The Current - Our aging parents face hard choices. Here’s how to talk about it

Episode Date: March 7, 2025

Everyone’s getting older, but not everyone wants to think or talk about it. In a new series, The Current looks at aging well and the hard choices facing older adults and their loved ones. We start with a conversation many people have been avoiding: how to talk to our aging parents about getting older.

What do you see when you look around? Lively cities, growing neighborhoods, things that connect us. For those into skilled trades, it's a world they helped create. Discover more than 300 careers, paid apprenticeships, and the unmatched feeling of saying, I made that. Learn more at Canada.ca slash skilled trades. A message from the Government of Canada. This is a CBC Podcast. Hello, I'm Matt Galloway and this is the current podcast. There is not much that I can guarantee, especially now, but there is one thing I know to be true. We

are all getting older and aging affects us all. Collectively, Canada's population is getting older at a fast pace. In just five years, almost a quarter of Canadians will be over the age of 65. And so, in the coming weeks, we are going to spend some time on this program talking about the hard choices and conversations facing older adults and those who love them. This morning I'm joined by two specialists on aging. Dr. Samir Sinha is a geriatrician and clinician scientist with Sinai Health and the University Health Network in Toronto.

He's also director of health policy research with the National Institute on Aging. And this year he is a visiting fellow at the University of Oxford. And that is where we've reached him. And Laura Tamblyn-Watts is president of CanAge and the author of Let's Talk About Aging Parents, a real life guide to solving problems

with 27 essential conversations. She is with me in studio. Good morning to you both. Good morning. Good morning. Dr. Sinha, how prepared are most people for what may come at them as they get older?

I don't think people are really well prepared at all. I think generally we don't want to think about the prospect of getting older, especially in a society that talks all the time about anti-aging and, and the problems of aging. One of the challenges I find in my practice is that I've got families and older patients who are like, how did I get here and what do I do now? And not a lot of forethoughts that went in, in many of the cases, and then really

just trying to scramble and figure that out. And this is why I really think that, you know, aging well is something where if you really, you know, make preparations throughout your life in very thoughtful ways, you can really write a much better third chapter, if you will. Can I just pick up on that? You used the phrase aging well. This is something that we all want. But why do you think, Samir, that we aren't comfortable talking about getting old? I think when we think about getting old,

we think about all the negative things that could happen. We think about the idea that we're more likely to become frail and less likely to do the same things we were doing when we were younger. We may be living with dementia. We may need to be relying on other people for care. I think it's just the overwhelming prospect of the negative aspects of aging

that really kind of create a mental block and then don't allow people to have the conversations or take the time to think about how to plan for a more successful future. Laura, pick up on that, because part of it is about us getting older. Part of it is also the conversations that we have with our loved ones as we all get older.

And we're not very good at having those conversations. When I wrote the book, Let's Talk About Aging Parents, I was trying to get to the point that we're trying to solve. Is it that mom can't stay in the house because she might fall down the stairs? Is it because she lives in a rural community and she's far from health care? Is it that because you're worried that she doesn't see anyone

all day, like, what is the problem we're trying to solve for? And then we can flip things on our head. Many times people will say, oh, we become the parents to our parents. And we've all heard that. No, no, we don't. We are always the kids. And I use these terms. Your parents are still your parents. Your parents are still your parents. And again, I use these terms in very broad and inclusive terms. They still remember you at 16, you know, crashing the car and leaving your hockey gear in the front hall. So we have to think about ways to have these conversations that are respectful. One of the best things about parents, they love

to give you advice. I wanted to get my dad to redo his will, who's a lawyer and hadn't redone it in 20 years. I asked him his advice because I also needed to redo my will. Turns out we both benefited. What does the phrase aging well mean in the context of this? We think about what it is that's important to us. So many people will think, okay, well, I don't want this or I don't want that. But what we don't do is turn it on the other. What's most important to you?

And then work backwards from there. We kind of do that in our thinking, or we're supposed to do that in our thinking about finances, but we don't do it in thinking about aging. And part of it is because we are so terrified. You mentioned your dad. Can I ask you about both your parents are still alive? Yeah, they're listening to the show for sure. Excellent.

