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Having Hard Discussions About Caregiving: Part 1
Need help talking with your parent about their health and care plan? April Suva-Surovi, CDP, shares tips for caregivers on starting this important, yet difficult, conversation. As a senior community relations specialist for Arden Courts - ProMedica Memory Care, she counsels and educates caregivers, family members and health care professionals on topics related to Alzheimer's disease and dementia.
Featured Speaker:
April Suva-Surovi, CDP
April M. Suva-Surovi, certified dementia practitioner, is the senior community relations specialist for Arden Courts Memory Care Assisted Living of Bath, Westlake, Parma and Chagrin Falls, where she counsels and educates caregivers, family members and health care professionals on various topics related to Alzheimer’s disease and dementia. She has been trained on the latest information regarding background information and research related to Alzheimer’s disease and related dementias through our Assisted Living Division training program, seminars and continuing education programs that focus on dementia and senior care, along with partnership educations with area physicians. April currently facilitates virtual Lewy body dementia and frontotemporal degeneration caregiver support groups. Transcription:
Having Hard Discussions About Caregiving: Part 1
Joey Wahler (Host): Planning caregiving for a senior involves difficult decisions, so in part one of this two-part episode, we're discussing how to approach that subject with a parent or another loved one receiving the care. Our guest, April Suva-Surovi, she's Senior Community Relations Specialist for Arden Courts of ProMedica Memory Care assisted living. This is Happily Ever After 40, a podcast from ProMedica. Where we discuss midwife health and wellbeing. Thanks for listening. I'm Joey Wahler. Hi, April. Thanks for joining us for joining us.
April Suva-Surovi: Hi. Thanks for having me.
Joey Wahler (Host): Great to have you with us. So first, if a senior needs caregiving, that obviously comes in various forms. So what are those basic options?
April Suva-Surovi: So, basic options that you look for are home health, somebody in the house, a private duty caregiver to help them. It may be an assisted living, where they need more care with their activities of daily living. It could be a memory care assisted living. It could go into then a skilled nursing facility, a long-term care facility, or even hospice care for that person.
Joey Wahler (Host): So generally speaking, when would you say from your experience is the quote unquote right time to broach this discussion with your parent or loved one?
April Suva-Surovi: Well, in an ideal situation, your parents have already told you their wishes and have their plans laid out for them. But unfortunately in most cases that I have seen, that is not the case. most of these conversations that. adult children are having with their parents are, being had when emergency has happened. I always say if your parents' health is declining, they have chronic issues, they have a significant diagnosis that really affects their activities of daily living, then it's really time to approach that, conversation, and really have tough discussions with them.
Joey Wahler (Host): Well, you make a great point that ideally you want to talk about this ahead of time, but you point out, unfortunately that's usually not the case. How can we try to sort of beat the common trend there? How do you encourage that discussion ahead of time for a change?
April Suva-Surovi: So I'm currently living this situation too with, my aging parents, and that is, knowing what their wishes are, having their plan in place, making sure that they have that list of items that we all need when it comes to planning in order. And that's looking at your will, your healthcare power of attorney, your financial power of attorney, a living will that has your advanced healthcare directives listed. I had a family once show me that their mother listed a facility, an organization that she would want for all her care needs.
She had a home health company listed. She had an assisted living, listed, a memory care assisted living listed, a nursing home and a hospice listed. So I was, I thought, wow, she's like seriously prepared for this situation. and she knew ahead of time everything that she needed. And so if before they have that care needed, if you can have that conversation with your person and your parent to let them know. Listen, if you wanna have the power and control of this situation. So let's talk about this now before you actually need these things.
Joey Wahler (Host): Because if you don't do that, maybe give people an idea of just a couple of issues that can arise if you wait until after the fact.
April Suva-Surovi: Sure. issues that arise is now that emergency happens and now you're struggling for making the correct decision for them or helping them make that correct decision. I always say, first thing to remember is at this point now your parent is losing control over their life. Now they're gonna be scared, they're frightened. We have to make quick decisions. their bodies are failing them, and daily life is starting to look a lot different for them. They're confused and I would say put yourself in their shoes.
