How To Talk To Your Parent About Assisted Living

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The moment an adult child comes to the realization that their parent may be in need of assisted living is usually brought on by some type of eye-opening or disturbing event. Simple occurrences such as forgetting to take medication on time or negligence around a stove will thrust an adult child into a state of emotional panic. “This realization takes many by surprise because, quite frankly, children have never known their love one not to be self-sufficient”, says Dr. Cory Kempton of Banner Thunderbird Medical Center, Phoenix AZ. “This panic coupled with a lack of tact in discussing such concerns will ultimately lead to a loved one’s resistance (at best) or defiance (at worst) toward any proposed resolutions. I would suggest adult children slow down, put themselves in their loved one’s shoes, and have a plan before starting that conversation.” Bombarding a loved one with senior living and what you estimate “needs to be done” will more than likely make things worse for everyone involved.

In an effort to support those who find themselves in this situation, our senior advisors have compiled a progression of how to approach the difficult conversation of assisted living and, more importantly, how to convince your loved one it’s the right decision.

1: Assess The Situation With Probing Questions

The first step is to objectively assess your loved one’s situation through conversation and closer attention to detail. Take a close look around the home during a normal conversation. Do you see any safety hazards that are of concern? Steer the conversation in the direction of your concern and ask questions nonchalantly. Perhaps ask questions about if they feel the home is still appropriate for their needs. Look closely at their prescriptions. Are they current? Steer the conversation in that direction and ask relevant questions. Do they still feel comfortable driving to the doctor? Perhaps offer to drive them and see if they take you up on the offer. Take a look in the refrigerator and pantry. Do you see any expired foods? What kind of diet are they maintaining? Ask your loved one what they have enjoyed eating recently. Test to see if they hear the doorbell or a knock at the door. Could they respond appropriately to an emergency?

If you find yourself feeling like everything is okay, you may want to indirectly introduce the subject of senior living anyway in order to feel out reactions and feelings through open conversations. In doing so, you’ll be lessening the weight of the subject in the future. However, if your concern is growing at this point, ask them if they ever thought of living somewhere else. Why or why not? Perhaps mention you heard of a friend’s mother who recently made a successful move. Or talk about exciting programs at a local senior center you read about in a recent article. Try to get an idea if that is something they might be interested in learning more about.

The idea here is to plant the idea in their head and give them time to mull it over but be careful to note their initial reactions and objections because it will be valuable feedback for you in the future.

2: Plan To Have Multiple Conversations

Imagine for a moment that you were told you had to move shortly and that you could take only a fraction of your possessions. How would you feel? This is exactly why it is so important to put yourself in your loved one’s shoes. Whether people admit it or not, there is definitely an element of sales involved with this sort of subject matter because a need for daily assistance is difficult to admit. Expert salespeople will be the first to tell you that sales is more about building rapport over time and exposing a need for their product rather than attacking with a one-time, high-pressure close. The same is true in the talks about assisted living with your loved one. You may have to have multiple conversations to help them see their need to make the move. Pay close attention – Are they forgetting things?, Having trouble with household appliances?, Do they seem depressed? With every visit make an effort to understand your loved one better. You’ll be glad you did when the day comes to have the direct discussion. The idea is to have a series of conversations that will ultimately lead to a frank and direct conversation about your concerns. In this way, the direct discussion won’t feel as much like an “ambush” from your loved one’s perspective.

3: Involve Family Members

If you feel strongly about the need for your loved one to make the transition to assisted living, it would be wise to involve any close family members in the decision making process as well. Imagine that your sibling began moving forward with what they deemed to be the best course of action for your senior parent without any inquiry about what you thought? What kind of unwanted family strife would you be stirring if you did the same to others close to your loved one? Take inventory of those closest to your loved one and plan to have a conversation with them. If you have siblings or other immediate family members, try to meet as a group before you have the direct conversation with your loved one. If there are disagreements that need to be aired, it is best to iron them out beforehand rather than have your loved one witness them firsthand. The stress of the situation is enough to handle without having to hear the family’s escalated emotions or opinions. Have an open type of forum where the family can listen to what you all have witnessed along with any questions and concerns you all have. Together you can agree on possible courses of action and an approach can be made with a “united front”. In this way, you will all present a consistent message to your loved one.

