On Aging
12:00 pm
Mon November 12, 2012

How To Start Talking Details With Aging Parents

Originally published on Tue November 13, 2012 11:20 am

Transcript

MICHEL MARTIN, HOST:

I'm Michel Martin and this is TELL ME MORE from NPR News. Later, if you wonder what Olympian Leo Manzano listens to to get fired up or cooled down, you need not wonder any more. We'll find out in a few minutes.

But, first, we are thinking about the holidays coming and a lot of people use that time to get together with family and, while a lot of comedy routines and not great movies have focused on how wacky and even painful those visits to the family homestead can be, our next guests say, if you have aging relatives, this holiday season, think about using that time home to have some important conversations that you are going to need to have, anyway, and have them before there is a crisis.

And, if you think this conversation has nothing to do with you, you might want to think again. An estimated 40 million American adults are now caring for an aging loved one in some way.

So for some tips on how to start or continue that conversation, we've called on two people with experience on this issue. Tami Cumings is a senior vice president at A Place for Mom. That's a senior living and care referral service. And Christopher John Farley is the editorial director of The Wall Street Journal's blogs. He's been on this program before, talking about caring for his aging parents.

Welcome to you both. Thanks so much for joining us.

CHRISTOPHER JOHN FARLEY: Thanks for having me. Appreciate it.

TAMI CUMINGS: Thanks for having me.

MARTIN: So, Tami Cumings, why do you think that it's a good idea to use holiday time home to talk about these things? I'm putting you on the spot here because you were actually the person who raised this idea.

CUMINGS: Well, you know, many times, families are just getting together with their loved ones after not seeing them for a while and so they may notice changes with their mom or dad that might really cause some red flags and notice that maybe Mom's lost weight or Mom's not taking her medications and so it really kind of triggers a red flag that maybe they need to start having a conversation with Mom or Dad about what they want for the future.

MARTIN: Give us a couple more red flags that you think people should be on the lookout for if they have aging relatives.

CUMINGS: I think it's just an overall change in their health condition. Sometimes, we see that seniors don't socialize as much as they used to, so those are two really big red flags to look for.

MARTIN: Christopher John Farley, your dad actually passed away a couple of years ago now and, of course, I'm sorry. I just joined that club. I wanted to ask whether you had had a chance to have those conversations with him before he passed away.

FARLEY: Well, first, I'm sorry for your loss and it is a tough time and, if you don't have things planned out beforehand, it can make a hard time even harder, which is why it's important to have certain kinds of talks about financial matters, about end-of-life plans before anything actually happens so you can focus, really, on the person and the situation and not have to worry about all these other things that can make the tough time even tougher.

And I did have a chance to talk to him about certain things before he passed. My mother, who is still alive and doing terrific - she was the primary caregiver for my dad. I was there the last few days of his life in the hospital with him and just because everything had been put in place by my mother - she had planned it all out. She knew where things were, what things had to happen. We were able to focus on my father and not on all these other things.

MARTIN: Tami Cumings, families often come to your organization which, as we said, is a national referral service where you help people get the kinds of things that they need to help care for an aging relative. And we're going to focus on the positive, but right now, I do want to ask you - what are the biggest mistakes you think people often make by the time you hear from them?

CUMINGS: I think it's mainly - we get a lot of families that come to us that are in crisis mode and, you know, we hear a lot of heartfelt, you know, stories because they've not really had the discussion with their parents ahead of time and they don't really know what their wishes are and then a situation happens where it's more of a crisis situation and then they come to us and, you know, they don't know the options for senior living out there. They're a little lost and so that...

MARTIN: Well, be more specific. Be more specific. What specific things is it that people are often lacking? Let's try to be as brass tacks as we can because I think that's what's most helpful.

CUMINGS: Yeah, absolutely. They...

MARTIN: A will. They don't have a will. They don't have a Medicare card. They don't have the insurance card. What else?

CUMINGS: Exactly, exactly. Some important documents that - really to look for and to know before these crises happens are their medical records, if they have a power of attorney, if they have a living will, any advanced directives. One thing that's really important is just physician contact information, who are their physicians, financial information, that Medicare card.

