How to Have the Assisted Living Talk

Introduction

If you’ve noticed your aging loved one is struggling to live alone or could use a little extra support with activities of daily living, assisted living could be the ideal solution. However, you might be nervous to bring up the topic to them, afraid they may become angry, defensive, or embarrassed. It’s understandable, and the conversation can be emotionally charged for everyone. 

Learn our tips for how to approach the conversation, when to back off and take a break, and how to revisit it again in a more productive manner.

Recognizing When It May Be Time to Talk

Some adults choose assisted living because they want a lower-maintenance lifestyle, fewer household responsibilities, and easy access to delicious meals, friendly neighbors, and wellness amenities. Others are directed to assisted living because they are not safe at home alone or because living with a chronic condition has made it difficult to maintain their own health and wellness.

If you’re curious if assisted living could be the next best step for your loved one, consider if you’ve observed any of these potential warning signs:

• A fall in the past 3 months
• Inability to keep up with household tasks like tidying up and laundry
• A decline in personal hygiene
• Increased sedentary lifestyle
• Skipping social events, including meeting up with family or friends
• Expressing feelings of loneliness or isolation
• Challenges and/or frustration with completing any of the activities of daily living (ADLs), which include dressing, showering, grooming, eating, ambulation, incontinence management, and transferring

If you’re noticing any of these warning signs, it is best to bring them up sooner rather than later. When possible, you want to research assisted living options with your loved one before there is a medical crisis or emergency. This way, you have both had the chance to weigh your options and make a decision. Making an important choice is much more difficult and stressful when done in a crisis situation.

Start the Conversation Early – Before It’s Urgent

While you might find yourself worried about bringing up assisted living, it is best to address it quickly instead of putting it off. The sooner you are able to bring up the subject with your loved one, the sooner everyone can begin to discuss any potential barriers and process their feelings about the transition. In addition, and perhaps more importantly, bringing up assisted living to your loved one will allow them the opportunity to ask questions, learn more about their options, tour potential communities, and make their own choice.

If your loved one is a planner by nature, bringing up the subject early (even before they are struggling at home on their own), can further empower them by giving them the opportunity to make their own decisions and advocate for their preferences.

Prepare Before You Talk

The best conversation about assisted living begins before you sit down with your loved one. Preparation can go a long way, giving you the chance to sit with your feelings and get your observations in order. 

When you have a quiet moment to yourself, sit down with your Notes app or a journal and jot down:

• Any specific observations you’ve made that concern you (a fall a few weeks ago, laundry piling up for weeks at a time, etc.)
• How you feel about your loved one living alone without support (nervous, worried, etc.)
• How you’ve noticed your loved one feeling about living alone (more sedentary, anxious to walk around the neighborhood, etc.)
• Comments or recommendations from your loved one’s medical team that could foreshadow or address the need for additional support

Now that you have your thoughts in order, you can begin to open the conversation to your siblings or other trusted family members. If you are the one who sees and cares for your aging parent the most, you might find that your siblings are surprised when you bring up assisted living as an option. This will give you practice laying out what you’ve seen, being as specific as possible, and how assisted living could be the best solution.

Choose the Right Time, Place, and Tone

Now that you’re ready to bring up the topic, it is best to ensure you are choosing the best environment for success:

• Don’t bring up the subject when your loved one is tired, overstimulated, or stressed out
• Do bring up the subject when your loved one is relaxed and at their best
• Don’t bring up the subject in a busy, loud public place
• Do bring up the subject in the car or in a comfortable spot at home
• Avoid distractions by turning down the television and setting phones aside
• Avoid “ambushing” your loved one by having multiple family members waiting at the home or on the phone

You know your loved one best, but oftentimes it is most effective to keep the initial conversation private and without a large group of invested family members. You want your loved one to feel supported, but you don’t want them to feel that it is a “me vs. everyone else” scenario.

Lead With Listening and Empathy

Go into any conversation about assisted living with the intention to listen. You might even find it helpful to tie a piece of string around your wrist that will remind you to always be listening. When you’re listening, pay attention to verbal statements, voice tone, and body language that might point to what your loved one is most nervous about.

