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The Talk: Discussing Future Housing Arrangements With Older Adults

How to have productive conversations on sensitive topics like aging at home

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​As loved ones age it’s a delicate balance to help them retain independence and dignity while ensuring that their living spaces are safe and comfortable.​

Sooner rather than later, it’s important to initiate “the talk” — or several talks — about planning and paying for where relatives will live as their health or financial needs change. Families often avoid these challenging conversations because they can be uncomfortable and emotional, and good intentions can be misconstrued. But if you delay the discussion until a crisis occurs, such as a fall or early signs of dementia, your options may be limited.

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​“So many people wait and react, instead of being proactive,” says Ryan McEniff, owner of Minute Women Home Care, a provider of home health aides in Lexington, Massachusetts, and a board member of the National Aging in Place Council. “You don’t need detailed plans, but have a couple of building blocks in place. … Do your homework.”​

Experts who specialize in aging issues agree that having the right approach is key. Part of that is making sure that aging adults understand that any concerns for their well-being stem from your love. 

​Try to see the other person’s perspective, and have a collaborative conversation, says Ali Hall, a San Francisco–based consultant with the Motivational Interviewing Network of Trainers. “Having a hidden agenda or manipulating people to do something is not the way to go about it,” she cautions. “Look for solutions together.”​

First, figure out what worries your loved one the most, Hall says. “Usually, people rant about what they don’t want; the flip side is what they want.”

Prioritize autonomy and independence and provide limited, pre-vetted options. Always explain why you’re offering a particular option and ask what the person thinks will work for them. Here are some topics for discussion:​

Aging in place

One of the most important housing questions to ask your family member, Hall says, is, “Do you want to stay here?” The vast majority of older adults want to live in their homes as long as possible — 77 percent of Americans age 50 and older, according to an AARP survey.

If aging in place is the priority, discuss how to make the home safer and more comfortable as needs change, which may require making physical changes and accommodations to the residence. AARP’s survey found that more than a third of Americans envision making simple modifications, such as adding an outdoor ramp or handrails on stairs, with a quarter planning a major renovation, such as building an addition.​

Emphasize the benefits of making small changes, such as improving lighting, to age in place better, Hall advises. Many older people are open to changes, but “the benefits have to outweigh the discomfort of the conversation,” says Lisa Cini, a senior living design expert and founder of Mosaic Design Studio in Columbus, Ohio.​

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Safety at home

What if your loved one falls or leaves the stove on? If physical security is a concern, experts recommend focusing the conversation on your shared values: safety, health, independence, joy and comfort. Consider getting a professional assessment to evaluate the home’s aging-in-place readiness and to identify potential safety hazards.​

“Say, ‘Because X is important to you, what can we do right away so you’re safer in your home? We can try [these options] out and see how they work,’ ” Hall suggests. It helps to provide published materials, like a pamphlet about hip fractures you can review and discuss together, she adds.

​In addition, investigate community-based services and home care help that make aging in place safer and easier. How your family members respond to a variety of options may tell you something important about what they’re thinking. ​

Moving out of the home

One of the most difficult discussions may be about moving an older person out of a longtime home filled with cherished memories and items. It’s a place where they feel comfortable, but at some point it may become practical or even necessary to move into a different living space.​

Having discussions early is key for smooth transitions—whether that involves at-home care, assisted living or memory care, McEniff says. Research what’s available, the differences in living arrangements and levels of care, and costs. In-home nonmedical care is approaching $40 an hour, with weekly minimums, but an overwhelming number of people need only a bit of care, he says.​

Moving in with others

The number of Americans living in multigenerational households has quadrupled since 1971, largely due to caregiving and financial needs, according to a report by the Pew Research Center.​

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If you’re considering caring for an aging loved one in your home, there are many issues to consider and talk about to avoid confusion and misunderstandings, experts say.​

Start by asking what is important to the person moving and to you, suggests Cini, who wrote about her experience sharing a house with four generations of her family for nearly five years in Hive: The Simple Guide to Multigenerational Living. You may want to set some ground rules and boundaries: Are certain rooms off limits? Who will buy the groceries? How will chores be handled?​

Financial issues

These difficult conversations can become even harder when money is involved, experts caution.​

“People don’t like to talk about money. Aging adults feel that it’s none of their adult children’s business or they don’t want to burden them,” says Arvette Reid, client services director at Lifecare Affordability Plan, which helps families plan and pay for housing and health care needs. ​

Step one should be to gather your relative’s financial documents, including wills and bank and pension statements, Reid says. Then investigate options for generating income, such as Social Security benefits, pension, investments, reverse mortgage, long-term care insurance and life insurance.​

Reid and her husband wanted his father to move from his house on two acres to an independent living community closer to them once his eyesight began to deteriorate and he became unsteady on his feet. But he was worried about finances. “He didn’t have a mortgage, so we talked about how he could pay the monthly fee by selling his house,” Reid says. “You have to start asking questions and revealing the reality.”​

In the end, it comes down to peace of mind, for both of you. “The only way you’re going to get peace of mind when it comes to health care and housing is to look at health and wealth together,” she says. “You cannot look at them separately.”​

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