Do they have long-term care insurance - because that's very helpful? Any financial bank information is helpful at all. Sometimes seniors are not open to share that and it just kind of comes with that generation, so that's what we encourage people to do ahead of time and get all that information.

MARTIN: Well, you know, Christopher John Farley, you could see it's some of its generational, but some of it is the relationship because, you know, you're the, as far as your parents are concerned, you are the child, and it's their job to take care of you. And so the idea that they would be sharing all this information with you as the child - even an adult child - is very strange to some parents. So how, you mentioned that your mom was very proactive in this area, but do you have some advice based on your own experience, on how to broach the subject?

FARLEY: I certainly do, and you shouldn't be afraid to broach the subject. That happened to me with my grandmother, where for a long time I wanted to talk to her a bit about some of the family history, put it off and put it off because others relatives advised me, you know, don't really have this conversation with her because it'll make it seem as if she's about to pass away. And finally, when I got around to talking to her, she wasn't in the kind of state where she was able to remember or discuss the kinds of things I wanted to know about the family. So that was a tragic loss for me and other people, I wouldn't want to see them go through that and see history lost. But number one, you should make sure you have a financial planner, somebody who can sit down, who is a professional, who can talk to you a bit about what the next steps are before you have to take those steps. Because when things happen, people are scrambling, people don't know where things are, and you want to make sure there's a plan in place so you can proceed in an orderly way and again, focus on the person and the emotions and the situations and not paperwork and all these other things.

MARTIN: If you're just joining us, you're listening to TELL ME MORE from NPR News. I'm Michel Martin and we are talking about conversations that you might want to have if you're planning to go home for the holidays. We're talking about the kinds of conversations you might want to have with aging parents or other relatives about what they would want as their process of life transition continues. Our guests are The Wall Street Journal's Christopher John Farley. He's written about caring for his own aging parents. Also with us, Tami Cummings of the senior care referral service, A Place for Mom.

Tami Cummings, obviously this is going to vary, depending on who you're dealing with. But do you recommend planning to have the conversations before you get home - like alerting those relatives that you want to talk about these things? Or do you recommend just kind of feeling your way through it when you actually get there? Is there a better way to initiate this conversation and is there a not so good way to initiate it?

CUMINGS: Well, I think in my personal opinion, I think it's a face-to-face because I think parents might avoid us I think if we say we want to have that conversation when we come to see you for Christmas or Thanksgiving. So I always think it's nice to just, you know, sit down and talk to mom and dad and get an understanding of, you know, what their wishes are going forward. And it is a tough discussion and many of our families have issues with it, but because the seniors again, you've got to kind of draw it out. And, but I think if you explain to them, you know, hey, I really just want to know what you want, you know, and what your desires are that I really think that's the best way to approach it.

MARTIN: And what if they say no?

(LAUGHTER)

MARTIN: Say, mind your beeswax. I'm the mom.

CUMINGS: That's true and they may do that. I would just probably maybe shelf it for a little bit and maybe come back to it and just, you know, explain to them how important it is to you that you know what their wishes are. And it may not be an easy discussion for them and I think let them know that. But, you know, maybe start with the financial stuff first. That's a little, you know, just different than talking to them about what their desires are for moving into a retirement or anything like that because most folks don't want to talk about that. So maybe start with a different piece of it.

MARTIN: Christopher John Farley, what's your advice on this?

FARLEY: Well, you know, Derek Walcott has a poem called "Endings," where he says: Things do not explode, they fail, they fade. And my take away from that poem is that things can happen unexpectedly, they erode and suddenly you're left in a situation that you have to deal with, and people just have to remember that. That if they keep putting these things off, if they keep thinking I'll deal with this in the future, you'll be left with a situation where a tragedy will happen, something that is inevitable, something you knew was happening, and then it's too late to deal with it in an orderly way.

So this holiday, this year, now is the time to seize that moment, have that conversations, that professionals involved - like a financial planner - and also get other family members involved. I mean, this is a heavy load for anyone to take care of. And so the more family members who want to be involved, who are involved, it makes the conversation easier, it makes it more of a family thing, and then the groundwork is put in place for things to happen in an orderly way and people can really focus on the other person and not on the tragedy of the situation.

