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Opening The Conversation on Care

Molly Rowe owns FirstLight Home Care of Salem, MA with her husband, Steve, and lives in Swampscott with their two sons.

A few weeks ago, I wrote about our regrets related to my father-in-law in the last few years of his life. Since then, I’ve heard many stories from people who’ve shared similar experiences caring for an aging parent or loved one. Every story is different of course, but there’s one sentence I keep hearing over and over: “Looking back, we should have had help.”

It’s mind-boggling to me, really, that we are all in this “caring for our parent” boat at one time or another, and yet no one knows how to row. One of our caregivers said the same thing to me last week as she spoke of her dad, who died of cancer, and how she and her mom took turns caring for him. Between the two of them, they were able to care for him 24 hours a day, seven days a week, but she, too, says, “Looking back, we should have had help.”

We say it, too, but starting the conversation about getting help just seemed too overwhelming at the time. How do you suggest to your parents that they allow a stranger into their house or that they move to assisted living? It’s not easy, we know, but we now know there are ways to approach it.

Ask questions. Don’t start with the words, “You need home care” or “You need to sell your house.” Start the conversation by asking questions: Do you wish you had help with something small, like meal preparation, grocery shopping or house cleaning? Do you feel safe in your home? Do you ever feel lonely? And then really listen to the answers. Your loved one might have needs or worries you didn’t even know about, and if you listen to them, they might be willing to work with you to come up with solutions.

Start small. Propose that they start with a meal service or a home-care visit of just a few hours a week, where the caregiver does laundry or light housekeeping while building rapport. Then, let your mom or dad decide if it’s helping and if they want more care — or none at all. Maybe the help they need is much bigger than a few hours each week, but starting small might make them see that without your forcing it on them.

Empower. A lot of the objections we hear don’t have as much to do with a person not wanting help as they do with a person not wanting to lose their independence. We tell families to let their loved ones be in control by involving them in the decision of what type of care they’ll get, the initial meetings with the caregivers and how often they’ll get care (e.g., every night between 6 and 9 p.m.).

Sometimes, “help” comes in different forms. As I write this, I know none of these approaches would have worked with my father-in-law. He never would have agreed to a caregiver in his home — even once a week — and certainly wouldn’t have moved. But one thing I think he would have agreed to was a personal emergency response system — one of those pendants where he could push a button if he fell or needed help. (This simple tool might have saved his life, actually, since he was home alone when he died.)

If you think the bigger care conversations won’t work, start the conversation here — with an in-home monitoring device to monitor medications, sense if they’ve fallen or even track their whereabouts if they lose their way.

I’m not going to say opening the conversation on care is easy — it’s not — but there are ways to do it that will actually empower your loved one rather than strip away their independence. You’ll both sleep better at night, and in the end, instead of looking back, saying, “We should have had help,” you’ll be able to say, “Thank God we asked for help.”

This article was originally posted in the Swampscott Reporter. FirstLight Home Care of Salem, MA provides non-medical in-home care to adults in Swampscott, Marblehead, Lynn, Salem, Peabody, Danvers, Beverly, and Lynnfield. For more information on the senior care resources in your area and tips for initiating those tough conversations, please visit FirstLight’s website at or contact us at 866-985-4031/

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