Here are a couple of facts that might surprise you: Nearly half of all Americans will need long-term care at some point. About one in five of us over age 50 will require this kind of care within the next year. If you’re a Baby Boomer—one of the 78 million of us born between 1946 and 1964–and if either of your parents is still alive and living at home, there’s a challenge ahead: Mom or Dad is almost certain to have a change of circumstances that will require a move from the family homestead to a much different kind of place—a senior apartment, perhaps, an assisted living facility, or even a nursing home.

Consequently, here’s the question: Have you had The Big Talk, the one about “getting old,” or “future plans?” Probably not: A recent study by the American Association of Retired Persons (AARP) found that two-thirds of us Boomers haven’t. The AARP claims that it’s because we don’t know what information our parents need or where to go to find it. Just as likely, though, we’ve put off having The Big Talk because it’s too uncomfortable.
Getting started. Many of our parents have recent and unpleasant memories of the difficulties that friends or relatives have had in this situation. Maybe it was the elderly cousin whose health precipitously deteriorated and required the nieces and nephews to scramble to get him into eldercare. Perhaps it was the neighbor who broke her hip and her son in Australia had to take a month away from work to solve the problem without any guidance.
Considering the situation as a necessary conversation for your own piece of mind is essential. The family—not just the parent, but also you, your spouse, your siblings and the extended family—shares this challenge. This approach broadens the focus of the discussion and preserves Mom’s or Dad’s dignity.
Newspaper or magazine articles can be used to start the conversation. We are usually able to find a related letter in a “Dear Abby” or other advice column in our local paper. You might begin like this: “Gee, Dad, I don’t know anything about what you’d want me to do if you’re unable to live at home. I’d feel a lot better if you would tell me, so I won’t have to guess.”

Now that you’ve got the conversation underway, what are the questions you’ll want to ask to prepare for the housing transition? Let’s start by examining the elder’s current living situation.

• “Mom, do you want to live here as long as you can? Are there some improvements to your house we should make so this will be possible?”
• “I’ve noticed that you are a little tired lately, Dad. Would you like to have someone help you with some things around the house?”
• “Is senior living of something you might consider in the future? What arrangements would you like us to make?”
• “I know you love your home, but even with the kids mowing the lawn and taking you shopping, are the other chores more work than you want to tackle these days? What would you think about moving into a more manageable place—a condo or a smaller apartment–at some point?”
• “When you feel living at home is no longer a good option for you, would you want to live with me, or someone else in the family? Would some form of senior housing be an acceptable option for you? What do you know about senior housing–say, assisted living–and those kinds of options? Maybe we could make a list of the things that are most important to you and see if we could find a good match. Does that sound like a good idea?”
• “Could somebody in the family begin to find out about senior housing facilities that might be a possibility for you in the future? How would you like to go about it? Have any of your friends moved into senior housing that they really liked?” Or, “When you have visited friends in their senior communities, have any of those facilities appealed to you?”

Turning to questions about health:

• “Dad, do you find you still have the energy to do the shopping, prepare meals, do laundry and personal care, and still continue to keep up the house and yard?”
• “Do you feel comfortable driving or taking public transportation to do the things you need to do?”
• “Are you finding it difficult to get up and down the stairs, get to the bathroom, and pick up the mail and your newspaper?”
• “Are you having any trouble doing the exercises your doctor has recommended? Are you remembering to take your medications?”
• “Would you be willing to let us talk with your doctors about your health? Could we go with you to your next doctor’s appointment to find out more about your medications and any problems you’re having?”
• “Have you made any decisions about the kind of medical care you may want in the future? Would you want someone else to make these decisions for you if you are unable to do so for yourself?
• “What are your thoughts about assistive devices—ventilators, feeding tubes, for example—to keep you alive?
• “Do you have records of the decisions you’ve made? Where do you keep them?”

Next Steps.

Hopefully, The Big Talk has gone reasonably well. Mom and/or Dad has been willing to talk, perhaps hesitantly, and you’ve made some progress in finding out about their current and long-term housing needs and preferences, as well as some health and related issues that will factor into these decisions.

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