And how would you want someone to really have this conversation with you how would you move forward from this? And it can be frightening. And then you're scrambling and you may not make the right decision that you really do need to make for them.
Joey Wahler (Host): Absolutely. And I think most of us of a certain age, as you point out in your situation, have been through this. And so based on experience, we know what some of those pitfalls can be. So as you well know as well, many seniors are reluctant to accept or sometimes even discuss caregiving. What advice would you give in first broaching that and handling that, especially if they're not on board right away?
April Suva-Surovi: So again, remember, Put yourself in their shoes. They're scared, they're confused. There's so many unknowns about the future. and think about how would you want someone to be having this conversation with you. My tips to go forward with this that I found have been really successful, is state the facts kindly in the calm voice. For example, dad, your legs aren't working anymore like they used to and you've had quite a lot of falls. I'm not able to be here to keep you safe from falling as much, and I'd really like, and I want you to be safe. So, state those facts, then give options so that they feel they still have control over their choices.
If you do give options, make sure these options are definitely feasible that will work for you and your family. For example, I'm gonna give you some options that I would like your feedback from them on. And so first option is to have a private duty caregiver come into our home for six hours a day while I'm at work. The other option is to have you move into a senior living apartment like setting where they will take care of you. And after you give those options, be prepared for pushback, anger, any other emotional outbursts. Like, no, I don't want a stranger in my house. I'm not going to live with old people. but always remember to stay calm.
Go back to how you would feel in this moment. Just quick example is my grandmother is 95 years old. She's still living at home. She has one of her adult children living with her. And anytime we broach the subject of, what do you want for your care? You know, let's talk about your power of attorney and your healthcare any of those documents that you should have in place. She goes Right to, what do you want me? And I'm like, we're, you're 95.
Joey Wahler (Host): But it's that feistiness that's gotten her to 95
April Suva-Surovi: Oh yeah. Oh, that's for sure. That's for sure. But you know, at the end of the day when she is gone, my family's gonna be left with a little bit of a mess to handle some of those situations. So, everybody knows their parent. Everybody knows their personality. And everyone's different. And so, going in, if you have your basic tips, it can help you. I have an aging parent who lives with my sister and he's definitely had a change in care needs and his autonomy over his own life was just stripped for him.
So when we lay things out for him with choices, he's been able to really manage those decisions himself in a very less combative way. And so that's worked for us. Another thing quickly to add is sometimes you may need a social worker, a doctor, or a pastor or someone else in their lives that they respect to back you up on this conversation, or they may be the one to have that conversation.
Joey Wahler (Host): Absolutely. All great advice. So besides a senior's overall health, of course, what other factors would you say need to be weighed in choosing the right caregiving?
April Suva-Surovi: So just, beyond their health, everybody's needs are gonna be different. So maybe someone needs, just someone to have eyes on them. Maybe someone needs a specific personality to have them work with them on. For example, now if your loved one has a disease with dementia symptoms, these conversations and decisions are gonna be completely different. If their reasoning and judgment was still there versus not. so each factor is a little different when you're deciding that type of care for them.
Joey Wahler (Host): And caregiving of course can be costly, so cost and available finances and insurance must be weighed as well. What's the best way for a family to calculate what's affordable?
April Suva-Surovi: Sure. Absolutely. and I can speak from when I've sat down with families too. So if your loved one was a planner and had everything in place, they made sure that they put in their, advanced directives and everything, finances available for this type of care. Now there's some situations where they are not gonna have the availability to pay private pay. And that's where I talk to families about, okay, so who's the financial power of attorney? Who's that person who's going to be able to go and look into the finances and see what is available? So I tell them the first thing, see. What assets they have, what they have available to pay privately.
If not, let's talk to somebody who specializes in Medicaid so that you can have that conversation. Do they qualify for Medicaid? Do they qualify for these other services that are out there? Even someone who may have been in the military? There's some veterans benefits. That are available out there for long-term care, for caregiving care. So it's really diving into seeing what's available and ahead of time. Now, like I talked about with those emergency situations, there's families coming to us and saying, I have no idea what's available. I don't even have access to their finances. And that's when somebody's really in trouble when they're not prepared.
