How to talk to your parents about the help they need

“Mum, wouldn’t it be easier if someone helped you with your bath?”

The question came on a Sunday afternoon, over coffee and cake, almost in passing. Her daughter had rehearsed it in her head all week. Her mother put down her cup, looked out of the window and said: “I’m not ready for a care home yet.” Then she talked about the neighbour who had bought a new car. On the drive home, the daughter cried in the car and wondered what she had done wrong. Nothing. She had done what almost every adult child does at some point: she had tried to open a conversation for which nobody in the family had any words.

Talking to your parents about the help they need is one of those conversations we all put off. Not because we don’t care, but because it touches something we would rather not touch: that roles in the family are shifting, that our parents are no longer who they were, and that we will never again be only their children. In this post I won’t give you a recipe for the perfect conversation, because there isn’t one. But I will show you why it is so hard, what is going on between you beneath the surface, and how to prepare so that your first attempt is at least a beginning rather than a wall.

Why nobody wants to go first

According to the Statistical Office of the Republic of Slovenia, one in five people living in Slovenia today is 65 or older. For many families, this means that the question of who will help Mum or Dad will come up sooner or later. As early as 1985, the American gerontologist Elaine Brody wrote that caring for parents is not an exceptional event that befalls unlucky families, but a normative family stress — a developmental task that awaits most adults, much as most parents can expect one day to let their child leave home.

Yet although it is expected, hardly anyone is ready for it. The conversation gets postponed for several reasons at once:

• Fear of causing offence. We are afraid our parent will hear the question as an accusation that they can no longer cope.
• Fear of our own realisation. As long as we don’t talk about it, we can pretend that nothing is changing.
• It isn’t clear who should speak. Siblings wait for each other, each convinced that someone else ought to do it.
• Family rules of silence. In many families, illness, money and death were simply never discussed. Nobody ever spoke the rule out loud, but everyone knows it.

The last point is often the strongest. If difficult things were never talked about in your family, it is no wonder you feel as if you are breaking something sacred the first time you say, “Mum, I’ve noticed you find it hard to get up from your chair.”

What you say and what your parent hears

When an adult child suggests help to a parent, what they have in mind is almost always care: they want their parent to be safe, not to fall, not to be alone. But the parent often hears the same sentence quite differently. They hear that they have become a burden. That they are no longer taken seriously. That someone is getting ready to make decisions for them. And because that hurts, they defend themselves — with denial, a joke, anger or a change of subject.

This isn’t stubbornness. It is the response of someone who is losing something they always took for granted: a body that obeys, a car that takes them wherever they want, a house they can manage. I wrote about how the body and self-image change with age in Self-image and ageing: when your body and roles change. If you understand that your parent isn’t defending themselves against you but against loss, it is easier not to take offence — and easier to persevere.

There are more than two people at the table

In relational family therapy, the approach I am training in, we see every conversation like this as an event in a system, not just between two people. When you talk to your mother about help, your father (living or deceased), your siblings, perhaps your partner, and everything that has happened in your family over decades are all invisibly present at the table.

Ivan Boszormenyi-Nagy, one of the founders of family therapy, described invisible loyalties: unspoken commitments that bind us to our family, and a kind of family ledger of giving and receiving. Who owes whom what, who was always the one who gave, who the one who received. When the time comes to care for parents, this ledger is opened. The daughter who was always “the good one” feels she has to do it. The son who moved abroad feels a guilt he can only express through advice from a distance. The brother who was his father’s favourite may not be able to bear watching his father weaken.

If one of the children was already the one looking after the parents in childhood — comforting their mother or caring for younger siblings — we speak of parentification. When the conversation turns to helping an ageing parent, this old role switches back on almost automatically. And with it comes an old tiredness that the person often doesn’t even recognise as their own.

The relationship between siblings matters too. Alliances and coalitions formed in childhood often reappear in new clothes when decisions about parents are being made. I wrote more about this in Siblings, alliances and coalitions: the invisible geometry of a family. When it comes to caring for parents, this geometry often shows in who phones, who turns up and who withdraws — and in who cannot forgive whom for it.

Before you talk to your parent, talk to your brothers and sisters

One of the most common mistakes is for one sibling to open the conversation on their own, the parent resists, and then another sibling tells the parent: “It’s not that bad, Mum, don’t listen to her.” The parent gains an ally against change, and the siblings drift apart. In family therapy we call this triangulation — tension between two people is resolved by pulling in a third.

That is why it makes sense for you siblings to talk among yourselves first. Not to hatch a plan behind your parents’ backs, but to clarify:

• what each of you has noticed (concretely, not as judgements),
• what each of you is afraid of,
• what each of you could realistically contribute — time, money, lifts, paperwork,
• who should open the conversation with your parent, and whether it would be better for all of you to be there or just one.

You don’t have to agree on everything. It is enough to know where you disagree and to agree that you won’t sort out those disagreements in front of your parent. If you don’t have siblings or aren’t in touch with them, it is worth checking with at least someone — your partner, a friend, your parents’ GP — whether what you are seeing looks similar to them.

How to begin: a question instead of a decision

Most first conversations that fail begin with a solution. “I’ve arranged home help for you.” “I think you should move into a care home.” “We’re going to sell the car.” A solution that comes from outside puts the parent in the position of an object that decisions are made about. Almost anyone responds to that with resistance.

It helps more to begin with an observation and a question. Make the observation concrete and free of judgement: not “you’re getting more and more forgetful”, but “last week I saw the hob was still on when I arrived”. And let the question invite your parent to say how they themselves experience it.