I'm glad that they're healthy and well. How do you think about this conversation when it comes to your own life? Like anything else, do as you say, not as I do. But there's lots of tricks to the trade. For instance, if I am worried that someone's going to fall down the stairs, that's fair. 56% of falls are severe. If you do fall and break a hip, your chances of dying in the first year are more than 24%. Your chances of dying within two years are 40. But if you put a second banister, you will reduce your falls by more than half. I'm still working on the second banister. But

part of that is patience. And I think it's important to understand that people are going to address these issues in the way that they want to. And we have to be a bit respectful for that. I would love to swoop in. I think we'd all love to swoop in with what I think people should do, but that's never really very helpful. Samir, can I ask, if you mind, about how you navigate these conversations? We're going to talk more about some of the specifics, but how you navigate them in your own life with your parents? Well, yeah, I think, you know, my advantage is being a geriatrician is that I think I've learned, you know, a real key question, which is what matters most to

you? And certainly for my older parents, you know, they both are retired in Winnipeg and they love living there, but I get a bit nervous because they had two sons, but one is in Toronto and the other is in Baltimore. So, of course, my brother and I get nervous because we think, well, you know, eventually, you know, they might need more support. They might need some help. And we're not just ready at hand to get groceries or do the things that we would love to do if they were in the neighborhood.

And so this prompts conversations, but open conversations, which we've been having for years now saying, well, are you happy living where you are? You know, you're away from us. What matters most to you? And I think we've really come to, you know, some good understandings that we haven't worked out all the details, but we have the broad sketches of what makes sense now, what may make sense in the future, and how we might negotiate those potentials as a family. These are hard conversations to have and hard questions to raise though, right? They are because I don't want to think about my parents any other way than my mom who's an avid gardener.

My dad loves to golf and read and go for long walks. That's how I've always known them for 48 years since I've been on earth. And so I always want to see them full of potential in doing things, but I also am worried about the call that will happen in future where I hear about a diagnosis or there's a new concern that happens. I don't want to see them suffer. I don't want to see them run into challenges. I always like to see my patients, you know, a great defense is a good offense, right? If we can be proactive about these things, then when these things happen, it makes them

less uncertain and it allows us to move forward together more easily. Where people live and where they want to live is such a big part of this. One of the things that we've been hearing is we've put this series together, is that obviously, I think it's fair to say, older people want to age at home,

even when that gets increasingly difficult. We paid a visit to Linda Hawley, who lives near St. Catharines. She lives lives on her own and she was having a home safety check from a local community support service. Have a listen. Linda, have you ever had a fall? Oh yeah, plenty. When's the last time you had a fall? About a week ago. And where was that? In the grocery store. Oh dear. Were you able to get up? Two men lifted. Oh, that was nice of them. And other times, there was my balance. Okay. So is there an area of your home that is of most concern to you? Just

the bathtub. So that's your main area of concern? It scares me. So Dr. Sinha, she wants to stay in her home, doesn't have the mobility she used to have and she's, as we heard, she's scared of the bathtub. How common is that? It's very common because again most of the falls that happen are gonna happen at home. They happen in places like the bathroom, they happen in places like the kitchen for example. You know that stair that doesn't have the extra banister. These sorts of things. Our homes were built when we were much younger and more mobile and we have to make sure that they can support us as we age. Laura, tell me a little bit about more,

how we go about having those conversations. Again, independence is such a key part of this, right? You heard it in her voice. Absolutely. So I think it's important to remember that people are not the same and that relationships are not necessarily cuddly and rosy. It's not easy.

How I will chat with my dad is completely different from how I chat with my mom. People don't fundamentally change. If they are proud people, if they're researchers, if they're people who don't want to deal with situations, you got to find the ways in. But their bodies are changing. Absolutely. We're all in and around the same age, I think. And so one of the things that happens is it's us, the adult children, that start to worry about your parents. You start to have those thoughts. You feel like you need to step in. You're not sure how. You're not sure what that intervention looks

like. This is Donna Hicks in Ottawa telling us how she knew that her mom, Kay, could not live independently anymore. She drove down the wrong way on a main street and I found her car keys in the freezer. She couldn't find them for two days and when I went over and found them in the freezer and then found the kettle stuck to the stovetop so it had run out of water, I knew that she wasn't safe anymore. Dr. Sinha, those are pretty clear signs that somebody needs help. If it's not that clear, how good are we, we being the adult children, at seeing the signs

that the conversation needs to happen or that it needs to take a different tone? Yeah, so usually when I'm meeting with families, it's sometimes in these situations and that would make me start thinking about dementia and how do we make the home safe and how do we get the right supports in place in that way. But there are challenges where I'll sometimes be assessing an older person, and it's clear to me that there are major issues here, but family members say, oh, I didn't notice that. I didn't notice anything, because they're sometimes used to having the same conversations they've had for the last 20 years, where they're not going to ask people about what day of the week it is, or what did you have for breakfast, for example.

