The Other Talk
A Guide to Talking with Your Adult Children about the Rest of Your Life
By TIMOTHY PROSCHMcGraw-Hill Education
Copyright © 2014 Timothy Prosch
All rights reserved.
ISBN: 978-0-07-183098-0
Contents
ACKNOWLEDGMENTSABOUT THIS BOOKINTRODUCTIONPART ONE Why Have the Other Talk?CHAPTER ONE Defining the Dimensions of the Other TalkCHAPTER TWO Recognizing the Negative Consequences of SilenceCHAPTER THREE Appreciating the Benefits of Family CollaborationCHAPTER FOUR Navigating the Baby Boomers' Perfect StormPART TWO Getting Ready for the Other TalkCHAPTER FIVE Setting the StageCHAPTER SIX Getting Your Documents in OrderPART THREE Turning the Other Talk into an Action PlanCHAPTER SEVEN Financing Your Uncertain FutureCHAPTER EIGHT Selecting the Best Living ArrangementCHAPTER NINE Getting the Medical Care You NeedCHAPTER TEN Taking Charge at the End of Your LifeCHAPTER ELEVEN Being There for Your KidsAPPENDIX A. SOURCESAPPENDIX B. ONLINE RESOURCES FOR THE OTHER TALKAPPENDIX C. TOOLS AND TIPS FOR THE OTHER TALKINDEX
CHAPTER 1
Defining the Dimensions of the Other Talk
I'll never put my kids through what just happened to me with my parents!
—Several focus group participants
Do you remember how difficult—and absolutely necessary—it was when it came timeto sit with your kids to have "the Talk," the one about the birds and the bees?If you are anything like me, your initial reaction was to procrastinate, to keepthe door firmly closed on any conversations that revolved around orgasms andvaginas and penises with your kid (in my case, a 12-year-old daughter).
But why would I even consider putting off a conversation that was so critical tothe future well-being of my child? There were three reasons:
1. It was an emotionally challenging subject. It was uncomfortable andembarrassing to sit down with my daughter to explain how the body parts interactand what the physical sensations would be.
2. It acknowledged an inevitable transformation that I didn't want to face. Ifwe didn't have the Talk, I could hold on just a little longer to my fantasy thatmy little girl, my bouncy, energetic, wide-eyed, giggly preteen, would remainjust that ... forever.
3. I wanted to maintain the existing parent-child relationship. I could pretendthat our relationship would never change. We'd still read the Sunday comics onthe couch, I'd still help her with her homework, and I wouldn't have tocontemplate some boy mauling her (or, God forbid, vice versa) in the backseat ofhis car.
Because of the anticipated discomfort for me, my wife, and my daughter, I evencontemplated the sex-talk drive-by, where I would drop off the brochures on herbed with the note, "Let me know if you have any questions." As a result, I couldstay hidden behind "the birds and the bees" euphemism and avoid any realsemblance of a two-way dialogue.
Ultimately, I decided not to procrastinate anymore, and I stepped up to thatTalk—I recognized that there were potential life-altering consequences toputting it off indefinitely: unexpected pregnancy, sexual disease, andunfulfilling relationships with the opposite sex, to name a few.
Of course, that first Talk isn't just about plumbing issues, like where thingsgo, how things work, and how embryos turn into babies. It's also about thejudgments and decisions that need to be made as our children enter an importantnew phase in their lives.
Initially, the Talk was uncomfortable for all of us, but as the firstconversation unfolded and subsequent ones ensued, we began to realize that wewere empowering our daughter for something that would have far-reaching andongoing consequences for the rest of her life.
The Other Talk
There is another equally critical time in your kids' lives when you need to sitthem down to talk about the facts of life—discomfort notwithstanding. This timeit's not about the beginning of life or how babies are made. It's about the endof life—yours—and the many issues and decisions that will confront you and yourchildren.
It's the Other Talk.
Unfortunately, if you're anything like the hundreds of families and medicalpersonnel and end-of-life practitioners whom I've interviewed in preparation forthis book, you will most likely put off indefinitely any substantive discussionwith your kids about what they might expect in your last years. In fact, mostparents never have the Other Talk. The National Hospice Foundation has foundthat 75 percent of Americans don't make their end-of-life decisions known totheir families through either verbal or written communication.
Furthermore, only 55 percent of adult children have talked to their parentsabout what to do if the parents can't live independently, according to a 2009Pew Research Center survey. Some children avoid this most intimate ofconversations because they believe their parents don't want to talk about it.Others think they know what their parents want. And some simply don't want toface the very real truth that old age will most likely include disease, injury,frailty, and even loneliness and depression.
Why Do Most Americans Keep the Door Firmly Closed on the Other Talk?
It turns out that the thoughts are remarkably similar to those that stand in theway of "the birds and the bees" talk.