Joey Wahler (Host): Absolutely. Well folks, we trust you are now more familiar with discussing caregiving with the recipient, and we invite you to listen to part two of this episode focusing on how to address a loved one's. Caregiving with siblings or other family members as well. April, a pleasure. Thanks so much again.
April Suva-Surovi: Thank you so much.
Joey Wahler (Host): And for more information, please do visit promedica.org. Again, that's promedica.org. Now, if you found this podcast helpful, please share it on your social media and thanks again for listening. Until next time, stay Happily Ever After 40. I'm Joey Wahler.
Having Hard Discussions About Caregiving: Part 1
Joey Wahler (Host): Planning caregiving for a senior involves difficult decisions, so in part one of this two-part episode, we're discussing how to approach that subject with a parent or another loved one receiving the care. Our guest, April Suva-Surovi, she's Senior Community Relations Specialist for Arden Courts of ProMedica Memory Care assisted living. This is Happily Ever After 40, a podcast from ProMedica. Where we discuss midwife health and wellbeing. Thanks for listening. I'm Joey Wahler. Hi, April. Thanks for joining us for joining us.
April Suva-Surovi: Hi. Thanks for having me.
Joey Wahler (Host): Great to have you with us. So first, if a senior needs caregiving, that obviously comes in various forms. So what are those basic options?
April Suva-Surovi: So, basic options that you look for are home health, somebody in the house, a private duty caregiver to help them. It may be an assisted living, where they need more care with their activities of daily living. It could be a memory care assisted living. It could go into then a skilled nursing facility, a long-term care facility, or even hospice care for that person.
Joey Wahler (Host): So generally speaking, when would you say from your experience is the quote unquote right time to broach this discussion with your parent or loved one?
April Suva-Surovi: Well, in an ideal situation, your parents have already told you their wishes and have their plans laid out for them. But unfortunately in most cases that I have seen, that is not the case. most of these conversations that. adult children are having with their parents are, being had when emergency has happened. I always say if your parents' health is declining, they have chronic issues, they have a significant diagnosis that really affects their activities of daily living, then it's really time to approach that, conversation, and really have tough discussions with them.
Joey Wahler (Host): Well, you make a great point that ideally you want to talk about this ahead of time, but you point out, unfortunately that's usually not the case. How can we try to sort of beat the common trend there? How do you encourage that discussion ahead of time for a change?
April Suva-Surovi: So I'm currently living this situation too with, my aging parents, and that is, knowing what their wishes are, having their plan in place, making sure that they have that list of items that we all need when it comes to planning in order. And that's looking at your will, your healthcare power of attorney, your financial power of attorney, a living will that has your advanced healthcare directives listed. I had a family once show me that their mother listed a facility, an organization that she would want for all her care needs.
She had a home health company listed. She had an assisted living, listed, a memory care assisted living listed, a nursing home and a hospice listed. So I was, I thought, wow, she's like seriously prepared for this situation. and she knew ahead of time everything that she needed. And so if before they have that care needed, if you can have that conversation with your person and your parent to let them know. Listen, if you wanna have the power and control of this situation. So let's talk about this now before you actually need these things.
Joey Wahler (Host): Because if you don't do that, maybe give people an idea of just a couple of issues that can arise if you wait until after the fact.
April Suva-Surovi: Sure. issues that arise is now that emergency happens and now you're struggling for making the correct decision for them or helping them make that correct decision. I always say, first thing to remember is at this point now your parent is losing control over their life. Now they're gonna be scared, they're frightened. We have to make quick decisions. their bodies are failing them, and daily life is starting to look a lot different for them. They're confused and I would say put yourself in their shoes.
And how would you want someone to really have this conversation with you how would you move forward from this? And it can be frightening. And then you're scrambling and you may not make the right decision that you really do need to make for them.
Joey Wahler (Host): Absolutely. And I think most of us of a certain age, as you point out in your situation, have been through this. And so based on experience, we know what some of those pitfalls can be. So as you well know as well, many seniors are reluctant to accept or sometimes even discuss caregiving. What advice would you give in first broaching that and handling that, especially if they're not on board right away?
