10 Ways to Talk to Your Parents About Long-Term Care - Why a Nursing Home is Not the Only Option

It’s one of the hardest conversations you’ll ever have with an older family member.

I’m not moving. This is my home.

You can feel it coming — that moment you’ve been dreading. You’ve watched the changes unfold, slowly at first, then all at once. They don’t move the way they used to. Sometimes, they forget things — names, places, even familiar faces. Maybe you’ve tried to talk about it, gently opened the door to the conversation. But instead of understanding, you were met with fear in their eyes, resistance in their voice, or the kind of silence that breaks your heart.

In Singapore and many parts of Southeast Asia, family caregiving is deeply rooted in cultural expectations. Adult children are often seen as morally responsible for caring for aging parents at home, and moving a parent into a facility can feel taboo or even shameful.

Contrast that with the United States, Canada, and parts of Europe, where professional in-home care, assisted living, and nursing homes are somewhat normalized — even expected at times — as part of aging.

The shift to elder care isn’t just a practical one. It’s emotional. It’s cultural. And it requires compassion, planning, and patience.

There are more options for long-term care today than ever — a response to a growing crisis driven by rising longevity in Singapore and worldwide. As people live longer, more individuals are facing challenges with daily activities or require supervision due to dementia. The need for support is already at unprecedented levels, and these numbers are only expected to grow in the decades to come.

Globally, the number of people needing long-term care and supervision due to dementia is projected to rise significantly, according to the WHO, with estimates suggesting a near-tripling by 2050, from around 57 million in 2019 to 153 million.

The way extended care is delivered and paid for varies widely depending on where you live and what support systems are available.

These simple, caring steps can help you open the conversation with empathy and confidence — and make sure your loved ones feel heard and included every step of the way.

1. Know Why You’re Having the Talk

Before you bring up the idea of a move or a care plan, get real with yourself.

Ask: Are they forgetting meals? Leaving the stove on? Are there bruises from falls they won’t talk about? Are you drained and overwhelmed from being their only support?

When your motivation comes from genuine concern rather than frustration or convenience, it sets a different tone. Lead with your heart, not your stress.

Are you seeing signs they’re no longer safe on their own? Are you running on empty trying to hold it all together? When your words come from love — not burnout or guilt — the conversation changes.

It might be easier if your loved one had an accident already before, or they’re ill or frail, and you’re just not able to care for them the way they need to be at home anymore (whether you’re the one doing the caregiving or, for example, you went in for home nursing at RC Caregivers in Singapore.)

If you know for a fact that it wouldn’t be safe or responsible to leave them alone all day or night, then it is time to have the conversation and take action.

2. Explore More Than Just Nursing Homes

In Singapore and much of Southeast Asia, "nursing home" is still a loaded phrase. But you’re not limited to that. Assisted living, home-based care, and hybrid options are growing.

For example, there are old folks homes in Singapore like Retire Genie, and there are alternatives to old folks homes that aren’t nursing homes but can provide assisted living or assistance with daily living activities.

In the United States, the LTC News Caregiver Directory has the largest database of caregivers, home health agencies, adult day care centers, senior communities, assisted living, memory care, and nursing homes available. You can easily search for quality extended care services based on any location in the United States - all free and without obligation.

Research:

• Assisted living communities like Red Crowns and Retire Genie
• Community care apartments co-developed by HDB
• In-home care providers like Homage and Jaga-Me
• Retirement villages and elder co-housing abroad

Think about what your loved one values. Privacy? Social life? Medical access? Match solutions to their needs.

This shift away from institutional care is happening globally. In the U.S., Canada, the U.K., Australia, and New Zealand, older adults are increasingly choosing assisted living communities, in-home caregiving, and even aging-in-place technology solutions over traditional nursing homes.

Memory care units, retirement villages, and continuing care retirement communities (CCRCs) offer varying levels of independence and support.

These options often prioritize dignity, autonomy, and lifestyle—values that resonate across cultures. Looking abroad can offer fresh ideas, especially if you're seeking alternatives that balance independence with safety and social connection.

3. Consider Their Perspective

Imagine giving up the home you built, where you raised your children, where everything smells, sounds, and feels familiar. It’s not just bricks. It’s identity.

Your older family members might feel like they’re being discarded or punished. That’s heartbreaking. Tell them what you see. Tell them what worries you. But also listen to what they fear. They need to feel heard before they can feel safe.

4. Let It Be Their Decision, If Possible

Unless they’re suffering from dementia or in immediate danger, your parent still has the right to make their own choices.

Treat them like an adult, not a child. Bring options. Ask questions. Collaborate. This should feel like planning, not managing.

