hi i'm tom callahan and welcome to only seniors this show is about crafting a discussion to have with your parents about the next steps in their lives as we age several decisions have to be made by the time seeing food how to care for them how to correct paperwork and maybe how to modify a house my guests tonight include and king was a from a can care remarry from brandywine senior living call our church from archer law and holy heart away from independent domain so we're going to cover a broad range of topics tonight and actually this is going to be the first of two parts first thing we want to talk about is having the talk with your parents and wishing compas so let's start with when it's a good time to have a talk who would like to start  art well i think that having a talk with your parent can take many forms i think many people are different stages of readiness to accept help and so i think that's really important when you're thinking about putting some care services in place for your parent i think we want to be mindful that they really need to be a part of that discussion as well because really the best and most successful transition to services is having a dialogue with your mom or dad and from a home care perspective what do you feel about when's a good time to have a talk i can tell you that in our family having been the caretaker of my parents for seventeen years that that has already filtered down to my kids who are in their mid twenty's we are already talking about about what i am my husband want i think that once you start a discussion with your parents it should filter down into the rest of your family but it shouldn't it's like having the talk with your teenager if you just do it at one point a kind of gets lost among all the emotions kind of wait for teachable moments when they happen if somebody if a neighbor falls or a neighbor is hospitalized that's a good time to bring it up while mom did you hear about mrs smith she fell and i think just to go into rehab if that happens to you and that's a good time to just start the discussion just look for the ice breaker another exactly exactly holly i think so much so what has been said is very true making it organic and making it occur at moments throughout a lifetime is so much more helpful i think to people than one particular sit down moment where someone might therefore be resentful or put up defenses i want to get defensive and upset where is use those teachable moments throughout a lifetime even as someone just says oh when i retire i'm going to go fishing more or whatever it might be well you know when i retire i'm hoping to have a barrier free shower in my house is so that it's easier to not trip over the top edge that i've been doing for twenty five years so many of those things can just be built into let's make life easier mom or dad or what would be more enjoyable to you when retirement mom or dad just made that happen so it's taking it you know one step further then you know or when i retire i'm going to f play golf it's ok great how about let's talk about a community style saving or what we're going to do with the house or from a legal standpoint well i think the biggest misconception is the idea of the talk  singular item which is something that everybody has kind of touched on here and you know what if a caregiver is at the point where ok i need to have the talk you know how's wednesday for this is that you're going about it wrong  you know from a legal perspective it's very it's all too easy he said well you're going to sign these documents it's time to have this conversation no it has to be has to be split up into a bunch of different parts that have as much educational so there's anything else and that's where you know when you're talking about things as much as anything else it's educational to teach them of the father where are we still where do we stand what kind of options are available you know  just so that they don't think well they're going to lock me in a room somewhere that doesn't have windows and that's the end of the game i think that's a really good point in that it doesn't that if you're the caregiver having the talk you don't need to have all the answers you can just start the talk don't feel that responsibility and not do the talk because you don't have all the answers that there's there are and now more than ever there are so many resources out there for information who should be involved in the talk that we have with the parents well i think that if an ass as karl mentions i think it's an evolutionary process i think planting the seeds early when you don't need help for example if you your mom her vision is failing so she maybe she's not driving as much as she is do so that's your head to say ok in the near future i'm going to she's going to need somebody to drive her shopping from shopping to doctor appointments so you can plant the seeds early and i think that's really why it's because then it gives them time to sort of think about it and ruminate on it when they're not stressed out when they're not in dire need so that a couple of months maybe a year prior to their really needing help pay for a thought about it so you've been talking since all along and i think that anybody who has an influence or can be involved in the discussion but you should be whoever is going to you know know years are primarily engaged during this process to drop documents and to be consulted on the import of documents and what they can do to help a family and to the extent that the family trusts the lawyer and wants to involve the warrior that's fine but the simple fact that the lawyer draws up documents does not mean the lawyer needs to be involved i get a lot of people say well the lawyer is going to help drive the living will and you know this is i not to be a big fan of it just simply because you know if you don't know me and i don't know you really that well and they're saying if you would if your kidneys fail what if this fails what if that and i'm going to approach it very detached clinical matter because  lawyer and i don't have any emotional attachment that this is this is liable to be very difficult way to approach portions of that conversation so it could actually drag down the converse you could actually stall it if you bring the lawyer into world i think so i think the lawyer has a good and then of course that's what i love to talk about as lawyers but you know the there's a limited part of that conversation i think that folks that are more involved with more important parts of the seniors life i think the home is the most important part of the life and so that you know the people who are involved with making accommodations in the home making home possible you know making that that those those are some of the most important people barring that people who are going to become home whether that's it in an independent living kind of situation and they all facilities something like that those are important parts of the conversation the lawyer most people don't go see their lawyer every week i mean that's just a fact of life and so the lawyer doesn't end up being intimately involved with what's going on which i think is a great segue right into hollywood and independent to me i think it comes back to trust and when you're having a conversation about planning for the future you want people in the room and around the table that you can trust and who know you well and so to that point and being able to really be able to have an honest dialogue where nobody feels threatened and where plans can be made even if it is