Is that because they feel embarrassed about that? That they feel that they don't want to put their family member in a strange position? Well, two things. One is I just think that people will have the same conversation just as they would as a normal family dynamic. I think the other thing is is sometimes you just hope

that what you saw isn't what you saw or that you just hope that it'll go away. So I think there may be a little bit of denial. There's also just a lack of recognition that could happen. But I think the key is, if there are concerns, to try and raise the issue and saying, Mom, Dad, I know you're determined to stay independent in this home for as long as possible

and I wanna make that happen. There's some things I've been seeing recently that I'm a bit worried about. Can we talk about them? Because I wanna to see if there's things we can do to help you stay independent and at home for as long as possible. And that's a positive way to start the conversation so that they don't feel immediately that,

oh, are you taking away my keys forever? Are you taking me out of my house forever? What are you about to do to me, as opposed to what can we do together to try and honor my independence, my dignity and with respect. Laura, how do you go about framing those? In the book you talk about what if conversations, right?

That's exactly it. Because one of the things we're trying to understand is can they reason it out? And that means can they reason it out in terms of mental capacity, but can they reason it out in terms of maybe denial or cost as well? So the old, you know, what happens if something happened to one of the parents or me if I

moved to Singapore or something? How would you get to the grocery store? What do you think would work for you? One of the most important things we can do is have these conversations in non-confrontational ways like hosting a series on The Current, because it then lets people say, I was listening to a thing when I was driving the other day, and it really got me thinking. You could say that.

Did you hear that thing? Absolutely. So any of these type of third party references are really important. The other thing is what's happening to their friends, right? They may not want to talk to you about you or them, but they're probably willing to tell you about what Mr. Smith and Mrs. Lee are doing and what they don't like or what their terrible daughter did or they went to some horrible retirement home, right? So sometimes when you're having those conversations, you know perfectly well, they're telling you

their fears and giving you information. And you can use that as a proxy to have that conversation. It is a proxy conversation. What do you see when you look around? Lively cities, growing neighborhoods, things that connect us. For those in the skilled trades, it's a world they helped create. Discover more than 300 careers, paid apprenticeships, and the unmatched feeling of saying, I made that. Learn more at Canada.ca slash skilled trades.

A message from the Government of our doctors. It's what makes Scarborough Scarborough. In our hospitals, we do more than anyone thought possible. We've less than anyone could imagine. But it's time to imagine what we can do with more. Join Scarborough Health Network and together, we can turn grit into greatness. Donate at lovescarborough.ca. Let me introduce you to one other person, Ken Gignac, who lives with his wife Shirley. She was recently diagnosed with Alzheimer's.

Ken has gone from being a husband to also, it's not a replacement, but also being a caregiver. We asked him how he thinks of the future. The future, you know what, sometimes I think about it, I think about maybe we should be downsizing or whatever, but I kind of don't want to think about it really. But I probably should be because it's probably within another four or five years, you know, I might have to do something. Right now, it's playing, just go from day to day now.

Laura, how common is that reaction to thinking about the future, that it's day to day? It's so much what can I manage right now, right? When we looked at how our system should be set up for health and social care, we did it with the profound presumption, the assumption that family, in that case I am using a conservative notion of family, like that two parents with six kids, would help. And that relationship would be one that would be a lifelong set of supports. We don't have that. In fact, we're easily six generations now, or five generations in the workforce already. We no longer have a sandwich generation, I'm 53, we're in a club family generation and people don't also do things like fall ill or die in order of age.

And so part of what I think is helpful is to take age in some ways out of it. And you can kind of take a deep breath and you can say things like, oh, I was thinking what would I do if and then I was thinking what would my kids do if and then, you know, we're on a big trip for reading week and then that horrible snowstorm happened and the what-ifs then become about situations that we need to solve for, not about you're getting older. So, always start with what is the problem we're trying to solve for and does it really have to be about being old? Or could somebody have, you know, sprained their ankle and had that same experience? Suggest that you can have the conversation almost at

