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Your long-term care conversation guide

three women sitting on couch talking
November 20, 2023
Talking with our loved ones about long-term care needs – either now or in the future – can be difficult. Here are some tips to help your family start the conversation.

People often don’t want to think about a time in the future when they or a loved one might need support to live independently, and it can be even harder to accept they’ve already reached a point where they need more help. Most of us will need long-term care at some point in our lives, so it’s important to make a plan for yourself and your loved ones.


Start by learning the basics

Before you start the conversation, you may want to get familiar with the basics of what long-term care includes. It doesn’t have to mean care in a residential setting like a nursing home or assisted living! Long-term care also includes services and supports provided in your own home. Most people with long-term care needs can stay in their own homes, as long as they have the right supports in place. (And in the future, the WA Cares Fund will be available to help people age in place in their own homes for longer.)


Understanding the wide range of services and supports available, including in-home care, can be reassuring and take some of the pressure off during your conversation by providing more options.


Have the conversation long before care is needed

To avoid the difficult feelings that come with these conversations, many families skip talking about long-term care until the need is urgent. But at that point, not having a plan to rely on can make the experience of navigating a care need even more painful.


Is your family gathering for Thanksgiving or winter holidays? Consider having an initial talk with your loved ones about the future when you see each other next. Long-term care needs can be sudden and don’t always wait for us to age, so the sooner you can start the conversation about planning, the better.


Pick the right time and setting

You want to make sure everyone is comfortable and able to focus on the discussion, so try to find a location and time that will work for your family. Minimize distractions like noise and other activities that demand attention. Make sure you’ll have enough time for a meaningful discussion.


Ease in with a conversation starter

While you’ll eventually want to make a detailed long-term care plan and get the whole family on the same page, you may find it easier to start small – especially if your family isn’t used to talking about this topic.


Try asking big-picture questions like “have you ever thought about where you want to live in the future?” or “as you get older, what activities do you want to make sure you can keep doing?” You could also start by mentioning a news article you read on long-term care, like this recent story from the New York Times, or bringing up a friend or family member’s experience with needing care. Then, ask if your loved one has thought about how they’d want to get care if they needed help with daily activities.


Keep the conversation going
Once you’re ready to talk details, it can be helpful to hold a dedicated family meeting to start making a formal long-term care plan with everyone who might be involved in care. You may even want to include a trusted friend or an adviser like a faith leader to help facilitate the conversation.


Remember you’re probably not going to be able to cover everything you want to discuss in your initial conversation. Your loved ones may not be ready to talk when you first bring up the topic, so be patient and keep checking in! Your and your loved ones’ wishes and circumstances can also change over time.


Having multiple conversations also reduces the pressure to decide everything right away and gives family members time to do research and think more about what you’ve discussed.


Approach the conversation with empathy

Listen carefully and with an open mind to what your loved one says with an open mind. Ask for their input instead of assuming you have all the answers. Express your understanding of their feelings, which might include discomfort, reluctance, fear or even anger, and acknowledge that this is a hard topic for all of you. Especially if you’re a parent or adult child, the role reversal of who is advising or caring for whom can feel very difficult.


“I” statements can be helpful for expressing your care and concern without making your loved one defensive. For example, instead of saying “You need to make a plan now or you’ll be in trouble later when you need care”, you could try saying something like “When I think about the future, I worry about how to make sure you get help if you need it. I think it’s important for us to talk about a plan together so we’re all prepared.”


Keep an eye out for signs you or your loved one needs help now

Have you noticed recent changes in yourself or your loved one that make you concerned? These could be mental changes, like memory loss that disrupts daily life and difficulty with more intensive mental activities like multitasking and using a computer. Or it could mean physical changes, including anything from injuries caused by an accident to increasing difficulty getting around the house. You may also notice you or your loved one are having trouble keeping up with routine tasks like house cleaning or groceries.


If you’re concerned about memory loss and mental difficulties, the Washington State Dementia Action Collaborative’s Dementia Road Map is an empowering, action-focused guide to help you understand and address every stage of dementia. It also includes detailed communication tips for talking with a loved one with dementia. Beyond dementia, the National Institute on Aging’s The Caregiver’s Handbook may be helpful for figuring out whether your loved one needs help and where to start as a caregiver.


Your local Area Agency on Aging is another excellent resource if you need help finding services and support in your community.


Check out our webinar

Interested in more tips? You can find a recording of our recent WA Cares Conversations: Talking With Loved Ones About Long-Term Care webinar on YouTube.