Recently I had a get together with a group of friends. We have known each other for over 20 years and gather to celebrate each other’s birthdays a few times a year. As you can imagine there have been a some big “milestone” birthdays along the way. It is truly marvellous that all 8 of us are still doing well and enjoying life. There have been cancer scares, a stroke (very mild, thank goodness) and all the usual bumps and bruises along the way.

Where the years really show, though, is when we talk about our families, especially elderly parents, relatives and friends. In those twenty or so years, six parents have become ill and died, and four older relatives are now suffering from ailments that need, if not hospital care, then at least assisted living. It’s a big strain on my friends, as they strive to make the best arrangement possible given the finances and needs of the elderly.

A common thread is the reluctance of the elderly to accept the help they need. Either they don’t think they need it or they think that with minimal help they can manage in their own homes. That puts a tremendous strain on those trying to make the necessary arrangements. Another common thread, which I think is one of the underlying causes of the first problem, is the difficulty the older generation has in discussing their wishes with those who will be making the arrangements.

Those of my friends and cousins who are finding it easiest to deal with the issues faciong them, are the ones who actually broached the subject years ago with their parents/relatives/friends. They asked the tough questions: Do you have a will? Do you have a power of attorney? Who do you want making decisions for you if you can’t do it for yourself? Where would you like to live if you can’t manage in your home anymore?

They made sure it got documented via wills, representation agreements, powers of attorney.

One of my friends has been quite Machiavellian about her aunt’s situation. She befriended the director of a lovely assisted living facility. The elderly aunt is coming for a visit to my friend’s home, and then they are going to meet the director friend for lunch, except “she’s really busy” so they’ll have to meet her at the facility. Chance for a tour, yes they take pets, isn’t this nice, etc. We’ll see if it works.

On the other hand, one of my cousins has a parent who is very “old school”, from a culture where parents never discuss finances or living decisions with their children. There is no power of attorney or other planning tool in place. My cousin has just about had a nervous breakdown dealing with her father. Things came to a head and she threatened to stop providing 24 hour care. Someone else finally talked some sense into him, sat both parties down and forced them to confront the problems. Things are back on track…for now. But the father is intractable, has a sense of entitlement as big as all outdoors and thinks caregivers are servants to be ordered about. I think my cousin is going to have to apply for adult guardianship to solve the problem.

So what to do? Yes, it is a tough topic to discuss. You can’t just sit down for coffee one afternoon and say “so Dad, what should we do with you when you lose your marbles? When the Depends don’t do it anymore? When the third care giver in a month quits because you are such a miserable old coot?”

Or maybe you can . Maybe it’s better to raise the questions while Dad still has a sense of humour, rather than when he really is a miserable old coot and is no long able to listen to reason. Do it for your own sake, and also for his.