just a very caring granddaughter who is home from college and wants to talk with grandma about what some concerns are that maybe her own mom has about grandma  whatever it might be but there's so many things that could be gently put in place with a trusting congress a set with those who love you and care about your around the table to make it a smoother process could start i think that's really really good point i don't think it always has to be everybody that is affected like and that it can just be the one on one conversation just as you were saying the plant some seeds just a granddaughter talking and then when major decisions are made then  everybody a part of that decision but just that just you know getting breaking the ice and getting them planting the seeds i think anybody can do that and another point sometimes it's helpful in my experience is to have a neutral party involved for example a visiting nurse or a foetal worker who might be a geriatric care manager to come in or somebody who has authority enough particular field and that is important because not all children have a great relationship with their parent and not everybody is comfortable having this conversation so for maybe your parents not listening to you and we all know and so sometimes it's good to have a neutral party like a nurse coming in and conducting what we call an assessment of the needs just just to have an assessment it's very can be very non committal it can be just rud assessment if they've gotten out of the hospital or that's a good time to do it once are discharged from the hospital because then you have to be in because now they do need some care and i hope i'm not going to head it by fell thought sometimes a neutral party can help i agree there you know one things i heard is you know timing is everything you know and that's goes back to the first question is making sure that we're doing this in a timely basis and what i'm also hearing being said is a you know we don't want to gang up on our parents right  great point of view maybe the granddaughter you know we have to look for our ins we have to look for the opportunities and we have to because he was saying earlier we have to look for the signs what's happening what's going on and then finding the confidant and the right person and so often i know as an occupational therapist i've been in on these discussions where the you don't child of the aging parent is looking for guidance you know my mom has this disease you know holly could you please explain to my mom what that my look like five years from now or how that might affect her living in her house because maybe mom doesn't understand and so there's so many parts of that puzzle that  neutral party or that professional or clinical person in the room can be helpful in those discussions but i think this prince is on to the next part of his really preparing for it and i think this is the big crux of the talk is getting prepared properly for it because there are so many key aspects involved so far we have the timing and we have the blue right can you raise a really good point the fact that you don't want to go off kind of half cocked with this but you want to kind of start getting your ducks in a row and start doing some research there's a lot of really good information out there there is actually a talk by  mom what's what's the most important thing for you that and that and not theirs you know and medical director the five wishes and there's really and there's actually a website called  g y s to get your together and it's all about the science about the steps that one takes to have the talk so there is a lot of information out there who would you call you who would you suggest people reach out to when their parents hear this talk well in addition to the people who just care about prison i think it's smart to have a little bit of knowledge base under your belt so if you're connected with the elder care community in the senior care community i think that always helps you know what to be throwing out you don't want to be providing misinformation examples like you could stay home but to have a twenty four hour caregiver it would cost this and you give an outrageous figure that isn't true that's not helpful either or you know here's what it costs to be in assisted living or to move to this house or here's what it costs to modify your bathroom well those things might be frightening but it might also be helpful if you have the right facts so sometimes knowing some of that information doing a little bit of the homework background is smart and knowing that there's there's lots of decisions to be make and you don't have to make all those this insight i don't know but you know you don't have to rip down a wall or rebuild a bathroom if a change in putting one grab bar in makes you safer or one top seed makes you safer so there's there's so many options out there and an occupational therapist different rehabilitation professionals who could help provide that in the house construction professionals and caps certified professionals who are certified a specialists from the home builders association a contractor an occupational therapist with that specialty can make a big difference of looking at the home for example good question or saying that because we have the option of going to throw to hillary community based on a right and you know not all it's not only think to stay home and i guess that's what you have to really understand is when is it not safe and the so that's a whole other that the whole of their i guess entity because some people  for various reasons it's either are unsafe to stay home whether they have alzheimer's the sees and they're prone to wandering or they're at risk of leaving the stove on or some other danger presents itself in the home and therefore or socially they're just becoming very isolated so that's another thing that you're doing when you're assessing your mom's needs and your father's needs what is it that they are what they need they need to stay home to we need to modify the house is that they are wish i think we need to bring them into the conversation as much as possible now most people do want to stay home however i have in my feel most some people are very social so being home if it's no longer enjoyable for them if they are very social beings and they've used they're used to being out with others it can be a huge benefits of being a communal setting like a facade living or out life care community or continuing care facility so i think it's important to know what continuing care long term care looks like and the costs of course and most importantly many adults month many older adults view when you face if they're living big think nursing are right just because it's and we spent most of my day encouraging family members to bring their mother out or the father out physically to see what their options are whether it be a life care community or assisted living or other kind of  senior setting because once they see it and then they can make a decision based on the information that you've presented as an adult child i think you need to know what is your what are your options and present your parent when you're preparing for the  talk i think and you mentioned something very it's very important for the people themselves the adult child to know the difference between an assisted living and skilled nursing home they should even just go out and visit even before talking to mom and dad about it because you don't wan present it as holland said as the wrong thing and so many times would i find the