It's an Emotionally Challenging Subject
Sitting down with your kids to talk about your later years can be uncomfortable,painful, depressing, even paralyzing, especially when you come to the part aboutthe various stages of your deterioration, mentally and physically, and, ofcourse, that last sentence: The end.
I found that to avoid stirring up these scary emotions, many of the parents Iinterviewed for this book had taken a protective stance: I don't want to put myfamily in a state of depression and panic by talking about it.
Not surprisingly, the reality is that this "sweep it under the rug" attitudeusually has as much to do with the mental fragility of the parent as it doeswith that of the children. It seems the longer we can cling to the previousphase of our lives (the one where we are healthy, independent, and carefree),the less we need to deal with the final one.
The unfortunate consequence of protecting your kids is that, when circumstanceseventually force your family to confront reality—whether it be a serious injury,a severe financial setback, or a life-threatening diagnosis—you (but most likelyyour kids) will be reacting in crisis mode. As a consequence, your options willmost likely be dramatically restricted, and the pressure to make decisionsquickly can become overwhelming.
We Don't Want to Face the Inevitable Transformation
The last part of your life can be a joyous time. You're freed from theconstrictions and boundaries of the workaday world. You may be blessed withgrandchildren, which offers another form of liberation (for example, "Whathappens at Grandma's, stays at Grandma's"). And you may have the opportunity toexplore new corners of life that you could never find the time for in youryounger years.
Because the good parts of this stage of life are so enjoyable, almost everyone Iinterviewed wanted to hold on to them for as long as possible by walling off thebad parts. The tool of choice was simple procrastination. You think: I'm notgoing to involve my kids in the issues surrounding my end of life until the timeis right!
Of course, the time is never right—until it's too late. Often what happens isthat the parent is suddenly stricken, mentally or physically—by dementia, aheart attack, or a fast-moving disease—and as a consequence, is unable tocommunicate coherently and effectively on the many decisions that need to bemade.
Children could pay a huge, multidimensional emotional price for their parents'terminal procrastination:
* Guilt and feelings of inadequacy over the potentially adverse consequences oftheir decision making, especially when confronting conflicting opinions fromvarious medical and legal professionals
* Shock over the difficulty of navigating the labyrinth of geriatric medicine
* Helplessness in dealing with the financial destruction created by the cost ofgeriatric care (In fact, one-third of all personal bankruptcies in America are adirect result of healthcare expenses, especially those that occur in the last 18months of life.)
* Long-term resentment among family members over the wisdom and consequences ofdecisions made on behalf of the parents in their last years of life
And this toll can linger for a lifetime.
We Want to Maintain Our Existing Parent-Child Relationship
For many of us, the most challenging and sensitive issues that we will come upagainst in the Other Talk concern the changes that we will experience in oursenior years. I'm not referring to our evolving physical condition that wenotice as we get older:
* Our stamina gets shorter.
* Our recovery time takes longer.
* Morning stiffness is part of waking up.
* Our row of plastic pill bottles gets longer.
* Looking for our reading glasses becomes an hourly event.
* Wondering why we just walked into a particular room becomes a regularoccurrence.
All of this can be mildly annoying, but none of it is debilitating. The desireto maintain the status quo can be.
The Evolution of the Parent-Child Relationship
As I learned from the hundreds of interviews I conducted with families as wellas doctors, nurses, and hospice workers, a fundamental and potentially difficultadjustment occurs as we age: the reversal of roles between parent and child thatis triggered when you reach the point, physically and/or mentally, at which youcan no longer operate independently.
In essence, the parent becomes the child, and the child becomes the parent.
Why is this reversal of roles so difficult and potentially life changing forboth parties? Because it is not merely a mechanical reassignment ofresponsibilities. Rather, it shatters the relationship that you as a parent havehad with your children since the day of their birth. As a result, you lose thepower and control of being the adult, and your kids give up the security andfreedom of being the children.
The Impact of Role Reversal on the Parents
For the parents, the hardest part of growing older may be the crushingrealization that we're about to lose control of the life and lifestyle thatwe've worked so hard to create.
Despite all the successes you may have achieved throughout your life, all thegood deeds you've bestowed on others, and all the love and support you've heapedon family and friends, at the end of life you may experience the fear of losingcontrol.
As described by Kathleen, whom I interviewed for this book, it can start out asan uneasy premonition:
Doing it our way isn't going to work indefinitely; in fact, I feel we're in thisin-between stage, a time when we can still control how we live but not how muchlonger we're going to last or be able to make choices before we've become "tooold."
When I contemplate it, what we're really dealing with is, "How much longer canwe continue to be us?"
I have learned, through my research, that the primary reason that the elderlybegin to actively resist turning over responsibility and decision making totheir offspring is their escalating fear of becoming powerless; becoming aburden on the family, physically and financially; losing their self-worth, self-respect, and dignity; and being abandoned by their family.
