Are you planning on a holiday visit with aging parents you don’t see often? This is a time to enjoy, reconnect and relax. It is also a good opportunity to see how your folks are doing and provide any help they might need. But just how to seize that opportunity without creating tension? That’s the challenge.
You probably have many questions you want to ask your parents. They may be forthcoming… but maybe not. After all, their role from early on has been taking care of you. Any hint of a role reversal, or suggestion that they may need help managing their lives, could be met with resistance, or resentment. Going gingerly and respectfully is essential.
Chances are your parents’ safety is your top priority. But it is critical to recognize that your parents’ priority may be independence, even if maintaining it compromises safety to some extent. Geriatrician Leslie Kernisan sums it up nicely in her article, “Four Things To Do When Your Parents are Resisting Help” published on NextAvenue.org: Logical arguments often fail to convince the people we have emotional relationships with. This is true even when they are younger and presumably have good mental faculties….That’s because people are not rational about many things, especially when it’s an issue that stirs up certain emotions in them. And issues that touch on aspects of our identity, self-worth and autonomy – all of which come up when we’re concerned about older parents — are especially prone to trigger emotional responses.
When clients come to us for their planning, we ask questions about their circumstances. For example: have you named someone to make your health decisions for you if you are incapacitated; who is that person; what documents do you have, and where are they located? As the discussion proceeds it often occurs to our clients that they don’t have this information about their own parents. Which presents a good lead-in to your conversation with your parents: “I am doing my own planning because I want to spare my family any unnecessary burdens if I become disabled or pass away. The lawyer I met with asked me a bunch of questions about my circumstances, questions I never even realized were important. Now I see it would be good for me to have those same answers from you, so I’m not left in the lurch if anything happens, and can help you if it becomes necessary.”
It is often useful to let your parents know that getting these answers will help alleviate your worry. This approach may still get you dismissed with an “I’m fine, just stop worrying” – but it does give you a better chance of opening up a meaningful conversation. Most parents do not want to see their child stressed.
What To Observe/Discuss When You Visit
- Driving: Is your parent’s car in decent shape? Scrapes and dings may indicate that his/her driving is unsafe. Ask your parent to take you for a ride, so you can observe first-hand. Ride-sharing services like Uber and Lyft are now available, so if and when your parent does relinquish the car keys, he will still be able to get around. If your visit leads you to believe your parent’s driving is truly an immediate danger to himself or others and your parent insists on driving, Florida allows you to report it anonymously.
- Refrigerator: A quantity of expired food may be a signal that all is not well.
- Mail: Is mail piling up? Large quantities of unopened mail may signal that your parent is having difficulty managing his affairs. You could arrange to have mail sent to you for handling, or arrange for automatic bill pay.
- Insurance: Have your parents directed their insurance companies to notify you or someone else if insurance premiums are not paid? Every insurance company provides forms for this purpose. One of our clients whose dementia had progressed failed to pay premiums. Thankfully her long-term care insurance benefits did not lapse because she had arranged in advance for the insurance company to contact her son in the event premiums went unpaid.
- Appearance: Has your parent lost or gained significant amount of weight? Is clothing clean? What about personal hygiene? Are there bruises or cuts or burns that could reflect that he is injuring himself/herself? Has he/she been to the doctor recently?
- Eyesight: Is your parent having trouble seeing? Reading?
- Movement: Is your parent steady on his/her feet?
- Behavior: Is your parent overly confused, forgetful, agitated?
- The Home: Is the environment safe? Clean? Does clutter present a tripping hazard? Improper shoes can also contribute to falls. Information about reducing falling hazards in every room of the home is available from the National Institute on Aging.
- Medications and Supplements: If they are scattered in a disorganized manner, or expired, this could be a warning sign. If you can make no other progress during your visit, get a list of all your parent’s medications and keep it updated.
- Legal Documents: Ask your parents if they have a power of attorney for health care and other advance directives and a durable power of attorney for financial matters. Who are the agents named in these documents – is it you? Someone else? Where are the documents located and do the agents have copies? These documents will allow someone to seamlessly step in and made their health and financial decisions if they are not capable of doing so. If your parents do not have these important documents, encourage them to consult an experienced estate planning attorney. If they agree, you can make the appointment for them, but you cannot attend the meeting…at least not initially. This ensures that there is no undue influence, not even the appearance of it.
- Neighbors: Listen if neighbors seek you out. Concerned neighbors are more likely to talk to you about your parents’ circumstances than to talk directly to your parents for fear of offending them.
Steps To Consider
Depending on how your visit goes, you may come away with an agenda of specific tasks that you and your parent agree on, from changing the smoke alarm batteries, to installing grab bars in the bathroom, to making an appointment with an eye doctor. But if more substantial changes appear to be necessary, consider these possibilities:
- Have Someone Check In On Your Parents Periodically: Is your parent amenable to a visit from someone who lives closer to them than you? A relative, neighbor, friend, clergyperson?
- Discussing Assisted Living: Your visit may be an appropriate time to start talking about assisted living options with your parent. You may also want to look into a continuing care retirement communities (CCRC). Make sure you make it clear to your parents that these living arrangements are not the same as a nursing home. Here are some useful articles on the topic:
- At-Home Assistance: Would it be beneficial for your parents to have help with personal chores or household chores? For information on how to find a home aide, listen to Attorney Joseph Karp’s recent conversation on the topic of home care here.
- Hiring A Geriatric Care Manager: These are professionals, often social workers or nurses, trained to evaluate a senior’s needs, identify appropriate resources, and communicate with family. Check out an AARP article about geriatric care managers here.
If Your Parent is Incapacitated And Endangering Him/Herself or Others
You may be absolutely certain of what’s best for your parent. You may be frustrated that they will not accept help, or take steps you think are needed to ensure their safety and welfare. We get calls every week from adult children in this situation, asking what they can do. We have to remind them that adults are permitted to make their own decisions, and that includes bad ones. Who among us has not done something others have advised us is foolish or downright dangerous? The bottom line is this: Unless deemed to be legally incompetent by a court, or incapacitated pursuant to a legal instrument they have created, such as a trust that defines “incapacity,” your parent has the right to do whatever he/she wants.
That said, it is another matter if your parent is truly incapacitated and making decisions that endanger his own life and safety or that of others. If you believe this is the situation, you can reach out to the Florida Department of Children and Families at 1-800-962-2873 and they will investigate. In Palm Beach and the Treasure Coast, you can also contact the Area Agency on Aging at 1-866-684-5885.
We are often approached by adult children regarding establishing a guardianship for their parent. Guardianship is a complex legal process that starts with a petition to the court. The court then determines whether or not your parent is in fact incompetent. Your parent is entitled to his/her own legal counsel. A very high threshold must be met for the courts to justify taking away an adult’s rights and giving someone else the authority to make their decisions. Guardianship should always be a last resort. Read about Florida guardianship.
No matter what, your parents will be happy to see you. Have a great visit, and happy holidays.