Here is what a conversation might look like that doesn’t reach its goal straight away but does open a door (a composite, not a real person):

“Dad, I’ve noticed you don’t go to the shop on your own any more. Why is that?”
“Oh, the steps at the bus stop. My knee.”
“So how do you manage?”
“The neighbour brings me something now and then. I don’t like asking her.”
“I understand. I wouldn’t like it either. What would feel least awkward — me taking you once a week, or the two of us finding someone to deliver?”
“I don’t know. I’ll think about it.”

Dad didn’t say yes. But he didn’t say no; he admitted the difficulty and was given two options he can choose between himself. For a first conversation, that is a lot. A conversation about help is almost never a single conversation — it is a series of smaller ones that stretches over weeks or months.

Help isn’t all or nothing

One obstacle is that both parents and children often picture help as a leap from complete independence to complete dependence. But in between there are many steps that are easier to accept: someone who helps with the cleaning, meals delivered, a lift to the doctor, an emergency call button, a grab rail in the bathroom, an agreement to speak every evening at the same time.

Good first points of contact for exploring the options are your parents’ GP, who can assess their health and refer them on if needed, and the community nursing service at the local health centre. At the centre for social work they can explain what kinds of home help and other services are available in your municipality and what the procedures are. The rules and conditions differ from one municipality to another and change over time, so it is better to ask directly than to rely on what someone heard from friends.

Smaller steps have another advantage: your parent can experience that help doesn’t mean losing control. Someone who has once accepted having lunch brought to them may find it easier to accept the next change too. But when the first suggestion is moving out, refusal is almost certain.

Exercise: preparing for the conversation in five steps

This exercise takes half an hour and you can do it today, with paper and a pen. It isn’t meant for writing a script, but for going into the conversation more collected and less overwhelmed.

1. Write down three concrete observations. What you saw or heard, with the date if you know it. No “always” or “never”, and no diagnoses.
2. Write down what you are afraid of. That she will fall? That you will have to carry it all alone? That you will quarrel? Your fear isn’t something you need to hide, but it is good to know which part of the conversation it will be steering.
3. Write down what you think your parent is afraid of. Losing independence, their home, their dignity, being in the way? Try writing it in their name, in the first person.
4. Choose one small suggestion. Not a whole plan — one step your parent can accept or refuse without losing face.
5. Decide when you will end the conversation. For example: when your parent says “I’ll think about it”, you thank them and stop. Agree only that you will come back to it.

If after the exercise you realise your fear is so great that you can’t speak calmly, that is valuable information. Perhaps it would be better for someone else to have the first conversation, or for you to talk to someone about yourself first.

When the conversation doesn’t go the way you imagined

Your parent may say no. They may take offence, cry, deny it, even accuse you. All of this is often part of the road rather than its end. It happens that a parent who firmly refused help comes back to it on their own a few weeks later — sometimes as if the idea had been theirs. That way they regain the sense that they decided for themselves, and you let them have it.

I described in more detail what to do when resistance persists even after several attempts in When a parent refuses help: what lies behind “no” and when to respect it. Here I want to stress just one thing: your task isn’t to persuade your parent. Your task is to say what you see, offer what you can, and stay in touch. The sociologists Kurt Lüscher and Karl Pillemer described the relationship between adult children and their parents with the word ambivalence: we feel closeness and resistance, care and anger, the wish to help and the wish to be left alone, all at the same time. This isn’t a sign that something is wrong with your relationship. It is simply what a relationship between two adults who were once parent and child is like.

But if there are old wounds between you that reopen with every conversation, it may be time to look at those first. I wrote about whether and how the relationship between an adult child and a parent can be repaired in Adult children and parents: can the relationship still be repaired?

Where this doesn’t apply

Everything I have written assumes that your parent is able to understand their situation and make decisions, that they are not in immediate danger, and that your relationship is safe enough for a conversation. When any of this isn’t true, the rules are different.

When there is immediate danger. If your parent has fallen and can’t get up, if they are suddenly confused, if they have trouble speaking or breathing, this is not the time for careful conversations. Call 112 (in Slovenia). Even when you notice repeated falls, getting lost in familiar surroundings or rapid weight loss, you should contact the GP as soon as possible — the conversation about what your parent wants can run alongside.

When it may be dementia. If your parent can no longer understand why they would need help, a conversation like the one I have described won’t work in the same way. Then the first step is a medical assessment; I wrote about the first signs and first steps in Dementia in the family: the first signs and the first steps.

When the relationship was abusive. If your parent was violent towards you or abused you, you are not obliged to take on the role of carer. You can decide to organise help from a distance, through services, or not at all. That isn’t a lack of love, but care for yourself. If your parent still intimidates you now, call the police on 113 (in Slovenia), and in times of severe distress the Samaritans confidential line is available on 116 123 (in Slovenia).

When your parent simply chooses differently. A competent adult has the right to make decisions that seem dangerous to you. To live alone in a house with stairs, to keep driving around the village, not to want strangers in the house. You may voice your opinion, but the decision remains theirs. This is one of the hardest realisations of this stage: that you can love someone and still not be able to decide for them.

What to remember

• A conversation about help isn’t one conversation but a series of smaller ones stretching over weeks or months.
• Your parent is often not defending themselves against you, but against the loss of independence and dignity.
• Begin with an observation and a question, not a solution. Offer a choice, not a plan.
• First get on the same page as your siblings — and don’t settle disagreements in front of your parent.
• In immediate danger or if you suspect dementia, the first step is a doctor, not persuasion.