, guilt, anger, or anxiety may also be expressed. At
times these may come in destructive ways. Often having a pastor or geriatric care
manager present can assist in finding a way for these issues to be expressed with the
greatest opportunity for a caring and loving outcome.

        “The conversation” whether easily achieved or an anticipated moment of concern
and anxiety is an important aspect of planning for all families. As is often the case, the
anticipation of the conversation may be more uncomfortable than the conversation itself.

J. William (Bill) Crittenden
Senior Care Management Associates, LLC
P.O. Box 16753
Chapel Hill, NC 27516-6723
(919) 636-2016
www.senior-care-management.com

				
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