Difficult discussions about setting and enforcing boundaries are, in many ways, the most important communications in parent-child relationships. They are necessary and driven by care, concern, and love, but they can also become entangled with heightened emotions, complex power dynamics, and intricate histories. During the earliest years of formative years, these discussions flow in one direction only—from parent to child—establishing a pattern that lasts for decades.

But as parents age and adult children assume more responsibility for coordinating their parents’ safety and healthy aging, more and more decisions may require hard conversations. When is it time to hang up the car keys? Is it safe to still live alone? Should they consider help around the house part-time? Would a medical alert system be appropriate and extend the time a parent can stay in his or her house independently?

Adult children assume more responsibility for coordinating their parents' safety.

Collaborative, constructive discussions to address such issues with aging parents parent may fill adult children with dread.

Welcome to sandwich generation role-reversal, in which parents and children gradually (often imperceptibly) exchange their original life roles as caretaker and caregiver. This transition is inevitable for those with older parents, and the first such discussion with a parent is a rite of passage that can raise a great deal of resistance on both sides.

How to talk to aging parents about medical alert systems

Talking to seniors about ways they can proactively safeguard health and independence later in life can be intimidating. As older loved ones approach their later years, aging (and its associated likelihood of health challenges) can create real threats, obstacles, challenges, and risks for older adults living alone. And when children, grandchildren, nieces and nephews express concern or worry, their loved ones may brush off concerns or minimize them.

This can lead to a frustrating conversation that leads to anger and hurt feelings rather than a safer outcome and less mutual trust rather than more.

To help set the right tone and to facilitate a constructive discussion of safety concerns with elders, here are a few considerations.

Choose the right time and setting.

Ironically and counterintuitively, the wrong time to raise a medical alert system, in general, is during the emotionally heightened immediate aftermath of a frightening incident that may have brought about awareness of the need for one.

Our most primitive brain structure—the amygdala—controls our response to immediate threats. You’ve probably heard of fight-or-flight. When people are afraid or threatened by anything (a near-miss in the car, a missing child at the mall, or an older relative’s fall/near-fall), we are flooded by the brain’s amygdala with stress hormones that tell us: “fight this or run away, now!” This is why we tend to yell at people we care about when we are frightened (and then regret it later).

So, if a medical alert system is discussed too soon after a scary near-miss, the fight-or-flight response can create a fight—naturally. And this kneejerk reaction may be difficult—even impossible—to overcome later.

Choose a time to start the talk when everybody is calm, relaxed, relieved, and happy to be together, and keep the discussion centered around those feelings.

Listen deeply.

If Mom or Dad raises objections, listen to them fully. Let them get them all out before trying to talk them out of their objections. Don’t leap in to answer immediately. What is she really saying? Brush up on your active listening skills ahead of time. Rephrase objections in words that your loved one agrees with. Make sure you understand your elder’s perspective completely before you try to contine the discussion. This is a two-way conversation; make sure you’re hearing what everybody is really saying, beneath the surface.

Talk about your own perspective and feelings.

Keeping the conversation focused on your own concerns, worries, and emotions can help Mom or Dad focus on you—it reverses roles back to their own comfort zone. Now they have to take care of your feelings again, as they did for decades.

And now you can talk to them from a perspective they understand: Their child is afraid about their fears. And they can help.

Help parents understand all the potential solutions if they want to review them and be involved.

The discussion may require a methodical review of options, including their pros and cons. Take it at the speed required to review these benefits and limitations.

  • Landlines are always connected, even during natural disasters, for example, but if a person has fallen and cannot reach a landline to call somebody, it will not help.
  • Cell phones are not always with a person, so cannot be relied upon as an emergency response solution.
  • Landline-based PERS systems are limited to in-home use.
  • Cellular-based systems travel with you. They offer the most flexibility and a wide array of features. One potential limitation of these systems is their cellular network; in some places on smaller networks, they may experience limited signal and connectivity.

Involving parents who will be wearing/using the medical alarm systems in the process of selecting the system may also help to ensure they will regularly wear the solution.