Opening communication lines about elder care is essential

With the holidays coming, it's a good time to start thinking about having that "little chat" with your parents.

Not the one about the birds and the bees, but something equally as important and difficult: planning for your parents' aging.

In years past, when people died decades before they do today, these conversations were unnecessary. Today they're required. All of us want to have some control over what happens to us as we grow older. The only way to achieve that is to put plans into place while we're able that will provide for our needs when we're not. Since eldercare impacts the whole family, that's where the conversations should begin. People without family need to do it with their friends.

But where to start? The topics don't exactly pop into normal discourse. "Hey, Dad, have you thought about visiting a couple of retirement communities to see what they offer?" or "Do you have long-term care insurance?" are not routine questions heard around the dinner table. Yet exploring them is critical to knowing what your dad will want.

Ideally, parents will initiate these conversations themselves, but few do. Who wants to admit to the possibility of becoming disabled someday, needing care, and having to figure out a way to pay for it? However, the reality is that more of us will be in this situation than in the past — medical science is keeping us alive far beyond our wildest dreams.

Thankfully, there are strategies for beginning this conversation. It's a process, like going on a diet or trying to quit smoking: Your accumulated efforts to talk about these difficult subjects may not work immediately but, hopefully, they'll keep you moving in the right direction.

The issues are complex, so, over the next several months, I'm going to take the space and time to write about them. Today I'll talk about some of the strategies for getting the conversational ball rolling — for parents who are mentally competent (there are different strategies for a parent with severe memory loss, which I'll address separately).

Important note: These ideas are framed for adult children initiating the conversations; however, sometimes it's the kids who refuse to talk about their parents' aging. If that's the case, the ideas can still be helpful, but with the parent beginning the process.

As with everything in eldercare, you'll want to select strategies that seem to best fit the personalities of the people involved — yours, your parents', your siblings' and everybody else involved.

The easiest and clearest way to begin the conversation is to be direct: Tell your parents what you want to talk about, then do it. Have good eye contact and relaxed body language. Express your need to gather information about their options and understand their wishes. Let them know that your first concern is what they want, which is why you want to talk. With some personalities, this is all it takes.

Or there's the indirect approach. Raise the issues by discussing someone else, taking the focus off your mom. If a neighbor just had a stroke, ask what's happening to her. Does her son have a Durable Power of Attorney so he can pay her bills? Or focus on what you're doing to plan for your aging and ask your mom's advice.

Use tools that are neutral. Clip something out of the newspaper or a magazine and say you'd like to talk about it. Or write a list of questions and send it to your parents, then make an appointment to talk with them — and do it. Sometimes ideas expressed in writing can feel less threatening.

Or work through people who have the most influence. Most people trust some people more than others, so if your mom's favorite person is your brother-in-law, have him begin the conversation.

An alternative is an authority figure, such as her physician. While her doctor can't divulge confidential information about her, you can call and talk to the nurse about concerns you hope will be raised at her next appointment, such as the need to hire help or give up driving.

Ask to have the information written down so your mom won't "forget." Other authority figures might be her attorney, minister or a trusted friend.

Whichever approach you try, avoid issuing orders. A lot of one-sided "you shoulds" will stop the conversation in its tracks. Instead, ask questions: "How does your sister like her new retirement community? Why don't we go visit her and see what it's like?"

Next week I'll give you additional ideas for starting the conversation, including one of the best — holding a family conference — and important ground rules to understand.

Liz Taylor's column runs Mondays in the Northwest Life section. A specialist on aging and long-term care, she consults with individuals and teaches workshops on how to plan for one's aging — and aging parents. E-mail her at growingolder@seattletimes.com or write to P.O. Box 11601, Bainbridge Island, WA 98110. You can see all of her columns at www.seattletimes.com/growingolder/.