For example, you might hear your dad getting angry and defensive about an assisted living community. But upon more listening and observing, you might realize it is because he feels embarrassed about his decline in hygiene or that he is nervous about making new friends. When you pay attention to what is said (and what isn’t), you can better understand the barriers or challenges your loved one might be dealing with.

Remember, you might have been planning this conversation for a long time, but it could be a true surprise to your loved one. Allow for time for them to process the conversation as well as to give pushback. Validate their feelings and resist the urge to fix their emotions; this can often be the hardest part for caring family members to practice.

What a “Successful” Conversation Looks Like

A successful conversation about assisted living doesn’t necessarily end with a happy senior who is excited for a quick move to a senior living community. Instead, you might end up having multiple conversations over the course of weeks or months, and your loved one may never be happy or excited for a move.

Adjust your expectations and parameters of success to include:

• Everyone in the room got to express their emotions and opinions
• We ended the conversation on a positive note
• We were able to grow our relationship in trust and respect
• We have a plan for revisiting the subject another time

Focus on Their Values, Not Just Your Worries

While your worries may have led you to bring up assisted living, focusing only on your feelings throughout the conversation isn’t the most effective approach. It can seem manipulative and insincere. Instead, focus on your loved one’s values and preferences as much as possible.

Examples might include:

• Dad, I know you love getting together for breakfast with your friends every Tuesday morning. You’ve missed the past 3 months of gatherings because you’re worried you won’t be able to get up and get dressed in enough time to make it. Assisted living caregivers can help you with that, and you can invite your friends over to your place for breakfast as well.
• Mom, that last fall you had really scared you. I can tell that you’re nervous to walk around the block ever since, and you really enjoyed your time outside. Assisted living caregivers are there to help you get outside safely and they are always there in case there’s an emergency.
• Mom, I know you’ve always wanted to be as independent as possible, and you are! But if you get a little extra help with housekeeping and downsize your house, you’ll have so much more energy to take care of yourself.

Using the phrase, “how can I help” can also be a great way to open up the conversation. You can hear what they are struggling with and then tie the connection to how assisted living could meet that need.

Address Common Fears and Misconceptions

Your loved one might talk about worries they have about assisted living, bring up stereotypes they believe, or even stories they have heard from friends. Use your conversation to address those directly, without sugar coating anything they are anxious about.

Topics you might want to bring up:

• Senior living communities provide different levels of care. Assisted living residents, for example, are much more active and independent than those who might choose to live in a skilled nursing facility that provides more clinical care.
• Caregivers are given background checks and significant training before they begin to work with seniors at a residence.
• Assisted living communities are a far cry from the clinical nursing homes of the 1980s. Today’s assisted living residences feel more like a hotel with lovely design touches, lots of natural light, and spacious apartments.
• Paying for assisted living means enjoying a predictable monthly expense that is nearly all-inclusive, which simplifies the budgeting process.
• Caregivers are there to provide personalized support and want to enhance independence, not take it away. Support might simply mean verbal cues, setting up supplies, or even just offering reminders.
• Work together to find a plan for preserving family memories and other ties to their current home.

If your loved one is still nervous after you talk about it, get online with them to see photos of potential residences. Even better, bring them along to tour an assisted living community.

Present Options Without Overwhelming

You want your loved one to feel empowered and advocate for their needs and preferences. However, if you come to the conversation underprepared and simply do an internet search together for “assisted living near me,” you’ll both quickly feel overwhelmed and frustrated.

Instead, do the work ahead of time and come to the conversation with a few different assisted living options. You might not talk about these options during your first conversation, but it is helpful to have brochures or general information about a few choices with you. This way, your loved one can see their options and begin to point out what they like and don’t like about each one.

As they look through the information from residences, take note of what they talk about and the questions they bring up. This can help you determine what is important to them. For example, if your dad points out that there are no men in the brochure photos, you might want to follow up with the residences to ask about their male population, men’s group offerings, and how they aim to connect new residents with male friends.

Navigating Family Dynamics and Disagreements

If you’re an only child or are the primary contact for your loved one, you might be the one making all the decisions. However, if you are in a family with other involved siblings, you might find that you need to manage those dynamics and disagreements as well.

Whenever possible, you want to talk about your concerns and the assisted living solution prior to bringing it up to your loved one. This way, you and your siblings can have a candid and honest conversation so that you can be on the same page before anything is brought to your parents. 