Although it is critical to include all members of the family in any care discussions or decisions, it would be wise to have only one or two of the most influential or closest family members approach your loved one for the direct discussion. If it is not a common occurrence for 4 or 5 of you to show up on your loved one’s doorstep at a given time, then don’t do it this time either. More than two arriving will feel like a type of intervention that can feel threatening and foster feelings of embarrassment. The one or two you choose will want to be compassionate and tactful with the idea of having open dialogue rather than pushing a one-sided coercion.

4: Prepare For Common Objections and Conflict

How a loved one will react to the possibility of senior living is difficult to predict but it is safe to assume that resistance is inevitable. Your preparation and understanding of conflict management for the direct discussion is key to keeping the conversation amiable. Hopefully your prior conversations together have given you some insight into what to expect in the way of objections but here are some common concerns below that will give you an idea of what to expect:

“I am not ready to leave my home yet.”

“I have too much stuff.”

“I can’t afford it.”

“I don’t want to leave my family and friends.”

“What if I run out of money?”

“I feel safer here in my own home.”

“I don’t want to go to one of those old folks homes.”

Many times objections are simply smoke screens to put an end to the conversation. Make an effort to see through the smoke and zero in on the real reason your loved one is resistant. In other words the objection of “I have too much stuff” may actually translate as “I’m scared”. Many times a loved one is reluctant to the idea because they feel they will let someone down. It could be an adult child, a relative, or a close friend. Perhaps they feel the family will not have a place to gather for holidays, so they resist in order to keep the family together. Once you understand why your loved one keeps saying “no” to a move, you can address that issue directly.

Strong feelings and conflict are bound to materialize but if you know how to better handle conflict resolution before the talk, a strong and respectful relationship will remain intact. As an adult child, you are in need of assurance your loved one is safe and secure while the parent needs to feel heard, respected and valued. Each need is valid so don’t view them as “competing positions”. Rather, humble yourself and consider the following conflict resolution tactics:

  • Remain calm, non-defensive, and respectful
  • Be alert to expressed feelings and non-verbal communication
  • Recognize and respond to the things that matter to the other person
  • Face conflict head on but respect the differences of opinion
  • Seek compromise and avoid punishing
  • Forgive and forget.
  • Move past the conflict without holding resentment
  • Rein in any short-tempered, angry, hurtful, and resentful reactions (controlled emotions)

Remember that the most important communications do not involve words. A reassuring touch, a calm tone of voice, or a concerned facial expression can go a long way toward relaxing a tense exchange.

5: Have The Direct Discussion

So you’ve had a few indirect conversations with your loved one and you have an idea of how they will react to the subject. You’ve planned for objections and how to deal with conflict and you’ve had the discussion with the family. Now you are ready to tackle the direct discussion about assisted living with your loved one. First, make an effort to choose a quiet time in a private setting when everyone is in a good mood such as after a meal, after church, or after taking a walk. The critical thing you want to avoid at all costs is “role reversal” where you are perceived as “parenting” your parents. The discussion will be most productive when both are equal in the relationship so keep that in mind throughout the conversation.

Start the conversation by asking open-ended questions such as “How are you doing in keeping up the house?” or “Are there any activities you are no longer able to do that you wish you could still do?” . Listen closely and then ask, “What are your daily worries or concerns as you go through your day?”. You’ll notice the framing of the question was not “Do you have any worries or concerns….” because that question can easily be dismissed with a “no”. Try to get an idea of what types of daily activities that are a struggle for them and frame them with your concerns. For instance, you may say, “I’m concerned about you coming down the stairs alone” or “I’ve been thinking more about you lately and I’m concerned about you facing an emergency such as a power outage, a fall, or an accident”. They will likely be dismissive of your concerns but continue to drive them with discernment.

