Preparing for one of the toughest talks you’ll ever have

If you have an elderly family member still living in their own home, the chances are that one day, you’ll need to have a conversation with them about their future care.

Whether that means going on to organise care for them in their own home or settling them in to residential care, this conversation and the journey that follows is a challenging one to navigate. 

As journalist Kate Legge described in The Australian of the decision she and her siblings made to seek a care facility for their father, who had been for so long the head of the family: “We are all distraught at how the natural order of family hegemony has come unstuck”.

This tough decision comes at different times for everyone; the triggers for care discussions can range from an unexpected, debilitating fall, to a diagnosis of a progressive condition such as dementia, or just a gradual decline in mobility to the point that living alone is no longer feasible.

Byron Cannon, the general manager at Linkage Care, an aged care advisory service, spends his days helping families through the process of seeking care for a loved one.

He said there were some common situations families found themselves in.

“You’re concerned your mum has some early-stage dementia, you’re living remotely from her but you’re really worried about her ongoing daily care and hygiene needs, so how do you deal with that?” he said.

“Or, you’ve recently moved a parent up from down south. Things are in crisis mode within your family unit, your husband is sleeping on the couch while you share a bed with your mother, who has dementia, so you can keep an eye on her. What can you do to address this situation urgently?”

He said such situations were emotional for everyone involved.

“People need piece of mind, knowing their parents deserve to continue life in a fulfilling way and that their care needs can be adjusted when needed,” he told Starts at 60.

“They want to get the get the care that’s best for them, from the providers that are best for them.”

One of the biggest questions clients had was on how to approach the discussion about care with their parent or parents, he said.

“We encourage people to be as armed with as much information as possible when having the conversation with elderly parents about care,” Cannon explained.

“It’s important to check all your options and look at what possibilities there are for your parent. Can they stay at home and receive appropriate care? Are there different services they can linked to?”

Don’t rush what could be a stressful talk, keep your patience and understand that your loved one may become frustrated or confused, Cannon advised.

“Take time to explain to parents what the situations might be and explain why they might be the best option,” he said.

This advice was backed up by the government’s own My Aged Care service, which called the decision to move into a residential facility, for example, “a time of stress, high emotion, a longing for the past and uncertainty about the future”.

“It is a challenging and emotional decision for the person moving and their family, friends and carers,” My Aged Care cautioned.

Because of that, many families postponed having a conversation with their relative until the need for care was critical, Christine Starr, the founder of Blue Lighthouse Relocations, told Starts at 60.

An adviser like Cannon, Starr has assisted many families during their introduction to the aged care industry.

“They know mum or dad will get upset so they put it off and put it off, which is probably why so many of our clients end up at a crisis point,” she said.

“Sometimes the elderly parent ends up in a position where they have a fall or an illness, they go to hospital and they’re told they’re never going home. They end up in a position where they’re sent to a nursing home far from family or moved around from respite bed to respite bed.

“Families end up regretting not listening to the trigger points when they should have.”

Visiting myagedcare.gov.au is a common starting point for many people seeking information on care for elderly family members, but Cannon warned that it was a complex site.

“It’s a great service with a huge amount of info, but actually navigating it is difficult,” he explained. “There’s also a lot of confusion about what peoples’ entitlements might be or how affordable care can be.”

Both he and Starr recommended talking to specialists in the aged care industry, as well as checking out the options on the My Aged Care site.

“It’s a complex industry and a complex situation,” Cannon said, while Starr recommended approaching a service such as Freedom Aged Care’s community liaison team, if the family’s preference was to avoid paying independent aged care advisers.

“Families really need an independent third party – someone who doesn’t have an emotional attachment – to help them talk about care with their elderly parent,” she said of the free Freedom service.

“That can be a platform for families who want to have a more frank conversation with their loved ones about care.”