Difficult Dialogues: Strategies for Initiating Tough Talks with Ageing Parents
Roshan Jacob
Social Gerontology Consultant @ advantAGE seniors | Geriatric Care, Consulting | Bangalore
As the time has arrived for you to take on the role of caregiving for your parents, it can be both challenging and occasionally frustrating. After years of your parents caring for and supporting you, the dynamic has now reversed. Many adult children struggle with asking their parents to relinquish their car keys, alter their financial habits, consider assisted living, or accept assistance from an in-home caregiver. While most seniors aim to maintain their independence, they may perceive these suggestions as attempts to undermine their autonomy, even if your intentions are for their best interests. Drawing from our experiences working with numerous older adults, we’ve gained insights from those who have expressed feelings of helplessness, wondering, ‘How Can We Convince My Father? He Will Not Listen.’ Although this journey is far from easy, it’s one that we must embark upon. Engaging in conversations about caregiving, estate planning, and financial management can be challenging, as these subjects may signify a loss of autonomy for your parents. While these discussions may touch on sensitive topics, they are crucial for your parents’ happiness and well-being in their old age. In this article, we’ve compiled our experiences as social gerontologists to help you navigate through some of the most critical talks you should have with your ageing parents. It also includes extensive expert advice on how best to approach these challenging subjects.
As our parents begin to age, it marks the onset of a challenging transition. These parents, once our mentors, nurturers, and educators, are now the ones we worry about and will eventually need to care for. Anticipating the future is a crucial reason to initiate conversations with ageing parents. Typically, there exists a communication gap. Ideally, a range of discussions that should take place but often do not. In our professional experience, such conversations are relatively rare in India. Families often avoid addressing a multitude of critical issues, spanning from financial matters to medical care to long-term living arrangements. Unfortunately, these difficult talks are often dodged as much as possible.
As adult children with ageing parents, the clock is ticking, urging us to prioritise and assemble at the discussion table. Common topics on this agenda include making decisions about finances, health, senior living, and other potentially challenging subjects. Eventually, you’ll find yourself broaching sensitive matters like whether your ageing parent needs home modifications for enhanced safety, considerations for home care, meal arrangements, and transportation. Frequently, family members grapple with initiating these crucial discussions, often leaving them unresolved and causing stress within the family.
Talk about finances and estates
Millions of rupees lie unclaimed in our banks’ vaults, reaching a record Rs. 8000 Cr (2.63 Crore accounts) due to unestablished next of kin for deceased account holders. Recent RBI data reveals that Tiruvalla, a Taluk in Central Travancore with significant foreign remittances, has a staggering 461 Crore unclaimed deposits. The lack of nominations or joint holders complicates the retrieval process when elders pass away, underlining the need to financial and estate planning as a priority.
This age-related issue significantly affects all generations, emphasising the importance of financial literacy for older adults. Discussing finances early, especially when signs of memory loss emerge, is essential. Consult with a Chartered Accountant for financial scrutiny and an attorney to update estate planning documents like wills and power of attorney. Confirm property details and ensure all relevant documents are in order. Taking proactive steps, such as becoming a representative payee on your parents’ account, prepares you for handling their financial transactions in the future.
In the realm of finances, many individuals, both parents and their children, often lack clarity. It’s crucial for adult children to gain a comprehensive understanding of their parents’ financial situation, prompting numerous questions. What investments are in place? Which banks do they bank with? Where is the pension account located? Are there any outstanding debts or mortgages? Where are the share certificates kept? Are there mutual fund investments? Have any loans been extended, and what are the repayment plans? Lastly, what are the current financial obligations?
The narratives we’re about to share have resonated with many of our clients and offer valuable lessons for those with elderly parents. Based on these compelling accounts, we advocate for proactive measures to prevent financial predators from taking advantage of vulnerable situations.
In a sudden turn of events, 82-year-old Vishwanathan fell ill, and over the past few months, his son frantically searched for answers. Eventually, he discovered that his elderly father had unknowingly sold the highly valued Infosys share certificates along with old newspapers and magazines. This discovery led to blame games between father and son, each accusing the other of misplacing the certificates. Unable to bear the burden of responsibility for the lost certificates, Vishwanathan’s mental health deteriorated, resulting in a diagnosis of severe anxiety disorder.
Savitha Kerkere, a 76-year-old widow in good health, was approached by her young neighbour seeking a short-term loan of 25 lakhs to start a restaurant. Touched by the neighbour’s sweet talk and the plight of losing her job, Savitha extended help, unknowingly setting the stage for a story of deception. Savita aunty, without consulting her children living abroad, displayed uncharacteristic generosity, leading to feelings of heartburn among them.
After 34 years of service at BPCL, 68-year-old Ramdas Menon relies solely on the interest from his bank deposits since there is no pension in his public sector retirement. A financial planner convinced him to venture into the share market for ‘hefty returns,’ and without seeking advice, he closed the deal. The result was a significant loss, leaving him in a state of depression today.