A very effective approach is to use the “sandwich method” in which you always approach the subject with a positive, then state your concern followed by another positive. For instance say, “Dad, you have been the rock of our family for as long as I remember and I love you with all my heart. We both agree that you are slowing down and I’m concerned about how you’ve been forgetting to take your blood pressure medicine. I know you have always prided yourself on your independence and I want you to remain in control of your life but I think we should talk more about the future. What are some things we can do?”. Allow your parent or loved one to hear your concerns and respond to your emotions. During the conversation, however, be wary of dropping the term “assisted living” prematurely. It will likely invoke negative imagery as most older generations have inaccurate perceptions of assisted living being “old folk nursing homes”.

After an exchange of feelings and when you feel the time is right, you can offer the option of assisted living by simply asking if they have ever considered senior living as a retirement option. Once you have mentioned senior living, expect to have resistance. You may need to draw from your conflict resolution skills you have already prepared for at this point. If they make it clear they want to avoid the subject, then respect your loved one’s feelings and plan to try again later. You may not reach a consensus after the first discussion – this is typical. But giving them time to chew on the idea is a necessary step in the right direction.

If your parents’ health or safety is at risk, consider pushing the issue but proceed tactfully and with compassion. By this point in the discussion, they should understand that you have their best interests at heart. Then and only then have you earned the right to open up and be honest about your own priorities and needs. Make sure your parents know that a senior living community is not just about making sure they are cared for – it’s about your own peace of mind as well. Make it clear to your loved one that you don’t consider them a burden, and you’re trying to do what’s best for everyone. Explain that you cannot realistically give your parent the type of care that an assisted living community can offer. Be positive and mention that there are options that make life easier, safer, more fun, yet independent in many regards. Focus on the positive aspects that this change in lifestyle will bring; the services, the social opportunities, and the security.

Explain to them how the move will impact their life in a positive way but always keep your emotions in check. If you seem sad or troubled about the topic, they may feel that you are planning to send them to some horrible place. On the other hand, if you appear overly excited, they might feel that you are happy to “get rid of them”. This can produce feelings of anger, sadness, or depression about the fact that they are struggling to care for themselves. Try to find a happy medium between these two emotions as your talk continues and beware of phrases that are counter-productive. Here are a few statements of what NOT to say to your loved one whom you feel is in need of a transition to assisted living:

“Change is good!”

“You’ll get used to it.”

“Just trust me; I’m making the best choice for you.”

“You’ll meet friends your own age.”

“Before long, it will feel just like home.”

“It will be a lot more fun than living at home alone!”

Although these statements are spoken with good intentions, you can see how they are “role reversing” in nature. More than likely, the first direct discussion will not be your last. Continue to have honest and compassionate direct discussions but let your loved one feel like they are still in charge and let your parent be the parent.

6. Recruit A Third Party?

If your loved one absolutely will not consider the idea of assisted living, you may need to call in for reinforcements. Believe it or not, it may be easier for them to talk to someone other than a family member. Brainstorm with siblings and other family members about getting another party involved that has some clout. Perhaps a priest or local pastor, a close friend or poker buddy could provide the right influence. Ask them to intervene to the best of their ability. Third parties can sometimes make miraculous headway when family fails.

7: Work With An Advocate

If you notice your loved one is warming up to the idea of assisted living, then it’s definitely time to be prepared and knowledgeable about specific options that are available to you. There are typically two avenues to choose at this point: 1) You can spend hours upon hours researching facilities, driving around, meeting staff and listening to sales pitch after sales pitch or 2) You can have an assisted living advocate who has already done all the work provide valuable and insightful recommendations every step of the way. Such high level advocacy may sound expensive but if you are working with the right company, the cost should be free to you as a client. Transitions Assisted Living LLC, for example, specializes in assisted living Phoenix, AZ and is paid by their respective community partners. They physically visit, tour, meet with administration, get pricing information, and cross-reference all heath records to provide you and your loved one the most accurate fit given your situation, location, amenity requirements and budget. Those who decide to go at it alone usually hit the point of frustration after a day of driving from place to place only to find out the website they viewed was disingenuous or there was a catch in pricing. Save yourself the wasted hassle, time and money and get accurate and quality facility information before visiting facilities.

