At Group Homes Australia, we pride ourselves not just on our model of care, but our willingness to help and support each community member. Tamar Krebs is the founder and co-CEO of Group Homes Australia. Tamar has worked in the Aged Care industry for the past 15 years both internationally and Australia. She has held senior management and leadership roles operating Retirement Villages, Hostels, Nursing Homes and Dementia Units. Tamar provides practical advice on starting the conversation about the ageing journey.
“We make lots of plans during our lifetime: plans for what school to go to, where to go on holidays, our careers, planning and choosing the suburb we want to live in and the home we may one day purchase. And yet as a society we don’t plan well for ageing – is that because it scares us?”
We have to talk about ageing, because we’re all getting older. For people diagnosed with dementia, this is a particularly pressing challenge, where changes to memory and communication make decision-making progressively harder. Although dementia may not be part of everyone’s ageing journey, it’s still a conversation that needs to be had, early on.
Here are 6 tips to having a constructive conversation about the ageing journey and planning:
1. Start the conversation early
Start the conversation early about growing older and planning for later years with your family. Find out the wishes of your loved ones while they are in their 50s and 60s. Ageing is not a very “sexy” topic of discussion it also may be perceived as depressing, and so we push off having the difficult conversations until sometimes it’s too late, and a decision get’s made for the person without their involvement.
2. Start by asking the big questions
- What’s important to you?
- What are the things that you want to make sure you keep doing?
- What are the things you want to make sure that you never have to do?
- What are the environments you want to live in?
- What should the family do if they can’t offer enough support?
- What matters to you in the end?
Having the conversation earlier has financial benefits too. If you want to stay at home, private care can be expensive. A plan may include starting to save for your future care earlier. Even house modifications may come into the discussion if you live in a two-story home.
3. Keep everyone focused on the conversation
In our experience at Group Homes Australia, when we ask about end of life wishes; most people say their preference is to stay at home until ‘the end’. It can be uncomfortable to press on with this conversation, to push the issue – but taking that conversation one step further is so important. For example you may ask the person, ‘Let’s say you weren’t able to stay at home, what would your preferences be?’ It may mean returning to the conversation later, when the person may be more open and comfortable to the idea of talking about their future.
4. How do you involve your loved one with dementia?
For people living with dementia, ideally making plans should begin early in the process of accepting the diagnosis – before the cognitive impairment makes it harder to follow discussions and consider options. Don’t leave the conversation until it’s too late, so the person can no longer be part of the decision. If relatives are left guessing (‘Well what would mum or dad have liked?’), it may have long term impacts emotionally for the entire family.
5. Know the whole person
If you can’t involve your loved one in the entirety of the decision-making process – if there is a sudden change in their circumstances or health – try to involve them in any aspect of the decision making process, where possible. Call on everything you know about the person and what is important to them and try to make decisions that reflect this. For example, is the person a keen gardener? Are there opportunities as they grow older, to get them more involved in gardening? Whether this is adapting their existing garden at home, or providing guidance for a younger keen gardener, to be able to capture their expertise, maintain their relevance and validate them.
6. Work through facts and feelings
If your loved one has decided to move into care, gaining clarity and alignment of views is a critical step in the decision making process. What is it that we’re looking for? And what is a realistic expectation that an aged care facility can provide? Residential aged care can be close to being cared for by the family, but it’s not the same. For families and partners, there’s usually a lot of anticipatory grief associated with these decisions, and you may wrestle with expectations, hopes and fears.
The last word
For most people, growing older can be, emotional and complex, and it can take many different turns. Don’t wait for a crisis to have a conversation and to make the difficult decisions.”