Other tips for remaining united include:

• Keep your loved one’s needs and challenges at the center of all conversations
• Ask your siblings for other ideas and solutions so that everyone can weigh their options
• Get the primary care physician involved and ask for their unbiased recommendations
• Resist the urge to be the caregiver martyr, even if you are the primary one, instead choosing to give your reality and observations so that your siblings can hear how things really are with your parent
• If the conversation becomes heated, stop and revisit it later
• Ultimately, your loved one’s Power of Attorney(s) will make decisions when your loved one can not.

Special Considerations for Memory Loss or Cognitive Decline

If your loved one is living with Alzheimer’s disease or another type of dementia, you might still be able to keep them an active part of choosing a community. Thanks to more awareness and early diagnosis, seniors today are being diagnosed in the early stages of cognitive decline, giving them time to get their affairs in order, including choosing a memory care residence.

Note that dementia is a progressive disease, and safety becomes a concern more quickly than when cognitive decline is not in the picture. This means you might be making a move more quickly in order to ensure your loved one is safe and comfortable.

Finally, people living with dementia will eventually be unable to make their own decisions. The Power of Attorney will make those decisions on their behalf. If you are the POA, be sure you are ready for that responsibility. If you are not the POA, you’ll want to ensure the POA knows your concerns and input, but they are not required to follow them. 

What to Avoid When Talking About Assisted Living

As you talk about assisted living with your aging loved one, avoid phrases and topics that might make them feel defensive, angry, sad, confused or stressed out.

Examples can be:

• Using guilt or ultimatums to manipulate their decision
• Giving too much information too soon
• Threatening to call their doctor or other family members to talk about the situation
• Giving them examples of everything they are doing wrong or what is wrong with their current home
• Treating the conversation like a one-time event

What to Do After the Conversation

Chances are, you’ll bring up the assisted living conversation once and need to bring it up other times in order to give everyone time to process their emotions, develop questions, and make decisions. This is normal and valid! A conversation about such a large life transition should be revisited again and again.

If you are at a point in the conversation when things are becoming unproductive or emotionally damaging, stop the conversation. You can revisit it again another time. Choose to engage in a neutral and enjoyable activity together so that you both end the visit on a more positive note. You might choose to take a walk together or go out and check on the garden. You can always come back to the conversation on another day when the mood feels right.

In between conversations, you can take time to journal your feelings about how things went. Jot down any thoughts or questions you might have. Research solutions that could ease your loved one’s specific worries or objections.

Conclusion: Respect, Patience, and Ongoing Dialogue

Finally, acknowledge that this conversation is a tough one, no matter how great your relationship with your loved one might be. These are highly personal and vulnerable decisions that take time to sort through. Tell your loved one that you are there to support them and that you love them. A few reassurances along the way can ensure your conversations remain productive.

Frequently Asked Questions About Talking to Parents About Assisted Living

When is the right time to talk to parents about assisted living?

It’s never too early to begin talking about senior living solutions, including assisted living. Knowing your loved one’s preferences and choices long before they need support can mean you aren’t making tough decisions in the midst of a medical crisis.

How do I bring up assisted living without upsetting my parent?

This can be a vulnerable and difficult conversation to have, but you can ease the atmosphere by first acknowledging that this is a hard talk to have together. Listen with empathy and understanding. Be prepared to revisit the conversation multiple times.

What if my parent refuses to talk about senior living options?

Consider enlisting the support of their primary care physician, who can talk from an unbiased point of view. The doctor can also recommend social workers or other professionals who can facilitate conversations.

How many times should we talk about assisted living before deciding?

You can talk about assisted living as often as you both need, especially if there are no immediate safety or health concerns. If you are working with a medical crisis situation, you’ll need to make a conversation more quickly.

What should I say if my parent insists they’re “fine” living alone?

Think about bringing up different amenities or services they might enjoy having, such as free housekeeping weekly, transportation, social events, or the convenience of having a dining room right down the hall.

How do I handle guilt when suggesting assisted living?

Remind yourself you are bringing it up so that your loved one can be as safe and healthy as possible. You can also work with a counselor to talk about your feelings and learn new coping skills.