Once you have consulted an advocate, you’ll have the information and facts about a few local assisted living facilities that can help you plead your case. You can list the positives, as well as the negatives, of each facility. By simply relaying the facts, you can help dispel a few of the negative connotations that your loved one associates with assisted living too.

8. Get Your Loved One Involved

Get your loved one involved right away in the decision making process. Perhaps help them with a list of “must haves” in a senior living facility. Be supportive and try not to attempt to control the process. Ask them what they are looking for in their retirement lifestyle and include them always in the search. Avoid making assumptions about their preferences. Ask open-ended questions that get them to express their thoughts. Remember to let them know that this decision is theirs to make and that you are happy to help in any way. Work as a team with an advocate in your area and plan visits. If you do have questions or concerns as you begin to look, Transitions Assisted Living LLC is happy to help you!

The road from home to assisted living is sometimes long and exhausting. It may take time and a lot of planning on your part to make it as smooth as possible for your loved one. Following these steps will help you work smarter and not harder and be ahead of the curve. In the end, the result will be well worth the effort, as your loved one will feel safe and secure, and you will have peace of mind knowing that they really are in the best place for their needs.

How To Pay For Assisted Living

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“How do I pay for assisted living?” That is the question many adult children will face as their elder parents and loved ones age. Unfortunately, the statistics show that they will face it soon after an unfortunate event or difficult circumstance. Medicaid, Social Security income and veterans benefits are the somewhat obvious options to help pay for assisted living but our experienced senior advisors have compiled a list of additional options you may have not yet considered.

  1. Cashing Out a Life Insurance Policy

A life insurance policy is traditionally purchased with the thought of providing one’s family monetary support in the event of a death. However, did you know a life insurance policy can also provide financial support in the here and now? To cash out a policy, ask your life insurance company about “accelerated” or “living” benefits. Typically, the company that originally issued the policy buys it back for 50 to 75% of its face value. The decided amount is based on the policy amount and monthly premiums as well as the policyholder’s age and health. Different rules may apply depending on the company and type of policy. For example, some policies can only be cashed in if the policyholder is terminally ill; others are much more flexible.

If the insurance company that issued the policy refuses to cash it in, don’t despair. Your loved one also has the option to sell the policy to a third-party company in return for a “life settlement” or “senior settlement,” which is usually a lump sum of 50 to 75% of the policy’s face value. After buying the policy, the settlement company pays the premiums until the policyholder dies. At that point, the company receives the benefits rather than the policy’s original beneficiaries. Another little-known option known as a “life assurance” benefit or a “life insurance conversion program”, allows seniors to convert the benefit of a life insurance policy directly into long-term care payments. Life insurance conversion typically pays between 15 and 50% of the value of the policy which is less than a life settlement — but is available for lesser-value policies that might not qualify for life settlement.

  1. Use an Annuity

An annuity may be a good option if you are concerned about outliving your resources. It can help you be sure that you’ll always have at least some money coming in even if you live longer than you expect. When you purchase an annuity, you pay a lump sum up front and receive regular payments back over a promised period of time – usually the rest of your life. The underwriter of the annuity takes the risk that you might live longer than the money lasts – while the purchaser is satisfied to have the guarantee of regular payments. Keep in mind that underwriters of annuities are not in business to lose money. In fact, an early death is how they earn a profit but annuities can still be a better option for you than just consuming your money year by year. Another benefit of the annuity is that they aren’t fully counted as assets by Medicaid when you apply for government assistance. The income from the annuity is counted as a “resource,” but the much larger sum originally used to purchase the annuity is not.