Promila Madhav, a 72-year-old unmarried socialite with a tough demeanor, sold her inherited property worth millions two years ago. Raghu and his gang, noticing her substantial fortune, took advantage of her isolated life and estrangement from nephews and nieces. Raghu, a former employee dismissed from a private bank, insinuated himself into her life during her hospital stay for surgery, posing as a well-wisher. Subsequently, Raghu manipulated Promila, a perfect stranger to him, to handle her affairs and swindled significant amounts.
Kasturi Mahadevan, an 82-year-old devotee of a mutt following her husband’s tragic road accident, found solace in spirituality as her daughters reside in the US. A mutt functionary influenced her to part with her prime locality house and used undue persuasion to draft a will in favor of the ashram. Despite intending to donate a substantial sum to the mutt, the crafty functionary tricked her and claimed the money in his name. Uncovering various shady dealings in the mutt’s name, the Seer terminated him, revealing how Kasturi was deceived under the guise of spirituality.
Vishwanathan, Promila, Savitha, Ramadas, and Kasturi have all fallen prey to financial deceit in their later years, to some extent, attributable to their own actions. It underscores the importance for adult children to discern when increased involvement in their elderly parents’ financial management is necessary. Indications that aging parents may require assistance include late bill payments incurring fines, unpaid taxes for consecutive years, creditor calls, and questionable investment decisions. Additionally, suspicions of parents being targeted by con artists or making large donations to dubious charities may warrant heightened vigilance.
Financial abuse is a common thing in later life. It can occur either through exploitation by strangers or, in milder terms, through “financial misappropriation” by one’s own child or close relative. Financial abuse can occur when a family member or friend takes over financial decisions and controls older adult’s money without his or her consent. Financial ‘neglect’, though more or less same has a slight difference and occurs if a family member, friend or power of attorney controls the money but disregards the older adult’s financial obligations or does not fulfil instructions under the power of attorney.
Financial ‘abuse’ and ‘neglect’ negatively impact the trust among family members. Adult children may not consider or realise that their actions are financially abusive or neglectful toward their parent(s) as most of them feel it their ‘right’. After all, ‘I am going to inherit’ attitude, so why not.
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Common examples of financial abuse include:
Similar issues affect estate planning, akin to the challenges we discussed regarding financial planning. When parents lack a comprehensive estate plan, extending beyond just a will, there’s a significant chance of enduring prolonged courtroom struggles to prove your entitlement to your parents’ property. Such distressing experiences compound an already difficult period, diverting attention from familial matters. Many adult children remain uninformed about their parents’ properties, with some never having visited these locations. Sadly, those settled elsewhere might not harbor interest in inheriting these properties. Complaints from older adults about their children’s disinterest in both landed and residential properties are not uncommon, as the latter might prefer more luxurious living spaces.
Mathukutty, fondly known as ‘Mathukuttychayan,’ has dedicated his entire life to being a planter, overseeing expansive hectares of coffee plantations. Today, he finds himself in a state of concern as old age sets in. Although he projects an image of contentment externally, the reality is marked by profound distress. His two sons, unfortunately, show no inclination to return to India and take charge of his plantations. Despite numerous requests, children have unequivocally rejected any involvement with the estates. Mathukuttychayan and his wife, both in their early seventies, grapple with uncertainty regarding the management of these properties. The estates, in essence, confront an existential crisis.
If your children exhibit disinterest or lack the capability to manage your properties, it’s advisable to liquidate these landed assets at the earliest. Mere sentimental attachment, whether it be due to cultivating the land or inheriting it from ancestors, shouldn’t compel the new generation to follow in your footsteps. Property transactions often take a considerable amount of time compared to other investments. As an elderly person, delaying this decision may mean missing out on enjoying the proceeds from the sale. Initiate a discussion with your children, and if the consensus leans towards not retaining the properties, it’s prudent to find a new owner as promptly as possible.
Dividing immovable properties isn’t a simple task, as differing opinions among beneficiaries can lead to complications. Family discord often arises when parents leave property to multiple beneficiaries, especially when it involves assigning value and liquidating sentimental or high-value assets like a family home. In the case of Suchitra, the younger sister emotionally attached to her parents’ house and residing in it, conflicting with Susheela, the eldest, who urgently needs financial resources. Resolving the inheritance split becomes a challenge. We were successful in facilitating negotiations between the sisters to avoid legal proceedings. In situations where a parent becomes incapacitated or passes away without a will, the potential for bitter disputes among siblings looms large.
Despite the urgency of the matter, estate planning often doesn’t find its way to family discussions as parents age. Surprisingly, it should be a priority for older individuals. A US legal referral site indicates that 64 percent of Americans, which could be around 95% in India, lack a will or trust. Failing to plan ahead can create substantial emotional and financial challenges for those left to handle the intricacies of a loved one’s estate after their passing.
