A Delicate Subject

By Michelle Slatalla

I called my parents recently to say I was thinking about putting them in a nursing home. "But I'm only 58," my mother said. "We're healthy." Not to be critical, but my parents are the sort of optimists who bought a retirement home with a second floor. And a spiral staircase. And low-wattage lighting on the landing."It's a death trap," I said. "We like our house," my mother said. That's just like them. And, it turns out, just like the rest of America.

An AARP survey released this month found that most people ages 45 and older want to stay in their homes as long as possible. This wish belies the fact that nearly 1 in 4 of the 2,000 surveyed predicted that within five years, someone in their household would have trouble getting around.

With the number of elderly Americans expected to double by 2030, when 70 million people will be 65 or older, you'd think we would face up to the reality of the most ubiquitous aging issues: housing, health care and finances. But according to AARP researcher Linda Barrett, most parents and their adult children still avoid the topics.

Not me. I called Dr. Donna Benton, a gerontologist at the University of Southern California (no, Mom, I did not say anything about your slippery new bathroom tile, which, if it did come up, was mentioned only in the context of nonskid tub strips), and described how I had broached the subject.

Dr. Benton laughed. "That was not a good way," she said in a tone that indicated I might benefit from a class she teaches to interested adults at U.S.C. called "Your Aging Parents." For one thing, "nursing home" is an antiquated term; her students learn that options range from long-term assisted-living facilities to short-term rehab to building a wheelchair ramp from driveway to door.

It turned out that I was in denial. And I was typical. "Since we were children, we have thought of our parents as being the strong role models," she said. As she spoke, a big heavy wad of something started to fill the part of my chest I prefer to reserve for breathing. I described this sensation to Dr. Benton in clinical terms: "You're making me feel creepy."

Luckily, not all adult children need a direct approach. Parents send signals. "If your parent talks about a friend who went to the hospital, and nobody knew what their feeling about life support was, you can say, 'So, Mom, have you guys already put all that stuff together?'" Dr. Benton said.

Start now. When it comes to a living will or who should have power of attorney, "You are not going to sit down and get it done in two hours," Dr. Benton said. "Give yourself time." (If someone already needs help, call your local, federally mandated area Agency on Aging; a list is at www.aoa.dhhs.gov/agingsites/state.html Or get a referral for a geriatric care manager from www.caremanager.org.

For especially queasy adult children (I have no idea whom she had in mind), Dr. Benton suggested leading by example. "Tell your parents about the decisions you are making for yourself about living wills," she said.

That would be very emotionally mature. Me? Next time I speak to my mother, I will mention the nonskid daisies I bought for my shower.

See our website at time.com/personal for more information about elder care. You can e-mail Michelle at mslat@well.com