Annuities are complex financial tools with many variations. Some can be purchased with the understanding of receiving future payments while others deliver immediate payments. Some are based on a fixed interest rate while others work off variable rates. You’ll want to do some homework and talk to a trusted financial adviser about what annuity options might be appropriate for your situation. Be aware that unscrupulous marketing schemes are rampant and annuity fraud is more common than most people realize. These thieves push phony annuity deals by targeting vulnerable seniors through telemarketing, education seminars, and webinars. You’ll want to choose a well-established and reputable company when you buy an annuity.

.3. Use a Reverse Mortgage

The reverse mortgage may be the solution you’re looking for if your loved one owns their home outright or has only a small mortgage on it. A reverse mortgage allows you to borrow money based on equity in your home, which is paid back when you sell the home or move out. The home owner has the option to receive the funds in either in a lump sum or in a series of monthly payments depending on the loan structure. Based on the home’s value, interest rates, the applicant’s age (usually 62), and other factors, the bank will decide on a value. The homeowner gets tax-free cash flow as a loan against that equity–a loan that doesn’t need to be repaid until the house is sold or the owner moves out or dies.

Keep in mind that someone must remain living in the home in order to qualify for a reverse mortgage so there are limited scenarios where this is an option. Consider the scenario of a senior couple where the husband is healthy, but his wife has advanced Alzheimer’s disease. The husband is looking for professional care for his wife and he owns his home outright. They could use a reverse mortgage, cash out the home’s equity, and pay for the wife’s care at an assisted living community with memory care, while the husband could remain at home. The borrower can stay in the home until death, even if the loan balance exceeds the home’s worth. Upon death, the loan balance must be repaid, which usually means selling the home. As a result, it is not a good option for those who wish to keep the home in the family.

Finally, reverse mortgages aren’t for everyone, so it’s important to work with a reputable lender and vet their terms thoroughly. Unscrupulous lenders have been known to cheat senior citizens with mortgages containing punitive terms and fees so make sure you understand the terms and read the fine print. There may also be high fees involved or clauses about homeowners’ insurance, mortgage insurance, and/or keeping the property well maintained. Such clauses can make it easy to lose the home.

  1. Use a Bridge Loan

If your loved one doesn’t have financial assets that are easily liquidated, a bridge loan may be a good option to consider. Bridge loans are short-term loans designed specifically to provide the funds for a move to assisted living. They “bridge” the time gap between the immediate need for assisted living placement and the future expectation of freeing up funds; such as the sale of the home, financial product, or even buying the time needed to obtain veterans benefits. There are two types available: the unsecured and the secured line of credit. The first type is an unsecured (no collateral required) line of credit intended to finance the first months of living expenses while seniors sell their home. Interest rates for these lines of credit range from 8.25 to 12.5 percent, so this option is best used when the time to payback is relatively short. The second type is the secured (collateral required) loan. Since it is secured, it is a lower-interest, lump-sum loan secured by real estate or another asset that all parties agree to collateralize the loan.

Qualification for both types of loans are based on the usual criteria such as debt-to-income ratio, credit history, and credit score. The senior or even an adult child can be the borrower and multiple family members can cosign the loan application. Of course, as with any loan, cosigners are liable if the borrower runs into trouble with repayment so make sure you understand the terms before following through.

  1. Rent Your Home

In circumstances where there is no one to remain living in the residence and the family does not wish to sell, then renting the property may be an option. The idea of being a landlord might seem scary, but for a percentage fee you can hire a service to manage the property for you. Larger acreages or small cabins in the forest, for example, are often cherished by family members. Consider using the rental income to pay for assisted living. In this way, ownership can remain in the family for years to come.

