There may be no more challenging conversation to have with a parent than telling them they need to move to a nursing home. You may be familiar with hearing your parent say the phrase, “Promise me you will never move me to a nursing home.” But care needs change, and it may become necessary. Your promise may need to be revised so your parent can get the care they need. Here, we offer ideas about how to prepare to talk with your parent about moving to a nursing home, approach the conversation, and mitigate potential issues to minimize conflict.
Prepare for the conversation about a move to a nursing home
You may not know how this conversation will go, so prepare for strong emotions at first. Your parent may blame you and express anger and resistance. Recognize that these emotions reflect their fear of disempowerment and losing independence. Your goal is not to try to fix or rectify these emotions but to accept them and acknowledge their valid feelings.
A legitimate question your parent may have is why a nursing home is required. Discuss the value and benefits of nursing home care in the context of your parent’s care needs. Remember that nursing homes offer the highest level of care besides those offered in a hospital setting. Therefore, your parent’s needs may be too great for an assisted living community or require an amount of time from a home care provider that would make the home care cost unaffordable to you. A nursing home may be their only option. Be as specific as you can about how this level of care is necessary for recovery and safety.
Choose the right time and place
Your parent may currently be in the hospital, a rehab, an assisted living facility, or at home, but consider the timing and place for the conversation regardless of the setting. Choose a time when your parent is more alert and calm. For some people, this will be in the morning, and for others, it will be in the afternoon. Ensure that the location is quiet and calm without distractions. Having a sibling with you or another family member may be helpful. A group of people can feel overwhelming and threatening, so keep the group small.
Address fears and misconceptions about nursing homes
Invite your parent to talk openly and honestly about their feelings and fears. Their feelings are valid, but fears may be based on nursing home myths. You can try to address concerns head-on with solutions and facts. For example, provide solution-based reassurance if your parent worries about the quality of care or privacy. Let them know the types of staff members who can assist them with certain care needs and that there are multiple shifts to ensure that help is available at every hour.
Reassure your parent that you will visit
Your parent may be concerned that if they move to the nursing home, they’ll get lonely and have no visitors. After all, if you have been their caregiver and now the nursing home will take your place, will they stop seeing you? You can address that concern by considering your schedule beforehand and offering a tentative visitation plan. The schedule can evolve to suit both of your schedules, but outlining specific days and times when you’ll visit may put them at ease.
Also, you can tell your parent that the time you spend together moving forward will be quality time instead of focused on caregiver tasks. In fact, they may find the time you share to be more enjoyable since you can focus on catching up and bonding with one another.
Consider involving other professionals
If it is helpful, consider asking for assistance from other professionals. You might talk to their physician, a geriatric care manager, or someone from their religious community. Sometimes, another person’s objective perspective can reinforce the need to move to a nursing home in ways that are more acceptable to your parent.
If you attend doctor appointments with your parent, consider asking their general practitioner or specialist to talk with them about the advantages and positive health outcomes of moving to the nursing home. If your parent can hear directly from their health care provider how the nursing home’s services can help them better manage their chronic condition, they may be more open to the idea.
Provide as much information as possible
Often, fear is based on not knowing what to expect. Provide as much detailed information as possible, such as what your parent can bring with them, the schedule of care, activities, visiting hours, and meal preferences.
Cost may come up, which is a valid concern. Be prepared to discuss ways to pay for nursing home care.
If your parent refuses to go to a nursing home, discuss the consequences of that decision, such as health and safety concerns.
Emphasize the positives of a move to a nursing home
Offering hope while keeping expectations reasonable can be a tricky balance. Achieving this balance will depend on your parent’s personality and your relationship with them. If recovery is possible, emphasize how round-the-clock care can support that goal. If recovery is unlikely, staying positive and making the experience valuable is still important. Work with your parent to identify which family and friends they’d like to visit with, and offer to schedule frequent visits with these individuals.
Focus on your relationship
Sometimes, the relationship gets lost in the chaos and confusion of significant care decisions. Decline, disability, and dependence are challenging for parents and their adult children to navigate. There is no road map for preserving a long-standing relationship that has now changed. Try focusing on the heart of the relationship whenever possible, and include humor, stories about grandchildren, and topics of interest to your parent. Remember that relegating your parents’ care to the hands of professionals will give you more time to focus on your relationship and spend quality time together.
Approaches to avoid
The goal of discussing a move to a nursing home should be preserving your relationship with your parent while ensuring their health and safety. Although your parent’s reaction isn’t in your control, how you conduct yourself is. Here are some recommendations on approaches to avoid:
- Don’t be forceful. No one likes being told what to do, so avoid being forceful. Try an inclusive and cooperative approach to help your parent come to a place of acceptance.
- Avoid fear tactics. Perceived or real threats can cause lasting harm to a relationship and are unlikely to work anyway. Your parent has the right to make their own decisions, even if you disagree with those decisions.
- Don’t distort the truth. There may be damaging repercussions if you aren’t truthful about nursing home care. If you don’t have answers to specific questions, be honest and say you don’t know but will try to find out.
Talking with a parent about moving to a nursing home won’t be easy. Accept the outcome, knowing you have approached the conversations with reasonable expectations, compassion, flexibility, and respect.
