How to Talk about Long-Term Care with Loved Ones

Discussing the potential need for long-term care can be a challenging topic for adult children to bring up with their parents as they age. But putting off the conversation until a later time isn't the answer.

Having a conversation about long-term care plans before specific care needs arise can help families align on the parent's wishes for care and help reduce potential family strife, and unpleasant outcomes. After all, long-term care isn't an event that happens to an individual, often it is an experience that impacts an entire family.

Ahead, we'll cover tips on how adult children can approach the long-term care talk with their parents and five key areas to uncover by starting the conversation.

Figuring out how to start the long-term care talk with your parents in a way that feels supportive rather condescending can be a challenge for a lot of families.

Use a story you've read, a conversation you heard, or ask for advice with your own long-term care planning to ease into a conversation. If you need help or tips on getting the discussion going, consider sites like The Conversation Project. It may feel intimidating to initiate a long-term care talk with your parents because of the emotions it may trigger, but the earlier you surface the conversation, the more time your family has to create a plan.

Here are some behavioral tips on how to approach the topic from a compassionate and productive manner:

• Be an empathetic listener: Try not to anticipate what your loved ones may say or how they will react, but instead, focus on listening carefully to their needs and perspective.
• Expect emotions: It's not uncommon that they may feel uncomfortable, angry, or embarrassed to have such a conversation.
• Phrase your concerns as questions: Avoid telling your parents what they should do.
• Be straightforward (in a kind way): Gently bring up any observations that may factor into the long-term care plan, like if their physical ability to do basic household chores isn't the same as it used to be, or if you're concerned they can no longer safely drive themselves; don't hide negative information.
• Be inclusive: When you feel comfortable, expand the discussion with the entire family to help foster a comprehensive discussion that includes everyone's perspectives.
• Revisit the conversation: Life changes, as do our thoughts and feelings–so these conversations are never a one and done. The discussion will happen over many different time periods versus just one sitting.

Consider starting the conversation by asking more open-ended questions like what their lifestyle wishes are as they age and what they envision care will look like if they need partial or full-time assistance. The conversation should lead you toward answering the following questions:

Discussing a plan that includes details on who will provide and manage the care, if needed, can help lead to sorting out the important role of caregiver.

Have an open dialogue that sets expectations for who will be delivering care when the need arises. Often times, the caregiver is assumed to be a family member, but the physical, emotional, and financial toll it takes on an individual is well-documented. 

Additional trained help is encouraged to give adult children space and a skilled hand with any health care needs.

Explore what location(s) might be an option for long-term care assistance, if needed. Care can be provided in a home or senior living community (for example, a continuing care retirement community, assisted living community, a skilled nursing facility), depending on the needs of the individual and family involved.

Encourage visiting the different options before making a decision–it may be eye-opening. If they choose to live at home, encourage them to stay socially engaged. Isolation in retirement can be an issue. 

The cost of long-term care is unique to each individual, and is based on factors like location, custodial and medical needs, and whether partial or full-time care assistance is required.

On average, the annual cost for long-term care ranges from $50,000 for home healthcare and assisted living to more than $100,000 for nursing home care, and the average duration of paid care is around three to five years.

Discuss different ways long-term care costs might be covered and determine if insurance or assistance from family members might make sense.

Should a time come when your parents are no longer able to make decisions on their own, an estate plan can provide you and your family with clarity. Important estate planning documents can include a revocable living trust, a power of attorney (POA), advance directive (or a living will), HIPAA authorization, and a healthcare proxy (or medical POA).

Ensure that these documents are easily accessible and that all family members are aware of the document terms and the rationale behind the choices outlined in the plan.

Discussing what care needs might be needed for parents as they age can surface a lot of emotions for families. The key is communicating and planning ahead, knowing that it's an open dialogue that can evolve over time. But, it's a conversation that is a gift beyond dollars for everyone in the family.