when it comes to community based living is everything gets lumped into once your folks know well that's a myth and that's gone you know there are different levels of nurse different styles of communities and they should know that and tom it's not just the living choices where people don't know what they don't know you know when even if it is something something as simple as wall i don't know how to pay for things i don't know what benefits are available one of the things that i do all the time is help clients their families prepare for payment of  these kind of care costs through governmental benefits through the v a or through medicaid and that program is kind of a black box for families they all they know is well i have to hand over a whole pile of bank statements and they do some sort of magic with them and i get clients on a weekly basis and i swear they do this i can't make this up and they say to me well you know even if everything's ok don't they still get that i think oh no i mean it's you know there are regulations and you know if you fit squarely within the regulations you know it's not magic it's not like you they go in there and be approved you know if there is actually something there to it and so you know getting the senior involved at that point with a lawyer can be difficult but you know as long as the caregiver has some sense of what the issues are and just walks through them the caregiver needs to know what they know what they don't know so that when those questions come up and he said yeah that is an issue but i know we have to talk to somebody else because i just heard of it and it is not something i am intimately familiar with because you don't want to spread this information but at the same time  the caregiver doesn't want to have to feel if they have to become an expert in the field overnight because that's we will we've all been doing this for a fair amount of time we will continue to do this for a fair amount of time and they are not of the sky to have everything we're not all going to have the answers and so we we rely upon one another on a daily basis and so are our clients and so they need to be able to caregivers need to know well it is ok to reach out because caregivers are constantly looking inward for strength and fortitude and continued efforts and a lot of this is not even about the the elderly person about mom and dad this is trying to crack the n of the caregiver and trying to get them to just kind of spread just a little bit and rely on a little systems and i think also we can also look at it that when i'm helping my mom and dad with the conversation that it's preparation for me you know that it's not going to end there i'm preparing for myself it's unfortunate now that we have this generation now that like my parents were really kind of the first generation where we needed to how this talk where you know they didn't live with their family they lived a lot longer in retirement and they didn't live near their family so now we have to have this talk and things are brand new but once i start having that conversation with my parents it's preparation for me it doesn't end there i mean it's critic hardware is a pretty good point that it's good to reach out to the lawyer at some point you don't want to have to bring you into the conversation with a parent yet but again when preparing for the talk get your ducks in a row  let's start you know start doing a little research you know i like to use the vacation analogy you know you just don't go down the the pier and get on the ship anymore you kind of want to know where the ship is going because i want to pack for where this ship is going you know one kind want to make sure to passport evolved there are so many things that have to be involved with this and there's so many different places for somebody to try and look out to and we're not all going to have the same answer on this one we start with you have who would you say to reach out to first if i want information where should i go first well knowing what i know now i could write to you but i think i would i probably would have gone to the internet first and asked a very specific googled a very specific question  and i'm a i'm a big reader there are a lot of books that are available but senior resource centers are i think are and if you still don't have anything i would look if you're if you know you need home care then of course then you have a focus and then you go in there to a geographic area and i would certainly use google websites and just do a search in your vicinity because you're going to need wherever they live and that way you can start from there when you're looking for home a karajan sees i mean if you just want someone close to where they live which makes a lot of sense you're going to look at places close to where they live because looking for senior care you're going to go places that are close to where they live so i definitely think everybody thing the internet it's the first place most people do love now but care not the only place and i agree with group with you about looking to senior centers they are oftentimes and utilize the resources in any city community at princeton has a great one of course here so speaking to a social worker or gerry specialist at the place to start holly in addition to those i would say using the local hospitals and their social work department would be a big resource because they're familiar with what's going on in the community where people are living whether it's a facility based living arrangement or some type of supportive housing or all the other services involved i also would advocate for the office on aging all counties have connections with office on aging and they often have their connections and the information of the different senior centers or support groups and support groups can be a huge resource with more information from personal first hand experience from other caregivers and other people carl and i agree generally with what has been said so far i think that part of it presupposes that we that the caregiver knows what the issue is to reach out to  and so my concern is that if somebody says i am completely lost and who among us has not talked to a client who either admitted to being completely lost or who was at jacked completely lost  thing everybody has in common is everybody trusts somebody and you know to use the football analogy you know everybody needs a quarterback or a head coach whatever you want to say you know and so my job as an elder law attorney oftentimes is to play quarterback and say i've got the ball and you'll direct me but i'm going to pass the ball to whoever going down the line now people aren't necessarily going to come to me because they don't know me but maybe they know a financial advisor they portraits for twenty five years and this part of the reason why we have those connections and that financial advisor will start to point us point people in the right direction i'm not going to get into everybody not going to right away but that will help because everybody knows some and they know more people than we i think the main message just coming apart in coming out in this is that there are indeed resources out there whenever more than ever there are resources there is somebody you can turn to for help no matter where you are you narrow your search learn what you're going to be looking for if not start talking to the people that you trust you should be talking to people to trust all along just don't be afraid to start this conversation it is one of the most important conversations