To make matters worse, since most people wait until a crisis hits beforeconfronting the need to transfer power and control to the kids, role reversal isoften forced on the parents with little or no discussion.
The Impact of Role Reversal on the Children
For the children, one of the hardest parts of seeing our parents age is thesinking feeling that we need to start taking responsibility for their livesphysically, financially, and socially.
Typically for the kids, the shock of responsibility at the "moment of truth" isfollowed by feelings of inadequacy, embarrassment, and resentment as the plightof their parents comes to dominate their lives. This cauldron of emotionalreactions is hardly surprising since the children who are about to take on theparent role often have little training and no warning that it's time to stepinto the caregiving role.
Unlike another major occurrence in life, childbirth, caregiving comes with nopreparatory classes on issues and techniques; no predictable nine months ofpreparation; no showers to help with the expense of the responsibility; and noparent to turn to for advice or just a shoulder to cry on.
As a result, for the children with parental responsibility, the world of rolereversal can be a very dark and lonely place. Again, the comparison withchildbirth is instructive. With childcare, there are nine months to prepare; theevolution to term is usually predictable and straightforward; and there isgenerally a crowding around of family and friends to share in the event. Withparent care, the catalyst is often a sudden, unexpected crisis; the decline isunpredictable and full of unpleasant surprises; and there is almost never anycrowding around of family and friends to share in the event.
The bottom line is that the impact of the role-reversal process can bedebilitating for both parent and child. Here's how Ralph, one of my researchrespondents, described the evolution:
When we're kids, we don't think our parents know anything. When we grow up andhave our own kids, we realize how smart our parents were.
Then, when our parents are in a position either physically or mentally wherethey can't fend for themselves, we become their parent. They realize they'velost control.
It's very scary; it's very hard; it's like a punch to the gut for them: "I'm notworth what I used to be."
They go through all that; then you say, "Would you like to move to a nursinghome?"
The Value of Stepping Up
I must admit that my first inclination in considering my responsibilities to mydaughter was to perform another drive-by, similar to "the birds and the bees,"sex books on the bed, and "any questions?" approach. Only this time it would beinstructions on how to access the key to the safety deposit box, which containsa will, a life insurance policy, and a paid-up funeral service receipt.
Fortunately, having heard from my research respondents about the unintendedconsequences of the "goodbye drive-by," I realized that the Other Talk shouldn'tjust be about the necessary transactions at the end of life.
It should go beyond funeral and burial plans, wills, and donations to science.It needs to delve into the judgments and decisions that must be made and howyour children will both have an impact on and be affected by them.
In essence, the Other Talk covers your life from here on. This will require somework on your part, both emotionally and rationally, but ultimately it will havepowerful implications for your family's remaining time together.
The preparation begins with creating in yourself, then sharing with your kids, atone and attitude that should permeate the Other Talk. You, the parent, areproactively taking the responsibility for empowering and preparing your kids forthe reversal of roles that will take place in your later years. You, the parent,embrace the eventual reversal of roles not as giving up power and control butrather as achieving security and freedom.
The Other Talk will set the stage for a smooth transition when the time comes toshift decision-making responsibilities. Here's how: First, acknowledge theinevitability of the need for and the wisdom of transferring decision making andmanagement of the day-to-day responsibilities. Second, discuss and establishground rules on the potential circumstances or triggers that will effect thechange of responsibilities for key functions such as bill paying, driving,living arrangements, money and asset management, and medical decisions.
Finally, the Other Talk culminates in a series of conversations that cover indepth how you would like to deal with four essentials:
1. Financing your uncertain future
2. Selecting the best living arrangements
3. Getting the medical care you need
4. Taking charge at the end of your life
Initially, the Other Talk may be uncomfortable for both you and your children,but as the first conversation unfolds and subsequent ones ensue, you and yourfamily will begin to realize that you are empowering your kids for somethingthat will have far-reaching and ongoing consequences for the rest of theirlives.
In essence, the Other Talk can have a powerful impact on your children on anumber of levels. It will help them cope with and successfully handle some ofthe difficult challenges that lie ahead for all of you. It will create a newdimension to the family relationship that comes from participating in, ratherthan suffering through, your last years. And it will teach them how to preparefor their own last years, giving your children a thorough understanding andactual experience for when they sit down with their own kids to have the OtherTalk.
If you are still feeling hesitant or uneasy or unconvinced about having theOther Talk with your family, I would ask you to consider three questions thatare addressed in the next three chapters:
1. What will happen if you don't have the Other Talk?
2. What can happen if you do have the Other Talk?
3. How can the Other Talk help you meet the unique challenges of your lateryears?
(Continues...)Excerpted from The Other Talk by TIMOTHY PROSCH. Copyright © 2014 Timothy Prosch. Excerpted by permission of McGraw-Hill Education.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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