The Challenge of Telling a Parent They Need a Caregiver

In the passage of parenthood there are two conversations that are invariably the most challenging and difficult. One is having the first discussion with an adolescent child about the "birds and the bees." The other is convincing a parent they need a caregiver to safely remain in their homes.

Even elders most in need of assistance for their day-to-day living can be resistant to the hiring of a caregiver. It requires the admission that their independence has forever been lost, and plays to an elder parent's fears about becoming a burden to their children. Author John Wasik excellently covered this issue in a recent New York Times article.

In the more than four years I've spent assisting families address their caregiving needs, I've learned a certain trick that makes accepting the need for caregiving more palatable for a loved one in need of assistance: Don't tell them they need a caregiver. Rather, suggest to the elder they have reached a stage in life where they are deserving of a "personal assistant" to relieve some of the burdens and challenges of everyday living. The thought of having a personal assistant gives the elder a feeling of empowerment and worth akin to the sense of reentering the workforce.

Another helpful tip is to ensure the elder feels in control of the caregiver search process. Being tended to by a caregiver for one's personal needs is highly personal and considerable effort must be spent on the selection search. Technology cannot replace the time and human intervention required for this often long and arduous process. Elders, like individuals of all ages, have myriad personalities and temperaments, and there isn't a "one size fits all" when it comes to caregiver selection. Personal compatibility between seniors and their caregiver is one of the most important factors in assuring quality health outcomes. My family has hired many caregivers over the years for my sister with multiple sclerosis, my grandparents and my uncles who had ALS, trust me the best caregivers fit in like family and the relationship is one of mutual respect.

It can be extremely harmful to force an elder to accept a caregiver who was hired without their input or selection. A family might have to interview as many as a dozen caregivers before finding someone who is compatible and acceptable to their loved one. Quality caregiving companies always have trained counselors to assist families with the process.

Employment longevity also is an important consideration when selecting a caregiver. Once an elder becomes comfortable with their caregiver it's important that they remain in place. Caregivers are among the most exploited workers in America and many aren't paid a living wage. I'm on record supporting the SEIU's "Fight for $15" wage drive for caregivers because if caregivers aren't universally compensated fairly turnover will remain rampant in the industry. If you are paying a caregiver less than $15 an hour, it's unlikely you will retain the professional for any reasonable length of time.

It's also imperative that you pay a caregiver's withholding and other taxes. In part, it's because labor law requires it. But there also is a moral issue: Caregivers routinely live paycheck to paycheck and don't understand the IRS will be demanding its cut of their pay come year-end.

If you are interested in learning more about how to talk to a loved one about caregiving and other living assisted needs, I recommend this AARP primer, as well as retirement author Jack Tatar's interview with actor Rob Lowe.

Yes, even Hollywood celebrities aren't immune to the challenges of caring for a loved one.

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