Having the aged care conversation

At Christmas time the ageing of parents often shocks adult children. Since they last saw them, their elderly parents often seem to have become increasingly frail and perhaps confused or withdrawn.

Ageing parents are often incredibly adept at hiding the fact that they are struggling to manage at home where their regular routines and familiar surroundings make it easier for them to cope on their own. But when these routines are disrupted, or they are removed from their home, it becomes apparent that all may not be as well as they would like you to think. 

So, what are the signs for which you should be on the lookout?

  • Notice or look at their personnel grooming and general appearance.  Are their clothes clean and do they look like they are attending to basic personal care and hygiene?
  • What condition is their home in? Does it look neglected? Are housework tasks, such as laundry, piling up? Does the garden look as though they’ve lost interest in it? These could be clues to a decline in health and may even indicate depression or dementia.
  • While occasionally forgetting appointments and losing glasses is normal, forgetting common words or getting lost or confused in familiar places may not be.
  • How is their sight and hearing? If they’re still driving it’s important to make sure they’re fit to do so. 
  • Are they reluctant to leave the house or pursue the activities they used to do?
  • Have they lost weight? This could be a sign of a health decline, depression or early signs of dementia. Check what food is in the cupboards and fridge to see if they have access to fresh food.
  • Are they in good spirits and happy to chat about what they’ve been doing? If not, then this, too, may be a sign of depression. 
  • How are they at getting around? Are they finding it difficult to walk reasonable distances or navigate through their home?

If this sounds familiar and alarm bells are ringing, what can you do?
It’s never too late to talk to your parents and, while they may try to trivialise or brush aside the issues, this is usually due to pride and not wanting to be a burden. They may also fear that they will end up in a nursing home and are concerned that they won’t have control over the type of care and support they are given. It’s important to remember that there are other options to residential care and that they can remain independent in their own home for years to come. 

Page 1 of 3. Click HERE to read more.

How do you best handle the conversation?

  • The first step is for you to become informed. Do your homework and get to know the services and supports available in your parents’ area, the idea of costs and eligibility etc. 
  • Choose a time when your parents are relaxed. They may even mention something which gives you a lead in. 
  • It’s as much about listening as it is about asking questions; listening to their wishes is important. What you think is important for them may not be what they want.  

Should you talk directly with your parents about their failing health? 

  • Yes, but start small and don’t bombard them with questions. An ice breaker, such as referring to another ageing parent or friend, is often the easiest way to start the conversation.
  • Ask basic questions, such as:  What worries do you have about Mum/Dad? What do you want out of the future? What do you want to do if you are struggling at home?
  • Talk to your parents openly and honestly; knowing you are concerned my allow them to acknowledge the changes and seek help.
  • You may be required to chip away at the topic over a number of visits, touching lightly on the questions and dropping ideas.
  • It is important to keep in mind that, although you may disagree with your parents’ priorities and wishes, their wishes prevail.
  • Express your concerns rather than telling them what to do.

Should you discuss this with your siblings first?
If the opportunity arises, then yes. Enlisting the help of family or close friends can sometimes help, but it can also backfire if you have different opinions about the way forward. It’s about knowing the dynamics of families and friends.

Page 2 of 3. Click HERE to read more.

What are the next steps to support your parents in the best possible way?

  • Encourage regular check-ups with their GP.
  • Address safety issues – assistive devices such as walkers, safety rails, removing mats, look at Telecare – emergency pendants and inactivity sensors for piece of mind.
  • Suggest some basic home help as a start. A little help can go a long way towards enabling your parents to remain living at home independently.
  • Are they socially isolated? If they can manage a tablet and internet, then Skype is a useful means by which to keep in contact with them while keeping a virtual ‘eye’ on them.
  • And plan ahead (see below).

And where do you get information which helps you to help them?

  • YOURLifeChoices has a lot of plain English information on aged care.

  • Ring the My Aged Care helpline on 1800 200 422, or visit www.myagedcare.gov.au
  • Search the web for home care services in your parents’ area.
  • Ring a couple of local aged care services and talk about their services.
  • Talk with their doctor, neighbours and close friends.
  • Investigate local transport options, seniors groups and other support services which keep them mobile and active.

The best plan is to ‘plan ahead’ while they are healthy and independent.

  • If you start the conversation now, you can agree on what support and what involvement they want from you when the time comes.
  • What is the status of their finances? Do they have they an Enduring Power of Attorney in place should the situation arise where they can no longer make decisions?
  • Do they have an Enduring Guardian for future health decisions and do they want an Advanced Care Directive (detailing what should happen in the case of a health emergency – needing ventilators, feeding tubes, etc).
  • What is important to them in relation to their future lifestyle and accommodation? Do they want to stay at home if there is only one of them, or do they want to move into a smaller home, a retirement village or aged care home?
  • Are they willing to accept in-home help when they start to struggle with daily living activities?
  • Ask where their important documentation is kept in a health emergency.
  • Draft a plan in case there is an emergency.