Discussing Long-Term Care With Older Adults in Your Life

When your loved one can no longer live independently, you may consider options for long-term care.

Talking to your loved one about their care can be challenging and emotionally fraught. While discussing the transition to assisted living, a nursing home, or in-home care can bring up difficult emotions for you and your loved one, having a plan can also alleviate anxiety.

Consider Your Loved One’s Wishes

It is essential to listen to your loved one. Consider their wishes and future plans when you discuss long-term care. Even if you have strong feelings about the best course of action, supporting your loved one’s continued independence and autonomy is crucial.

Some older adults want to remain in their homes. Others prefer to move somewhere they can get round-the-clock care. Should they choose to move, it might be important to your loved one to remain in a community with friends and family nearby.

Giving your loved one time to process their thoughts is also vital, as receiving long-term care constitutes a monumental life change. Addressing long-term care might require more than one conversation. Your loved one might need to meet and discuss their plans again after reflecting on their wishes.

Foster Communication Between Aging Parents and Other Family Members

Often, family members work together to organize long-term care. Adult children of older adults who need assistance with activities of daily living or health care should consider involving their siblings and other close family members in the planning process. As family members collaborate, they can share information and resources to help their loved ones in need of care. Family members can also support one another when older adults resist discussing long-term care.

Consider Consulting a Geriatric Care Manager

Sometimes, however, families do not get along, and arguments hinder long-term care discussions. In cases of familial conflict – or when families can't help their loved ones plan because of geographic distance or busy schedules – a geriatric care manager may be able to help.

A geriatric care manager or aging life care coordinator is a professional who could help your family navigate long-term care. They can help you talk to your loved one about long-term care options. As individuals with experience in fields related to aging, they can help answer complex questions about emotionally challenging topics.

For instance, an older adult with a new diagnosis of dementia might need to recognize that their ability to live on their own will decline, and they will ultimately require long-term care. Providing support and guidance, an aging care manager can broach that conversation with the older adult and help them find services that fit their needs.

Review Long-Term Care Options for Older Adults

Consider all available options when addressing long-term care planning with your loved one. Although some older adults with significant medical needs require care in an institution such as a skilled nursing facility, others can continue living at home. They could receive in-home care, or a family member could assume the primary caregiving responsibility.

Moving to a long-term care community can provide older adults with social opportunities, services, and assistance. Most assisted living facilities, continuing care retirement communities, and nursing homes offer activities for residents. If your loved one cannot or does not wish to remain at home, remind them of the positive aspects of long-term residential care, such as access to services, assistance with daily living, and round-the-clock medical care.

Ask Your Loved One About Advance Directives

When discussing long-term care, talking to your loved one about advance directives can also help your family plan for the future. Your loved one can express their wishes about their care with advance directives.

• With a living will, your loved one can make end-of-life decisions, such as choices about prolonging life if they face a terminal illness.
   
• Using power of attorney documents, your family member can designate a trusted individual as an agent.
   
• A health care agent can make decisions on a loved one's behalf if they become unable to handle their own affairs or communicate their wishes.
   
• A financial agent handles their money — for instance, paying bills if your loved one is in the hospital.

Paying for Care

The costs of long-term care are an important consideration when talking to your loved one. Note that Medicare covers short-term skilled nursing. However, it does not cover long-term care in a nursing home or assisted living facility.

If your loved one has not planned for how to pay for long-term care, encourage them to start thinking about how they will manage the costs. Some older adults purchase long-term care insurance, while others qualify for Medicaid or pay out of pocket. In other cases, families share long-term care costs, lessening the financial weight on their loved ones.

Connect With an Elder Law Attorney

Discussing and arranging long-term care involves personal, financial, and legal considerations. For assistance, your loved one can work with an elder law attorney to help them prepare for their future care.

For further reading on long-term care options, check out the following articles:

• Older Adults Lack Information in Search for Long-Term Care
• Long-Term Care Insurance and Medicaid Planning
• Assisted Living vs. Nursing Homes: What's the Difference?
• Getting Help When Providing Care at Home for Aging Parents