Having "The Talk" about long-term care

Intro

As we all age, one of the most important and awkward conversations we can have is about future care needs.

The Talk is an important conversation about long-term care and caregiving expectations, yet less than half of adults have it. Long-term care affects the whole family, so taking the time to ensure everyone is on the same page can make a big difference.

Before The Talk

To help things go smoothly, read this post and do some prep work before The Talk.

Schedule a time long before care is needed: If you wait until things are urgent, emotions may increase, and decisions may be rushed.

Ask for permission: Get them to buy in by phrasing The Talk as an opportunity to learn about your parents' wants and needs.

Can we schedule a time for an awkward talk? I'd like to learn about your wishes about long-term care if you ever need it.

Choose a comfortable place: Choose a quiet, private place where you know your loved one is comfortable. Face-to-face is best.

Involve others: If you have siblings, include them in the conversation.

Educate yourself: Learn about the basics, care, and insurance aspects of long-term care. For example:

• Read about creating a LTC plan and download our checklist.
• 70% of seniors need long-term care.
• Many aim to receive care at home instead of a senior community.
• Get insurance early to avoid a decline, get better coverage, and save money.

Goals and expectations

No one likes to talk about aging, and this conversation can be emotional, so set realistic goals and expectations for yourself.

Be empathetic: Don’t decide ahead of time or assume. Listen carefully, ask questions, and allow pauses for silence so your loved ones can process their thoughts.

Watch this 3-minute video about The Talk where a daughter provides her parents space to express their wishes.

Go with the flow: Follow where the conversation leads to go deeper and better understand their wishes.

Stay positive and add humor: While this topic can be serious, your approach doesn’t have to be.

Perspective: Use "I" instead of "You" when expressing personal feelings to avoid assumptions. For example, say, "When I think about the future, I worry about how I'd help you get the care you need," instead of, "You need to make a plan now."

Emotions are common: This conversation isn't easy, and most people dislike talking about aging. Some may feel uncomfortable, angry, or embarrassed to have this talk.

Watch this 3-minute video about The Talk where emotions turn to tears.

Be honest: Share your concerns about caregiving. You can love them and coordinate care without taking on all emotional and physical demands.

Expect objections: During "The Talk," it's natural for parents to push back.

Here’s how to respond to common objections:

• Them: We have a medical directive, power of attorney, and a will.
  You: Great! But long-term care often begins well before the end of life and typically lasts about 3 years.
• Them: We're healthy.
  You: That’s awesome, but many healthy people still need long-term care. The longer you live, the more likely you'll need long-term care.
• Them: We don't want to be in a facility.
  You: Most people get long-term care at home with professional caregivers.
• Them: I'm too young to worry about this.
  You: I get that, but planning early gives us more options and peace of mind.
• Them: I’d rather drive off a cliff than need long-term care.
  You: Hopefully not! Long-term care isn’t about dying; it’s about maintaining a good quality of life.
• Them: We can’t afford it.
  You: Cost is important, but starting now helps us explore options without pressure.

Watch this short video about The Talk in which a daughter handles objections from her parents.

During The Talk

Arrive prepared with key questions and points to help guide the conversation. Focus on fostering an open, honest dialogue and make active listening a priority.

Discuss risks: Ask about the risks for everyone. Parents might be worried about the expense of long-term care, while children may be concerned about sacrificing their time, energy, and career if they’re expected to be caregivers. Talk about ways to reduce these risks.

Caregiver creep: Who do you want to deliver your care? Bring up the idea of "caregiver creep," where small tasks like picking up groceries slowly grow into larger responsibilities, such as bathing. Avoid the "boiling frog" scenario where siblings become overwhelmed little by little as the care needs increase.

Where care will be provided: Most adults prefer care at home, but needs may change over time, possibly requiring a move to an assisted living facility or a nursing home. Be open to future discussions as circumstances evolve.

How to pay for care: Long-term care is expensive. Talk about covering costs through insurance, MedicAID, or personal funds.

• Living will and estate planning: When decision-making becomes challenging, essential documents like a living will or power of attorney provide guidance. Seek legal advice to set these up and ensure everyone knows where to find them.

The next talk

You probably won't cover everything you want to discuss in your initial talk. If tensions get too high, it's okay to pause the conversation until later.

Recommend that you resume The Talk later to allow everyone to do some research. Multiple conversations also reduce the pressure to decide everything right away. Share a link to this website.

Wrap up

In our LTC approach, we recommend you Learn about options, Talk with family, and Create a plan to help care recipients and caregivers live their best lives. The Talk is a key part of this approach.

If you're still unconvinced, then watch this 2-minute video with Maria Shriver and Rob Lowe discussing The Talk. Celebrities... they're just like us. 😏

If you enjoyed this interview, you might also enjoy another with Rob Lowe talking about "The Adult Birds and Bees Conversation." 😄