Starting a conversation about care

Reasons for having a conversation about care

There are likely to be many reasons for why you need to talk sensitively with the person you’re caring for about their future.

It might be that they approach you to discuss care options, or to ask for your help and advice. But in many cases it’s likely to be you and other friends or family members who are the first to recognise problems, or realise that changes need to be made.

We had always talked as a family about planning for disabilities, and my parents realised that a property miles from anywhere wasn’t suitable in their seventies.

Elizabeth’s story

It can be tempting to stay quiet in order to avoid upsetting your loved one, but if you have serious concerns about their health, safety or wellbeing, it’s important to speak up. It can be particularly difficult to discuss a sensitive issue, such as deteriorating health or future care options, but talking about the situation is the first step towards making positive changes.

The sooner you talk about it, the sooner you can identify the problems and help your loved one to do something about them. This also gives them time to consider all the available options, rather than having to make a rushed decision because their living situation has become critical.

There are many reasons why you may feel you need to talk to the person you’re supporting in relation to their care, and you may recognise some of the examples listed below:

• They seem to be struggling with everyday tasks and may need organise home care
• You have noticed that they’re finding it increasingly difficult to get around and may need to look at different mobility aids and options
• You’re concerned that they could have dementia 
• You think they might need to consider moving into a care home or sheltered housing
• You’re unsure of their finances and want to know if they’re experiencing any difficulties with housing, care or living costs. For example, you might think there are some benefits that they don't know about and could claim, such as Attendance Allowance
• You don’t know if there is a Power of Attorney (in England and Wales, Scotland or Northern Ireland) in place
• You have concerns over their ability to drive safely.

Getting ready to talk to a loved one

To increase your chances of a positive response, think about the conversation in advance. Consider what you want to say, how you’re going to say it and when would be the best time for a chat. Blurting things out in the heat of the moment is rarely effective.

• Choose the right time: choose a time when your loved one is most likely to be receptive to a conversation (and not when you’re feeling stressed or lacking patience). It’s probably best not to bring up a difficult subject late at night when people are tired. Choose a time when you’ll be able to talk about the issues without feeling rushed – for example, don’t start a difficult conversation just before a carer is due to arrive or five minutes before you have to leave for work. Allow ample time for you both to express views and discuss options.
• Choose the right place: pick somewhere quiet and private where you’re unlikely to be interrupted. If it’s likely to be an emotional or difficult conversation, try to have it at home, where your loved one feels comfortable, rather than in a public place.
• Who should be there?: if there’s a particular person that your loved one is close to, and is more likely to listen to, ask if they can come along with you. Chat to this person beforehand so that you both understand the issues and what you’re trying to achieve. However, don’t involve too many people to avoid looking as though you’re ganging up on them and have already made decisions.
• Plan in advance: think about what you are going to say so that your message is clear. If there are particular things worrying you, or specific issues that you need to discuss, jot down a list of key points beforehand.
• Be informed: it can help to do some research into the facts beforehand. Check out any relevant areas of our website – for example on sheltered housing, care homes or benefits and pensions – so that you can explain options and answer questions if asked. You might want to take along leaflets, printouts or a laptop so that you can look at information together.
• Finances: be aware that at some point you may need to have a discussion about their finances and any possible savings they have, as this may have an impact on their care choices.

If there are particular things worrying you, or specific issues that you need to discuss, jot down a list of key points beforehand.

Starting the conversation and opening lines

When it’s time to talk, it’s important to put your loved one at ease – get a cup of tea, act naturally, smile and be mindful of your body language. If you appear relaxed, they’ll feel more comfortable and are more likely to listen to what you have to say.

Opening lines

Make it clear from the beginning that this is a two-way discussion with their best interests at heart. Your aim is to identify any concerns that they have, or any problems that they are experiencing, so that you can decide, together, how best to tackle them. For example, you might say:

• 'You know that I love you/care about you and want the best for you.'
• ‘Is there anything that is worrying you or that you’re having difficulty with?’
• ‘I would like us to talk about xxxx so that we can work out if there’s anything we can do to make your life easier/more comfortable.’
• ‘I would like to make sure that you're happy with xxxx. If not, there might be things that we can do together to help.’