As the spouse, child, care provider or friend of a senior, one of the most pressing concerns is knowing the right time to approach that individual to discuss assisted living, transportation and other issues.
A panel of experts tackled this issue at a “Navigating ‘The Talk’ With Seniors” presentation at St. Dominic Village.
Carmel Bitondo Dyer, M.D., executive director of The University of Texas Health Science Center at Houston’s Consortium on Aging, led the presentation and outlined three common reasons that “the talk” with a senior loved one might be necessary.
The first is diminished vision: Vision affects a senior’s ability to drive. Regular eye check-ups are a necessity, but a better gauge on vision is car accidents. If a senior who drives has had more than one car accident in a given year, it might be time for him or her to stop driving.
Dyer shared an example from her own life about diminished vision. When she learned that her husband’s vision had deteriorated to the point that he was legally blind—he was 55 at the time—she had “the talk” with him about driving.
“’Now that we know about it, you can’t get behind the wheel,’” she told her husband. “It is our responsibility as family members to make recommendations when vision isn’t good.”
A second, common reason to have “the talk” is physical frailty. If a senior falls frequently or has trouble preparing meals, shopping, getting to doctor’s appointments, cleaning the house or cleaning clothes, “the talk” might be necessary. Often, physical frailty leads to a new living situation, either with a caregiver in the home or at an assisted living facility or nursing home.
A sure sign of frailty is that other people are taking advantage of the senior. When individuals cannot check their mail or mow the lawn, thieves can catch on, Dyer said.
The third reason is a change in memory or thinking. This change can be difficult to ascertain because most people aren’t drilling their loved ones about today’s date, Dyer said.
When Dyer examines patients, she looks for the five “Ms”— memory, mood, mobility, medication and medical history based on age.
“When we find things we can reverse, we are happy,” Dyer said. “But some things can’t be reversed, like Alzheimer’s.”
The panel included Susan Gaze, founder of Tender Transitions, which provides support to those transitioning to retirement communities and nursing homes; Kendall Cockrell, an elder law attorney with The Cockrell Law Firm; and Sue Hepler, Ph.D., a clinical social worker and geriatric psychologist.
The panelists agreed that a frank discussion with a senior that ends with everyone in agreement is ideal, but doesn’t typically happen. Instead, the panelists recommended finding that special person that a loved one will listen to to initiate the discussion.
Panelists recommended broaching “the talk” over a card game or another activity the person enjoys. Find out the individual’s medical and legal wishes, and help the senior get his or her financial and legal matters in order.
“When you become in crisis, people starting making decisions for you, and those might not be the right decisions,” Gaze said.
The panel provided several ways to get the conversation started:
- Talk to the individual at a time when there is no crisis.
- Listen to what the individual has to say.
- When discussing safety or a living situation change, do it with love.
- Be empathetic of the individual’s situation.
- Remind the individual that they are not alone, that they have support.
- Don’t pressure the individual—it may take more than one conversation.
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