Difficult Conversations

The most difficult thing is often getting a conversation started.

Talking to your parents about the challenge they often face in changing their lifestyle to meet their needs in later years.

Most of us will at some time in our lives have to face difficult decisions: should my mother continue to live on her own as she becomes frail? Is my father-in-law going to manage now he has been widowed? Am I in the house I will choose to stay in when I retire? Does my aunt need full time care and not just home help?

What makes that conversation so hard is the scope for misunderstanding.

If your focus is an elderly relative’s safety, you may encourage them to move into a retirement home. But if their priority is their independence, the importance of their local network or the memories the house holds for them, a different solution may be the right one after all.

Be prepared to talk and listen, just start with an open mind, a blank sheet of paper, and plenty of time.

“Once I finally found the courage to discuss my parents’ options with them, I found that they were already thinking about it and were grateful for my input.”

Getting Started

• Take the plunge as early as possible. Action is likely to become more pressing as time passes, while a wider range of options and better outcomes generally result from early planning.

• Conversation is a two-way process – make sure that you aren’t so well prepared that you don’t listen and respond to what the other person is saying.

• Imagine you are having the conversation with yourself – think about how you would want to be approached on the topic.

• Prepare your case well. Arm yourself with the relevant facts and illustrate your points with real examples.

• Avoid talking over the phone – a difficult conversation works better face-to-face.

• Take your time – choose a time when you won’t be rushed and you can sit down over a cup of coffee in a relaxed setting.

• Don’t expect an instant result – difficult conversations often take a long time to finish, so be prepared to break and return to the topic on another occasion.

Understand the issues – Create shared  solutions

• Remember to consider the views and feelings of other family members, both before your first conversation and as your discussions progress, so that all those affected are appropriately consulted.

• Before you begin it may be a good idea to seek neutral or expert advice on the subject you’re going to tackle so you are able to be as knowledgeable and reassuring as possible.

• Stress that you have everyone’s best interests at heart and that your aim is to make the best of life’s opportunities.

• You may not get the result you want – be open to compromise.

• Try to keep the conversation calm and reasoned. Although you may feel a whole range of emotions, you will be most helpful if you stick to rational argument.

• When confronted with a difficult situation, people can react with hostility simply through fear, so don’t allow yourself to become upset by an adverse reaction to your suggestions.

• Everyone involved will need time to let what has been discussed sink in. Agree to take a break and return to the topic afresh another day. Taking time will ensure the best outcome for all.

Are you prepared?

1. Have you thought about how the person will be feeling?
2. Have you explored the different answers to your question?
3. Have you sought expert advice where necessary?
4. Have you consulted other family members?
5. Have you set aside the time to have the conversation calmly?
6. Are you in a relaxed, familiar setting?
7. Are you ready to listen as well as talk?

“Are you sure you can cope?"

In the end it comes down to five possibilities:

1. Stay put and consider adapting the home or hiring help as necessary
2. Find a more suitable home – for example, somewhere smaller, on one floor, closer to relatives
3. Move into sheltered accommodation, which offers security and support as well as plenty of freedom
4. Go to a residential home where everything is taken care of, from cleaning and meals to entertainment
5. Opt for a nursing home for full time care

Questions to ask

• What do you find hard to manage in your home at the moment?

• Consider the stairs, accessibility of the bath, height of the bed.

• Do you find the housework, washing and ironing a burden?

• What about property maintenance? Are you able to replace batteries in the smoke alarms, arrange for the furnace to be serviced, clear the gutters?

• Are you still preparing regular meals? Think about how much you enjoy cooking, the ceremony of mealtimes, possibly alone.

• Do you have trouble hearing the doorbell? The phone? The television?

• Do you worry about home security?

“Are you sure you can cope alone?”

• Is maintaining your home becoming a burden?

• Is there a garden that is becoming a chore rather than a joy?

• What help is available in an emergency?

• Do you wish you had more company?

• How far away are your closest relatives, those you love, your friends?

• What about other important links – your local church?

• Can you walk to the shops?

• Can you park close to your home?

• Do you still feel safe driving?

“Have you made a will?”

Why do I need to?

• Because doing so enables you to make choices and decisions. It saves time and difficult conversations for your family, removing uncertainty and reducing the risk of disputes. It also saves money.

What happens if I don’t?

• Your next of kin will become responsible and be left to make all the decisions on your behalf. You will not be able to choose to whom you leave your money, nor who administers your estate. You will not be able to specify any special requirements about your funeral or earmark particular items for friends and family. You will not be able to benefit charities.

What about tax planning?

• You can reduce inheritance tax through discretionary trust wills. Leaving funds to charities is also a way of reducing the inheritance tax liability.

Can I leave money to step-children or grandchildren?