MARTIN: But I was going to ask about siblings, Tami Cummings. What about that? You know, sometimes it occurs that siblings don't agree about what should happen. And, you know, there are families, you know, this is a religiously fluid country and you may have many family members with the same parents who have different religious practices and commitments after a certain point and have a very different world view about what should happen. They may have different opinions about the parent's finances and what role they think they should have in relation to them, if you get my point here.

CUMINGS: Yeah.

MARTIN: How do you recommend, do you address those things without it becoming one of those big ugly messes that people then go on to, you know, do movies about, right?

CUMINGS: Yeah. We actually have this situation happen a lot with our advisers that work with our families. And a lot of times our advisers will get the siblings on a conference call together and talk through options as a group. So we're not just talking to, you know, one side of the family, we're talking to all of the siblings because sometimes you don't really know who is the head decision-maker. And so lots of times we just try to involve the siblings in those conversations so they all hear, you know, what the options are, you know, talk through what's best for their mom and dad.

MARTIN: Well, you know, everybody does not have financial planners, you know, Christopher John Farley. It might not be part of their culture. It might not be part of their family background. They might not see themselves as having the means to have an outside professional kind of address these issues. Are their some bare minimum documents that or resources that individuals really need to have - even if they don't see themselves as being of means? I'm thinking of power of attorney or durable power of attorney, or something like that. Tami?

CUMINGS: And nowadays, pretty much, you can pull those things off the Internet so you don't necessarily have to go to a financial planner and pay to have those done. Sometimes if it's complicated it's good to have an attorney involved, but a lot of those things are just my parents, for instance, are getting up there and they've already put together their living wills and did that on their own. You know, so there's a lot of things where if people don't have the resources they can do that on their own as well.

MARTIN: Christopher John, could you give again some more advice from the son's perspective about how to break through that wall of resistance, especially over the holidays, where you could see where parents might say gee, this was supposed to be our happy time to get together. Why are you bringing, you know, all this, you know, dark cloud over our get together? Can you offer just a little more advice about how you can raise these matters?

FARLEY: Well, the reason why the holidays are good time to do this because one, people are sort of feeling in a warm family way anyway so it's a good time to sort of get into some of these other, you know, more disturbing matters then get back to the fun and the turkey and whatever else. And two, you're face-to-face with the person and they can see all the sort of nonverbal facial cues and they know where you're coming from. If you do these kinds of things just over email or over the phone or over social media, that's when things can become heated, when siblings can go to war because they're not really getting the emotional connection that needs to come with it so you can see that you're all in this together, that this is a family thing and it's not one person trying to make a power grab for something. So I would really recommend the holidays as a good way to go about this.

MARTIN: OK.

FARLEY: And you're right also that not everybody has a financial planner and not everyone has this as a part of their culture. I want to pause and give a plug to my wife Sharon Epperson's book called "The Big Payoff," which is all about getting those kinds of documents and putting together these kinds of plans for the end of your life because people don't know the information they should have and you can get the book on iTunes.

MARTIN: OK. All right. Well, thank you for that commercial, but which we didn't expect. Tami, before we let you go, what if you blow it?

CUMINGS: Yeah.

MARTIN: What if you totally blow it? You go home and you totally blow it? You go home and you cause a big mess? The parents say you're just trying to get my money. Stay out of my business. What's plan B?

CUMINGS: You know...

MARTIN: Very briefly.

CUMINGS: I would continue to have discussions with them, 'cause and just really say hey mom, it's because I care and I really want to know what your wishes are. And, you know, you might even use a situation where - because this is happening with families all around the country and we have friends that go through this. You know, my friend went through this with her mom the other day and, you know...

MARTIN: OK.

CUMINGS: ...it was a crisis situation, and so mom made me think, I really need to sit down with you and talk to you.

MARTIN: OK. All right. Thank you so much...

CUMINGS: Yeah.

MARTIN: ...for sitting down and talking with us. Tami Cummings is a senior vice president at A Place for Mom. That's a senior living and care referral service. She was with us from member station KUHF in Houston, Texas. With us from NPR New York, Christopher John Farley, the editorial director of The Wall Street Journal's blogs.

Thank you both so much.

FARLEY: Thank you.

CUMINGS: Thank you. Transcript provided by NPR, Copyright National Public Radio.