any time. In fact better to do it. Understand that these are many small conversations almost nobody likes to be sat down at the kitchen table at a holiday and said mom dad uncle Bob you know now is our time where I'm gonna tell you what to do or we need to confront these situations. One of the other thing that's important to remember is denial is not just about the older person. I'm in a sweet spot where my different older adults in my life, touch wood, are kind of okay. And I know that the minute someone loses their driver's license or the minute somebody gets a diagnosis, my life is going to change too. Which is why you, not you, but one could imagine that you'd be reluctant to have a conversation

like that because it's going to impact you. It absolutely, if I turn that rock over, it means I now have to deal with whatever it is. Samir, there are many seniors who we talked about aging well, they're trying to live at maximum, right? They are traveling, they're trying to get their adult kids out of the house, they're remarrying, they're doing all of the things. What advice do you have for people who are trying to live to the fullest but also be cognizant of the fact that we've never been older? Do you know what I mean?

You're getting older. Yeah, no, I think everybody's kind of living in the moment and just trying to make it day to day. And in the case of Ken and Shirley, here's an older couple, for example, and he's just like, I'm not trying to think about the future. I'm just trying to think about today and what we're going to get through today. But I think this is the value of having these conversations where I think especially when you can bring in a third party like a social worker or myself as a geriatrician where in

the case of Ken and Shirley, I'd say, I know you're doing a heck of a lot as a caregiver and you're doing what you can to support surely to stay at home But we need to talk about the future because I want to tell you about what dementia can look like in the future What Shirley's care needs might need? How are you doing? Because if you go this whole equation changes as well Because then by actually breaking it down and really making it about supporting both of them, you actually can start talking about finances, what things might look like. It's a huge weight off people's shoulders because now it's out on the table. We talk about aging in place, but I like to talk about aging in the right place, where

I'd say, I know you want to stay at home with 24-7 care, but we don't have a government system that will allow us to do that and you don't have the savings. So let's talk about what is possible and what can be done so that you can still make the choice that's best for you. It really is amazing to see the relief and the greater certainty and a lot of that stress that can be relieved as well. Just finally, are we getting better at this? I said in the introduction that in five years, almost a quarter of Canadians will be over the age of 65. That suggested there is urgency. We're getting a bit better about this, but my

goodness, I just think that so many people are not having these conversations and we'll have no choice but to deal with these issues. So, you know, I'm always the glass half full kind of guy, so I'd like to say that I think we're getting a bit better, but I'm really happy that we're having this conversation today. Are we getting better at this, Laura? I'm really happy that we're having this conversation today.

Are we getting better at this, Laura? I mean, the book is out there. You see it on people's shelves on the dining room table because people think that they need to have the conversations. Are we actually having those conversations? I think what's really important to remember is that there is a massive urban-rural split and there is a massive resource in question. So just to kind of give a sense, we have about one pediatrician for every 2100 child and youth, people 1700. We have about

one geriatrician for every 21,000 seniors. I spent a lot of my time in a teeny little fishing community called Sandy Cove, Nova Scotia. And if I need help and care, the J.P. Hospital is closed. There's no geriatrician. There's no doctor. Exciting thing is there's lots of fun things we can actually do. We can create what's called a NORC, a naturally occurring retirement community. In my little community, I think the average age is about 70. Well, we can actually have someone come in and provide services to a whole group of people very effectively and very affordably, but it requires a different idea. And you know what? If you're in an urban center, you can send your groceries to your mom on Uber, you can put trackers if dad wanders around. There's things that we can do that are not

necessarily high-level medical, and I mention that because we need to preserve those rare resources for when we really do need the specialist magicians like Samir. But also understand that not everybody has access to that in rural communities in particular. It's much more difficult. Much more difficult. This is going to be a big conversation. I have a feeling people want to have this conversation, I think, and if they don't, maybe this will prompt them to have it. Thank you both for being here. Samir, thank you. Thanks for having us. And Laura, thank you have it. Thank you both for being here. Samir, thank you. Thanks for having us.

And Laura, thank you very much. Thank you. Dr. Samir Sinha is a geriatrician and director of health policy research with the National Institute on Aging. Laura Tamblyn-Watts is the author of Let's Talk About Aging Parents, a real life guide to solving problems

with 27 essential conversations. As I mentioned, this is a conversation that perhaps people are reluctant to have. They know that they need to have it, but they don't know how to get it going. We'd love to hear from you. Is your family dealing with some of these hard choices that come with aging? Parents needing more support?

If you are the senior, how do you feel about your children wanting to help more? How do you start that conversation? How have you started that conversation? And what has that conversation led to in terms of changes when it comes to health or finances or relationships, you can email us thecurrent at cbc.ca.