  1. Use Long-Term Care Insurance

If your loved one bought long-care insurance, you’re among the lucky ones. Long term care insurance is an umbrella term for insurance that covers nursing home care, home-based health care and assisted living in addition to other medical services. It can help pay towards the cost of assisted living for those who have a policy but there are a few restrictions. For example, most long-term care insurance policies won’t cover the costs unless the insured is unable to perform two or more “activities of daily living” (ADLS). These activities include such things as bathing, dressing, walking, getting from a bed to a chair, using a toilet and eating. The insurer will usually evaluate with a physician of their choice—not yours—to see if your condition qualifies for coverage. Long-term policies vary in types but the most common is the “facility-only” policy that covers care received strictly in a licensed assisted living facility or skilled nursing facility.

  1. Pool Family Resources

You may be surprised what solutions can be achieved by getting the entire family together to discuss your loved one’s move to assisted living. Brainstorming in a group setting can prompt ideas nobody had thought of before. For example, a sibling with available funds may be willing to pay for assisted living now until the home is sold or other funds are freed up. These costs of funds could amount to a significant savings as compared to a bridge loan. Or, perhaps a sibling would be willing to pay for assisted living for an agreed time period in exchange for a title of some sort or deed. Others may be able to agree to a monthly contribution and the pooling of resources can pay. Communicate with other family members and develop a plan.

These are just a few options families have successfully utilized in the past to pay for assisted living. Transitions Assisted Living is committed to empowering family decision makers with vital information as it relates to assisted living Phoenix, AZ. Though we do not make financial recommendations, we do make it our business to recommend high quality senior care locations that relate best to your loved one’s specific situation. We want your loved one to make a single and successful transition to their new location!

Top 5 Things to Know Before Selecting Assisted Living Phoenix

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Selecting the right assisted living Phoenix location is not an easy choice by any means. The burden of the decision can be an overwhelming and time consuming task for busy parents and professionals. Here are five “must knows” before endeavoring to find the right fit for your loved one.

1) Know Your Loved One – This seems to go without saying but we would encourage you to take the time to sincerely inquire into what‘s truly important to your loved one. Perhaps they are extremely social and would be happier in a community of residents that provide opportunities to meet new friends. Or, perhaps they feel a strong need to remain close to family, so location would be a higher priority than one might think. Take a moment to interview your loved one and prioritize the things that they deem important. You may be surprised and you will have more “buy-in” from your loved one as you narrow your search.

2) Determine a Budget – Determining a budget can sometimes be difficult because it sometimes forces us to face the issue of life expectancy face to face. Smaller monthly budgets may provide duration of funds but higher monthly budgets many times provide additional amenities. Balance is key. Ultimately, the longevity of our loved one is difficult to predict so we encourage families to err on the side of caution in this regard and plan for the long term. Don’t allow running out of funds cause you to lose sleep at night.

3) Determine an Area of Town – Determining an area of town may seem like an easy decision at first glance but when you are balancing a budget, it can quickly become less important. Most of us would prefer to have our loved ones close to our home. However, the facilities near your home may not be the right fit for your loved one or their budget. Don’t allow a small 20 to 30 minute drive keep you from making the right choice. The happiness and contentment of our loved ones should be paramount to our convenience.

4) Research Facilities – There are many ways to research facilities. Most people do their research online and make phone calls but this can many times prove to be frustrating. Although this method is a good initial way to get a general overview of amenities, etc; it is not a substitute for an actual visitation. Keep in mind that many of the top-notch facilities and communities feel little to no need to market themselves. They are established and somewhat content to be at 90-100% capacity so they are sometimes difficult to locate online. Also, remember that getting a price quote of any sort over the phone is near to impossible.

5) Visit Facilities in Person – Although this is quite time consuming on a large scale, this is the most critical step in making a wise decision. Any internet savvy assisted living facility can put up an impressive website featuring seemingly loving caregivers, happy residents, and beautiful amenities. You want to physically visit the facility you are considering for yourself. Let Transitions Assisted Living guide you to the highest quality facilities so that you can see for yourself. When there, watch the caregivers and staff closely. Do they interact with the residents? Do they know their names? How secure is the property? Is the bathroom accessible and have safety rails? Randomly speak to a resident and ask them what they like and don’t like. Look closely and take your time. You’ll be glad you did!