April Suva-Surovi: So again, remember, Put yourself in their shoes. They're scared, they're confused. There's so many unknowns about the future. and think about how would you want someone to be having this conversation with you. My tips to go forward with this that I found have been really successful, is state the facts kindly in the calm voice. For example, dad, your legs aren't working anymore like they used to and you've had quite a lot of falls. I'm not able to be here to keep you safe from falling as much, and I'd really like, and I want you to be safe. So, state those facts, then give options so that they feel they still have control over their choices.
If you do give options, make sure these options are definitely feasible that will work for you and your family. For example, I'm gonna give you some options that I would like your feedback from them on. And so first option is to have a private duty caregiver come into our home for six hours a day while I'm at work. The other option is to have you move into a senior living apartment like setting where they will take care of you. And after you give those options, be prepared for pushback, anger, any other emotional outbursts. Like, no, I don't want a stranger in my house. I'm not going to live with old people. but always remember to stay calm.
Go back to how you would feel in this moment. Just quick example is my grandmother is 95 years old. She's still living at home. She has one of her adult children living with her. And anytime we broach the subject of, what do you want for your care? You know, let's talk about your power of attorney and your healthcare any of those documents that you should have in place. She goes Right to, what do you want me? And I'm like, we're, you're 95.
Joey Wahler (Host): But it's that feistiness that's gotten her to 95
April Suva-Surovi: Oh yeah. Oh, that's for sure. That's for sure. But you know, at the end of the day when she is gone, my family's gonna be left with a little bit of a mess to handle some of those situations. So, everybody knows their parent. Everybody knows their personality. And everyone's different. And so, going in, if you have your basic tips, it can help you. I have an aging parent who lives with my sister and he's definitely had a change in care needs and his autonomy over his own life was just stripped for him.
So when we lay things out for him with choices, he's been able to really manage those decisions himself in a very less combative way. And so that's worked for us. Another thing quickly to add is sometimes you may need a social worker, a doctor, or a pastor or someone else in their lives that they respect to back you up on this conversation, or they may be the one to have that conversation.
Joey Wahler (Host): Absolutely. All great advice. So besides a senior's overall health, of course, what other factors would you say need to be weighed in choosing the right caregiving?
April Suva-Surovi: So just, beyond their health, everybody's needs are gonna be different. So maybe someone needs, just someone to have eyes on them. Maybe someone needs a specific personality to have them work with them on. For example, now if your loved one has a disease with dementia symptoms, these conversations and decisions are gonna be completely different. If their reasoning and judgment was still there versus not. so each factor is a little different when you're deciding that type of care for them.
Joey Wahler (Host): And caregiving of course can be costly, so cost and available finances and insurance must be weighed as well. What's the best way for a family to calculate what's affordable?
April Suva-Surovi: Sure. Absolutely. and I can speak from when I've sat down with families too. So if your loved one was a planner and had everything in place, they made sure that they put in their, advanced directives and everything, finances available for this type of care. Now there's some situations where they are not gonna have the availability to pay private pay. And that's where I talk to families about, okay, so who's the financial power of attorney? Who's that person who's going to be able to go and look into the finances and see what is available? So I tell them the first thing, see. What assets they have, what they have available to pay privately.
If not, let's talk to somebody who specializes in Medicaid so that you can have that conversation. Do they qualify for Medicaid? Do they qualify for these other services that are out there? Even someone who may have been in the military? There's some veterans benefits. That are available out there for long-term care, for caregiving care. So it's really diving into seeing what's available and ahead of time. Now, like I talked about with those emergency situations, there's families coming to us and saying, I have no idea what's available. I don't even have access to their finances. And that's when somebody's really in trouble when they're not prepared.
Joey Wahler (Host): Absolutely. Well folks, we trust you are now more familiar with discussing caregiving with the recipient, and we invite you to listen to part two of this episode focusing on how to address a loved one's. Caregiving with siblings or other family members as well. April, a pleasure. Thanks so much again.
April Suva-Surovi: Thank you so much.
Joey Wahler (Host): And for more information, please do visit promedica.org. Again, that's promedica.org. Now, if you found this podcast helpful, please share it on your social media and thanks again for listening. Until next time, stay Happily Ever After 40. I'm Joey Wahler.