Let’s talk home care: Tips to start the conversation, address concerns

July 3rd, 2017

By: Sharon Roth Maguire, MS, RN, GNP-BC

Many people shy away from discussing issues surrounding aging, especially when decisions could threaten an older person’s independence. While these conversations aren’t always easy, they’re important to have to ensure your parent can continue living safely at home.

Some seniors need just a little help, such as with chores around the house or grocery shopping, to maintain their independence and energy. Others may need more advanced help with showering or taking medications to safely remain living at home. Home care services can assist in all these situations.

I urge you and your parents to discuss home care preferences early and often – and not just after a problem or crisis arises. The sooner you start talking about it, the better prepared you and your loved one will be should the need for home care become reality.

Let’s talk about how to initiate a compassionate, productive conversation about home care, strategies to deal with three common concerns, and what to do if you live far away from your mom or dad.

How to initiate a home care conversation

First, know that this will take more than one discussion. Think of each conversation as a “dose” that makes decision-making more palatable for you and your loved one. You may have 10 things you want to discuss, but maybe only talk about one or two at a time.



Ideally, your first conversation will be about their wishes for the future and will not require a concrete decision about something. You could open with something you experienced in real life or saw on TV. For example, “I was talking to my neighbor and they mentioned they’re getting some help from a home care company. I realized I don’t know how you would feel about that if you need a little help someday. Could we talk about that?”

Be honest, but also sensitive to your parent’s feelings. This conversation can put seniors in the delicate spot of realizing or acknowledging they’re not who they used to be and they may need some help. You want to be an ally, not an adversary, to their desire to live independently. You don’t want to push them away or make future discussions more challenging.

Ask what’s important to them. Would they prefer a male or female caregiver, particularly if at some point they need help with personal care? Would they be more comfortable with someone who speaks their language?

Here are a few more tips to follow when discussing home care with your loved one:

  • Make it a team effort: If you start the conversation with, “I already researched …,” it sounds like you’ve made the decision for Mom or Dad. Instead, say, “Let’s research what options are available together.”
  • Begin with less personal services: “Home care” includes a wide range of services. Don’t dive into the home care discussion by immediately suggesting help with something like bathing. Instead, ease into the conversation by proposing a less-personal service, such as housekeeping or meal preparation.
  • Don’t force your agenda: If your parent resists discussing home care or flat out refuses, give them space to think about it. Unless there’s an immediate safety concern, it’s OK to say, “I understand you don’t want to discuss this right now, but would you think about it, and let’s revisit it in a few months?” I call this loving persistence. You also can make the thought of home care less scary by saying, “What if we just try it? It’s not permanent, and if you don’t like it, we’ll stop.”

Finally, you may not always agree with your parent’s decisions. But you need to recognize and respect their right to make their own choices.

3 common objections seniors have when it comes to home care

Once you get the conversation going, be prepared for your parent to have concerns or push back on the idea. Here are three common objections that families we work with say their loved ones have, along with strategies to deal with them.

1. I don’t need home care

No one wants to be perceived as incapable. And while you may see a decline in function in your parent, they may not see it – or they may not be willing to acknowledge or admit it.

Be sensitive to your parent’s feelings and ego. Some seniors may find it offensive if you start the conversation with, “You need help.” They may think, “What do you mean I need help? I made it to 90 without help, and I don’t need to start now.” Instead, frame the discussion as “I want to help.”

Most parents don’t want their children to be worried or upset, so speak to that as well. “There are many things you can still do for yourself, Mom, and we want you to keep doing them. But it will make us feel better knowing you’re getting a little help with your housekeeping.”

2. I can’t afford it/You can’t afford it

Money can be just as sensitive a subject as home care. First, establish and understand who will pay for home care services. Will it be your parent, you and your siblings, or you only?

Check with your parent’s insurance company to find out if they will cover services, and which ones. If your parent or their spouse is a veteran, they may qualify for certain services. Contact your parent’s community aging and disability resource center to find out if they qualify for local programs available to income-eligible individuals.

Then you can say to your parents, “We’ve learned that on average, it costs ‘this much’ for four hours of care a week, which is probably all you need. That’s affordable, Mom.”

3. I don’t want a stranger in my house

Many people feel uncomfortable at first having someone they don’t know in their home. Assure your parent that they’ll have the chance to meet and interview any potential caregiver.

They also may be concerned about the potential for stealing. Again, remind them that you’ll only employ a company that uses rigorous screening practices when hiring, including background checks and drug tests.

What can you do if you live far away?

If you don’t live near your parent, initiating a home care discussion may be more difficult. You need to be even more mindful about what you know and don’t know. No one likes for people to make assumptions about them.

Visit your parent to determine how they are doing and what is going on. Trust me, the cost of a plane ticket will be worth it. You may find they are doing better than you thought. If that’s not the case, you can have a conversation in person and talk specifically about how home care may help them.

When you can’t be there in person, touch base with them regularly. This could be an old-fashioned telephone call, but don’t rule out a video call using FaceTime or Skype. You’d be surprised how capable many seniors are with technology. They want to see the grandkids! Video calls can be useful to see how they and their surroundings look. Are they brushing their hair or putting on makeup as usual? Are there dirty dishes in the sink or is the trash piling up? These visual cues can give you insights as to how they are doing on their own.

You also can enlist the assistance of friends, neighbors or church members to check in on Mom or Dad to ensure their safety and health. Finally, if you have siblings, keep in regular contact with them so everyone remains informed and on the same page regarding how your parents are doing and what their wishes are going forward.

Home care is a sensitive topic, but it doesn’t have to end in a fight or hurt feelings. By starting the conversation early, listening to and respecting your parents’ wishes, and exploring options together, you can help your parents live safely and happily at home.

To learn how BrightStar Care may be able to help your parent live safely at home, call 866.618.7827 or contact a BrightStar Care® home care agency near you.

Topics: General Health