• Yes, indeed, you can, provided the provisions are in your will.

I have a disabled child. Can I make special provisions for him/her?

• Yes, you can. It is quite straightforward to draw up provision for a disability trust in your will. You can also do the same for under-age grandchildren and other relations.

What about the family home?

• You can arrange for your home to be held jointly with your spouse so that it passes automatically on your death. Or you can make special arrangements in your will to reduce the inheritance tax liability associated with the value of the home.

Can I make provision for family pets?

• Yes, you can, possibly bequeathing them to specialist animal charities with money for their upkeep.

“Have you signed a POA?”

What happens if I become ill? Who will look after my property?

• You can create a Power of Attorney. This can be used if you become incapable of managing your affairs, either mentally or physically, or if you have a bad accident. It can also be used if you go away for extended periods.

“What if you’re terminally ill?”

I don’t want to be kept alive if I become terminally ill.

• All decisions are made by your doctors. But you can make clear your wishes and whom the doctors should consult by using a Healthcare Power of Attorney and a Living Will.  In Tennessee these forms are called Appointment of a Healthcare Agent and Advance Care Plan.

This sounds like a good idea. What should I do next?

• Although you can create these documents on your own, it is sensible to have an attorney assist you.

“Have you got enough to live on?”

Make a list of all your expenses over the next few years and set those against your predicted income so that you can plan and prioritize.

• Make sure your financial planning is flexible enough to adapt to your changing needs.

• Reduce overall future costs by planning ahead, for example investing now in a savings plan to provide for future care costs.

• You may be able to use money locked up in your home but do so cautiously; remain in control and retain ownership of your home so that you are able to access what you need when you need it.

• Careful planning provides choices.

Careful planning provides choices.

• Paying for treatment needs and hiring needed in home support.

• Staying in your own home while adapting it to meet changing needs.

• Moving when the time is right for you.

“What happens when you’re gone?”

No one likes to think about death, let alone plan for it and for the funeral that must follow.  But the reality is that it comes to us all and simple pre-planning can relieve those left behind of having to guess preferences during a period of grief and bewilderment.

Planning a funeral

Consider the following questions:

◦       What type of service would you like?

◦       Would you like hymns? Which ones?

◦       Would you prefer to be cremated or buried? Where?

◦       Do you have any views about who should attend?

◦       Do you have a preferred charity should people wish to mark the occasion with a donation?

A simple way to log this information is to add a letter of wishes to your will, which you can change at any time – for example if you change your mind about the hymns. The cost of the funeral can be taken out of the estate or there is also the option of a pre-payment plan. Important questions to ask the company providing a pre-planning funeral package are:

1. Do they guarantee to cover both funeral directors' fees and disbursements in the plan?
2. Does the plan include burial? If not, how much more would that be?
3. Should the company or the funeral director go out of business, what would happen to the plan?
4. Does the company refund the whole amount paid if you change your mind?
5. What, if anything, will relatives have to pay?
6. Are all administration fees included?
7. Can you choose the funeral director?
8. What happens if you move home?

“Where’s it at?”

• insurance (Medicare / Medicaid number, supplement, other policies)

• doctors (names, phone numbers, and other contact information)

• medical history (medications, allergies, conditions, procedures)

• identification (social security, military ID, driver's license numbers)

• address list (friends, neighbors, family)

• service providers (attorney, financial advisor, clergy, accountant)

• financial (account numbers, checkbook, investments, tax records)

• legal (wills, powers of attorney, health care directive)

• deeds (house, other property, car title, boat title)

• insurance (life, medical, auto, homeowner's)

• household (mortgage, apartment lease, property tax records)

• vital records (birth certificate, marriage license, divorce decree)

• final wishes (organ donation, burial, property distribution)

“You don’t seem yourself.
Have you had a check-up recently?”

Explain:

• If you are fit and well, your later years can be as exciting as any other life stage. The threat of illness takes so much of the optimism away from planning for retirement, while the reality of strokes, brain disease or osteoporosis, for example, can mean a complete review of dreams and ambitions.

• Yet there is so much you can do to delay or prevent the onset of illness. When approaching someone to tackle the issue of how well they are looking after their health, arm yourself with the facts and give them the good news about prevention and cure.

Make sure you…

• respect your parent's independence, even while taking care of them

• allow your parent to make as many decisions as appropriate

• have reasonable expectations of what your parent can do independently

• talk regularly with your parent about their concerns, desires, and frustrations

• make informed decisions that are in the best interest of your parent's needs

• show compassion while you are trying to be efficient and responsible

• recognize when you are getting worn out and need a break

• make use of support groups, family, and other caregivers in your situation

• take regular breaks to do something enjoyable for yourself

Difficult conversations - They start with you!