There’s another dent in Dad’s bumper. A pot was ruined after Mom forgot she was boiling water on the stove. Grandma frequently forgets to take her medications. Grandpa is having trouble taking care of himself.

When is it time to have the talk about the car keys, assisted living, or even just allowing their children to help them more with daily tasks? When do you have those tough conversations with your aging parents?

“It is never too early to begin the conversations and planning for future medical care,” says Diana Kerwin, M.D., chief of geriatrics and physician on the medical staff at Texas Health Dallas. “It is important to know what your parents’ beliefs and desires are, or their vision of how they want to be cared for in the event they develop an illness or a disease that might affect their ability to make decisions.”

Getting involved early, Kerwin says, will make those conversations less tough when the time comes to ask for the car keys or giving up a bit of independence, or to begin discussions about assisted living.

“Get involved early in learning about the care your loved ones need,” she says. “There is no set point, but if an older parent lives alone, he or she will require more complex care and a greater support system because aging makes us frail and vulnerable. The activities of daily living can begin to be a challenge.”

And as parents age, it’s up to those who love them to keep their eyes open for potential warning signs.

“Become an observer of normal behaviors for your parents,” Kerwin says. “When things begin to go amiss, such as bills not being paid or meals and/or medications missed, that’s the time to get more involved in their care.”

According to a survey conducted by Pfizer and Generations United, “Respondents said the hardest conversation to have with aging parents is telling them to stop driving and hand over their car keys—more difficult (39 percent) than talking to parents about their final wishes or wills (both 24 percent).”

Worrying that your parents may be reaching the point where driving is no longer advisable? Experts recommend going with your parents on a drive, using a checklist like this one to pinpoint any concerns—and check for both daytime driving and nighttime. If the checklist reveals that your concerns are valid, talk to your parent about those concerns, and whether curtailing driving during certain hours of the day or night is appropriate, or even about arranging alternative transportation.

“With driving, note any minor accidents or getting lost,” Kerwin adds. “This is a good time to bring in the physician, as losing your independence as a driver is a difficult adjustment.”

Talking to your mom and dad about lifestyle changes revolving around independence can be tough. Kerwin says to keep in mind that approach is everything.

“Remember, the feeling you communicate remains much longer than words,” she says. “Tell them you love them and want to support them so they stay safe.

“Do offer to go to doctors’ appointments, so you understand the current status and concerns of the care provider.”

The AARP’s guide “Prepare to Care” suggests reviewing these questions before sitting down with your parents:

• Who is the best person to start the conversation with your loved one(s)?
• What are your biggest concerns and priorities as you help put together a caregiving plan for someone else?
• What is the best thing you think might happen as a result of this conversation?
• What is the most difficult thing for you about having this conversation with a person you care about?
• What are you afraid might happen as a result of this conversation?
• How do you think your loved one and other family members might react to the conversation? How does your family usually respond when uncomfortable subjects are discussed?
• How can you explain to your loved one and other family members why it is important to have this conversation?
• In addition to emotional support, how much financial support are you willing or able to provide if your loved one needs it?

And self-care is important to factor in as well. Kerwin says that as parents age, their children may be able to care for them, but if circumstances don’t allow that, or if you find yourself needing help navigating the world of caring for a parent, help is there.

“Older adults have greater medical needs and require more attentive care,” she says. “If children are able to be the overseers of their parents’ evolving physical and mental health, that is a good option. If not, there are geriatric supports for families to work with to ensure maximum wellness.”

Do you need to have that tough talk with an aging parent? Do you need help coordinating care and finding support? Texas Health has geriatric medicine specialists throughout North Texas.