Elderly Care: Crafty Lead-Ins For Potentially Difficult Conversations

Elderly care in my state (NC) has been a growing concern, as NC is aging faster than the national average. In our original blog, posted in 2017 we were telling you that the over-60 population in NC was predicted to exceed the number of children under 17 by the year 2018. (Source: NC Health News January 2017). That is now a fact! Many adult children of aging parents are contending with the challenges that come with caregiving for parents with complex medical needs, but few are prepared to do so. That remains a fact, also.

Mother and DaughterThe 40-70 Rule of the senior-care-at-home company Home Instead reminds us that if you are close to 40 and your parents are close to 70, now is the time to HAVE THE CONVERSATION.

But how do we begin?

A December 2016 News & Observer article by John Drescher, then the senior vice president and executive editor of the Raleigh, N.C. newspaper, shared his experience as the adult child of aging parents and highlighted some of the key reasons why it is so important to “Have the Conversation” sooner rather than later. One sentence summed it up: “What my parents needed was a case manager – and eventually, I realized that case manager would be me.” As Drescher pointed out, many adult children cannot personally coordinate elderly care for their parents as he did.

In many families, questions remain unanswered about who will step up when Mom and Dad need elderly care help. In these cases, adult children sometimes say to us: “Okay, you’ve convinced me that I need to Have The Conversation. Now, how do I do it?” If you have any sort of budding concern about your parents—and they are not forthcoming with details, consider these lead-ins to lower resistance and move forward.

Time-tested strategies for starting elderly care conversations

The Consultative Approach

Contrary to the Dale Carnegie school of thought, there are times and situations where people do not appreciate being asked to talk about themselves. As far as elderly care is concerned, especially if sensitive or private health challenges are involved, aging parents may wish to avoid the subject of their own lives altogether. On the other hand, parents are always interested to hear about their children or grandchildren. This is an excellent way to get them talking, and it’s an opportunity to notice what they ask about.

To take things a step further, consider asking for your parent’s advice and focus on your own problem. For instance, you might say, “Now that our family is growing, we need to think about estate planning. We need to think about who will raise our child if something happens to us. Where did you start? How did you choose your attorney?”

More conversation starters:

“It’s funny, Mom; at this stage in our life, our house seems full to overflowing now that the kids are getting bigger and accumulating more stuff. Do you and Dad ever feel like the house where we all grew up seems big and empty now?”

“I’m starting to think about retirement, even though it’s a long way off. Did you think about that sort of thing a lot when you were my age? How did you find your financial planner?”

If you are given an inch, go for the proverbial mile! When your parents begin to share and engage in dialog, ask more questions and keep tugging on each thread. Above all, be genuine and adopt an attitude of praise.

“Flip It”

Another conversation strategy for avoiding defensiveness is to focus the conversation on someone else. Your parents may bring up the malady of a neighbor or friend from church. This is your time to “flip it”, or seize the opportunity. Begin by asking “What can we do to help?” or discuss what that person might need. Then, flip it. Talk about how your family would manage the same challenge if it happened to you.

As Tom Brokaw once said, “The unforeseen will occur.” Use the uncertainty to lay a foundation for future elderly care discussions. “Is my number by your phone in case of an emergency?” “Who has or knows about a key?” “We lucked out that time, but what would have happened if you had been unable to drive?” Your parents may share their concerns, in which case it is generally best to offer reassurance. Mention that the whole family will handle it together.

If an opportunity does not readily present itself, you can tell an elderly care story about a colleague at work. Make one up if you have to! Talk about Frank and how he had to leave to go to Michigan to care for his father. Talk about how his father didn’t have his work number, and how there was a delay in reaching him with the news. Then get the family to imagine the colleague’s situation. Sooner or later, the family will start to wonder how they might manage the same challenge. Sometimes, you have to plant a few seeds and wait a little while. You can also ask about a third party: “How is [so-and-so, friend or neighbor] doing these days?”

Pay careful attention to word choice, as this can help to remove the emotion. Remove the “you-you-you” from your language to lessen defensiveness. One trick is to speak in the third person. For instance, instead of “you need help around the house,” you might say, “now is when many people think about getting some help in, even part-time.” You might also use the technique of mentioning other people. Maybe mention how your co-worker Frank hired an at-home caregiver to stop in twice a week and help with some routine tasks around the house that were becoming a challenge for his father.


Sometimes, you may see a newspaper headline that can create a lead-in for a conversation. This is especially effective for lowering resistance because parents are often happy to discuss society and current events. For instance: “I just saw an article about real estate prices over where you live. Are you seeing a lot of houses getting built over there?” See how your parents respond. Is the neighborhood changing? Are older houses being torn down to make way for McMansions? If logic prevails in your family, this might be a good time to discuss getting the most value from the investment in the current home, which can lead to a conversation about downsizing or moving in general.

When you use these lead-ins effectively you’ll get a sense of your parents’ comfort level with the subject of “what’s next.” The main rule of thumb to follow: if you begin to feel any resistance or “back off” signals from your parents, do not proceed further. It is always better to disengage and find a better time to try the conversation again rather than risk a setback. Having a care or planning conversation is more art than science, and there are no absolutes. If you are unable to start the conversation the first time, just keep trying different approaches until something works.

“It’s Alright Now”

You can catch more flies with honey, as they say. As a practice, start off each conversation by acknowledging the positive and talking about what’s working well. For instance, you might say, “I’m glad to see that you moved the cabinet items you use every day down for easy access so that you and Mom don’t have to get up on a ladder anymore. That was a great idea.” Most everyone enjoys praise, and when your compliments are genuine, it will go a long way. Then, you will have a better opening to project the conversation into the future. You will find your parents more open to discussing questions such as when they will know that it’s time to move out of the current home or change the overall approach.

It’s Partnering, not Parenting

Everybody is uncomfortable enough when the roles of parent and child have started to reverse, especially if the conversation turns dark and heavy. I know a family that began to plan as a family unit. When they began to say the word “unit,” they would point at another and say “YOU-nit” and giggle, all ages kidding around. They decided to change it to “We-nit” and it stuck. “Better to be a We-nit than a nitwit,” the patriarch declared. Today, the “We-nits” have been through a few elderly care challenges and they continue to talk and revisit their plans from time to time. Taking a collaborative approach and keeping it light brings everyone onto the same playing field. A little levity can make a big difference.

There are many different ways to HAVE THE CONVERSATION, and there is no right or wrong way to do it. The key is to start sooner rather than later, be persistent, and be respectful of the elders’ wishes. If the approaches listed here seem uncomfortable or unnatural, or if it seems too soon, it is always easy to simply stay in touch, keep communication lines open and listen. Sooner or later, an opening to discuss elderly care topics will come.

If it’s about time for you and your family to HAVE THE CONVERSATION, we can help. Our Advocates have extensive experience coaching families like yours through the conversation, even when it may be uncomfortable or meet with opposition. CONNECT WITH US on our website, or call us at (919) 628.4428 to schedule a FREE initial consultation.

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