How to Talk to a Parent About Assisted Living

Earlier than feels necessary. The National Institute on Aging says the best time to plan is before an older person needs extensive help, because planning gives the family time to learn what services exist and what they cost, and lets the person make important decisions while they are still able.

The institute also notes that these talks are most productive when there is not an emergency. After a fall or a hospital stay, choices have to be made in days and everyone is frightened. If you are already seeing changes at home, our guide to the signs it may be time for assisted living can help you put what you are noticing into words.

Pick an ordinary moment. A quiet afternoon at your parent's kitchen table is better than a holiday dinner with the whole family listening.

Begin with something you have seen and a question about it. The National Institute on Aging suggests mentioning your worry without sounding critical. Its example: "Mom, it looks like you don't have much food in the house. Are you having trouble getting to the store?"

Then follow your parent's lead. The institute's advice is to try to fulfill the person's wishes to the extent possible and to attach practical help to every suggestion. If your mother wants to keep cooking, offer to set up grocery delivery. A parent who sees that you are solving the problem they named, and not the one you arrived with, is more likely to keep talking.

It helps to say out loud what you are not doing. You are not deciding for them, and you are not selling the house this week. You are worried, and you want to know what they would want if things got harder.

No script works for every family, but a few habits tend to keep the conversation open, and a few tend to end it.

• Ask before you tell. "What has been hardest lately?" opens more doors than "You can't live here anymore."
• Talk about what your parent would gain: meals made, people nearby, help at night. Avoid a list of everything they can no longer do.
• Listen to the objection behind the no. It may be money, the dog, the garden, or fear of a place they picture from decades ago.
• Do not argue. The National Institute on Aging gives the same advice for the move itself: be supportive, listen to concerns, and do not argue about why.
• Let it rest. If the talk turns tense, stop and come back to it another day.
• Keep your word. If you promised only to look at options, do not arrive with a deposit receipt.

The National Institute on Aging recommends finding out about the available housing options first, so that you can discuss them together. Some older adults picture a nursing home when they hear the words assisted living. In California the two are different kinds of place with different licenses, and there are choices in between, from help at home to a six-bed board and care home on a residential street. Our overview of senior care levels in California sets them side by side.

Looking is not committing. Visiting one or two homes together, with lunch included, gives your parent something real to react to. Some people soften once they have seen a place. Others come away sure that they want help at home instead, and that is useful to know. Our assisted living tour checklist can turn a visit into a shared project: your parent asks the questions and judges the answers.

A no is often a not yet. Ask what would have to be true for them to consider it, and what help they would accept in the meantime. When a parent keeps refusing and you are worried about their safety, the questions become harder and partly legal. Our guide on when a parent refuses assisted living explains what a family can and cannot do. If your parent is ever in immediate danger, call 911.

Whatever the answer, the feelings on your side are real too. The Alzheimer's Association says caregivers may feel guilty and wonder whether they are doing the right thing, and that these feelings are common.

A doctor can answer the question families argue about most: how much help does this person actually need. If you are concerned about your parent's physical or mental health, the National Institute on Aging suggests proposing a visit to a health care provider and offering to make the appointment, give a ride or go along.

If you do go along, the institute's guidance to patients is a good guide for you. A companion can take notes and help remember what the doctor said, but should not take too strong a role, because the visit is between the patient and the doctor. Your parent may also want some time alone with the doctor. Ask your parent beforehand what they would like you to do, and ask the office how your parent can give permission for the doctor to speak with you directly.

Hearing it from a physician is different from hearing it from a son or daughter. Some parents who wave off a child's worry will take a doctor's recommendation seriously.

Disagreement among siblings can stall everything, and a parent will notice the split. The National Institute on Aging suggests a family meeting or conference call that includes the older person and everyone who will be involved in their care, to talk calmly about what care is wanted and needed now and what might be needed later.

1. 1

   Share what each person has seen

   The sibling who lives nearby and the one who calls on Sundays often have different pictures. Put the facts in one place before anyone proposes a solution.

2. 2

   Include your parent

   The institute describes the goal as a plan that works for everyone, especially the older person. A decision made in a side conversation is harder for a parent to accept.

3. 3

   Divide the work

   The institute suggests matching tasks to strengths: who is good at finding information, who is comfortable speaking with medical staff, who is good with numbers, who lives close enough to help day to day.

4. 4

   Agree to revisit it

   Needs change and so does each person's availability. Check in regularly with your parent and with one another to see whether the plan still works.

Hamssa Benrekia is a senior living placement specialist in Torrance who speaks English, Arabic and Spanish. When a family is ready to look, she can talk with you and your parent about needs, preferences and budget, then suggest licensed assisted living homes in the South Bay and Harbor area of Los Angeles County and go on the tours with you. To start that conversation, contact Hamssa, or read the California Assisted Living Placement Guide for the whole decision.