Talk about plans for long-term care
Indians are experiencing longer lifespans each year, but many will eventually reach a point where independent living becomes challenging. Unfortunately, numerous older adults struggle to come to terms with the changes and diminishing abilities that come with aging. While some elders acknowledge the decline in their memory or the difficulty in managing day-to-day tasks, others may be unaware that things are slipping through the cracks. Some are well aware of the challenges of advanced age but choose to avoid addressing them, while others remain oblivious. Our experience highlights that only a minimal percentage of adult children have conversations with their aging parents about plans for when independent care becomes difficult. Surprisingly, only 10 percent engage in discussions about plans for their disabled years and the financial aspects of their care as they age.
In the contemporary world, expecting you or your spouse to provide full-time care, including bathing, feeding, and managing eliminations for an aging parent, is unrealistic. It’s important to communicate that you lack the necessary skills and capacity for a full-time caregiving role, especially with other work commitments. The solution often lies in seeking home assistance during the twilight years. Another critical consideration is where your parents will reside. While many elders express a strong preference to age in their own homes, this may not always be practical. Some may insist sentimentally, citing aspects like “I had my childhood” or “My parents’ memory.” However, the feasibility of staying alone in the house must be thoroughly discussed.
We see terrible things happening for want of a timely action. Mostly the damage is irreversible which is a high price you paid for not getting help when the help is needed. We see untoward incidents, like people getting scammed, or failing to take care of serious health problems, or when they’re not supposed to drink alcohol and failing to take medications.
Research indicates that one in three adults aged 75 and above faces cognitive and physical impairments, leading to challenges in handling Activities of Daily Living (ADLs). This leads to issues like inadequate nutrition, irrational behavior, and forgetting to take medications which in turn will lead to serious health consequences. Without daily support and monitoring, these individuals are prone to serious mishaps. For those experiencing such difficulties, “aging in place” becomes impractical. However, convincing elders to consider alternatives can be challenging, as many prefer their final years in their own homes. Children often find it challenging to convey the unsuitability of living alone, leading to the next option—arranging full-time caregivers.
Certainly, the most significant risk for seniors living independently is the potential for falls. The use of numerous medications (polypharmacy) can induce dizziness, amplifying the risk of falling. Additionally, the physical frailty that often accompanies aging becomes a contributing factor. If your parent resides alone, they may take inappropriate risks, such as climbing on a chair to change a light bulb, or they might forget to turn on a light at night. A fall marks the start of a series of events with significant health consequences, from which a senior may not fully recover.
When broaching the topic of a long-term care plan, remember to include a discussion about the associated costs. It’s advisable to initiate this conversation sooner than later for better preparedness. Unlike some other countries, long-term care insurance is not available here, necessitating the allocation of a considerable amount for long-term care.
In a previous chapter, we compared home care to care facilities. It’s crucial to reiterate that, in our perspective, as long as your parents are healthy and independent, staying in their homes is advisable. Avoiding a move to a retirement home is important to prevent potential psychological impacts of uprooting from a familiar environment. When you observe that your parents can no longer manage independently, it’s time to discuss long-term care. Depending on the nature of their condition, considering institutionalisation might be necessary for optimal management, especially if constant monitoring and round-the-clock assistance are required.
Before discussing institutionalisation, ensure your points are supported by factual information. Elders appreciate honesty, so avoid bluffing. Instead of casually mentioning a move to a care facility, persuade them by highlighting the potential benefits. Conduct thorough research: What type of care facility aligns with their preferences? Consider factors like religious traditions, community reputation, and the qualifications of those in charge, especially in social gerontology. Evaluate financial aspects, such as entrance fees, monthly costs, or foster care contracts. Scrutinise amenities, protocols, hygiene standards, emergency procedures, preventive care, food quality—essentially, ensure the care facility fulfils their needs and expectations.
Many, including seniors, harbour skepticism about “old folks homes.” It’s crucial to dispel myths surrounding senior living facilities. Those who haven’t experienced assisted living or skilled nursing homes often envision dreary, boring places. Your parents might share this perception, resisting institutionalisation. Clarify that modern care facilities, regardless of the label, are no longer the traditional old age homes. Instead, they offer controlled environments designed to boost health. Emphasise how your loved one can thrive in such a setting, receiving superior care compared to staying at home. Highlight the presence of expert staff available 24/7 for medical assistance and other needs.
Here’s a final piece of advice: Organising your parents’ affairs isn’t just about preparing for the end; it’s about ensuring things are managed in their way and the right way. Throughout the years, they’ve handled things on their terms, and that autonomy can persist. Encourage them to see this as a significant financial and lifestyle decision, emphasising your support for their choices while prioritising health and safety. Together, you contribute to shaping the last chapter of your parents’ remarkable legacy.