5. Don’t Wait Until They Can’t Decide

The worst time to make a long-term care decision is during a health crisis because it becomes a family crisis unless advance plans have been put in place.

Don’t wait until a fall or hospitalization makes the choice for you. Bring up the topic early. Treat it like a backup plan, not a countdown. This gives your parent time to digest, explore, and even choose.

6. Give the Conversation Time

You’re not closing on a property. You’re talking about their life. Don’t expect a decision in one talk.

Spread it out. Let them reflect. Return to the topic gently. Moving someone is emotional — and emotions don’t rush well.

Expect resistance, not because they’re being difficult, but because it’s hard to confront change — especially when it feels like a loss of control. Older adults may need time to grieve what they fear they’re giving up: independence, familiarity, pride.

Validate those feelings. Keep the door open, not just for solutions, but for trust to grow each time you revisit the conversation.

7. Keep It a Dialogue, Not a Decision

This isn’t you announcing what’s going to happen.

Ask:

• “What’s been hardest for you lately?”
• “What would make you feel more comfortable or secure?”
• “Can we look at some places together, just in case?”

Let them co-author the plan.

8. Avoid Information Overload

You might be tempted to show them every brochure and care plan. Don’t.

Too much info feels like pressure. Prioritize clarity. Pick one or two ideas to explore first. And don’t turn it into a family press conference.

Start small. Maybe it’s a short video tour of an assisted living community or a casual visit to a nearby day care center. Keep the tone exploratory, not decisive.

When your loved one feels like they’re part of the process—not the subject of it—they’re more likely to stay engaged and open-minded. Let curiosity lead before commitment.

9. Emphasize the Positives

Focus on what they gain, not what they lose.

Say: “You’ll always have someone around if you need help,” instead of, “You’re not safe alone anymore.”

Mention: Better meals, companionship, less housework, more peace of mind.

Don’t sugarcoat. Just shine a light on what’s good.

Help them picture a better daily life, not just a safer one. Maybe it’s joining a morning tai chi class, having someone else handle the cleaning, or enjoying meals without eating alone.

These aren’t small things—they’re quality-of-life upgrades. Frame the change as a step toward more comfort, connection, and freedom from stress rather than a sign of decline.

10. Reassure Them You’ll Still Be There

No matter where they live, they need to feel you’re with them.

Visit. Call. Send their favorite snacks. Bring family photos. Make sure they know this is a transition, not a goodbye.

Your love and presence matter more than any facility.

Understand Their Cultural Lens

Whether you’re in Singapore, the U.S., the U.K., or anywhere else, it’s vital to see this conversation through your parents’ cultural lens.

Older generations often carry deep-rooted beliefs about family, duty, and aging. For many, the idea of needing care outside the family feels like shame or failure—not just personally but culturally.

In Asian households, for instance, values like filial piety and multigenerational living are not just traditions—they’re expectations. A parent might hear “assisted living” and think abandonment, even if your intention is love and safety.

These cultural values don’t disappear when families move abroad. A second-generation Filipino in California or a British-born child of South Asian parents in London may embrace modern healthcare choices and independence.

However, their parents might still see aging as a stage meant to unfold quietly at home, supported by children, not strangers. That emotional and cultural gap is real—and if you ignore it, you risk building resentment instead of trust.

Understanding where your parents are coming from doesn’t mean you have to agree with everything. But it does mean respecting their story. Ask about how their own parents aged. What did care look like in their home country? What would feel comforting or unsettling to them now?

These conversations help you move forward with empathy, not just logistics.

No matter the culture, generational attitudes will almost always differ. Aging parents tend to prioritize stability, familiarity, and dignity. Adult children—especially those raised in faster-paced, globalized environments—may focus more on options, safety, and long-term planning.

These aren’t wrong instincts. They’re just different. Bridging that gap means slowing down, listening more, and being willing to explain the “why” behind your suggestions—not just the “what.”

What Long-Term Care Looks Like Around the World

Care costs and systems vary drastically based on geography and culture.

Singapore and Southeast Asia:

• Singapore: CareShield Life provides basic long-term care insurance. Families often supplement with MediSave and out-of-pocket payments. AIC subsidies help lower-income families.
• Malaysia, Indonesia, Vietnam: Family is the default caregiver. Government programs are minimal, and private options are limited but growing.
• Thailand and the Philippines: Attracting retirees from other countries. Quality private care is more affordable than in the West.

Western Countries:

• United States: Health insurance and Medicare only pay for short-term skilled care. Medicaid helps those with limited financial resources. Most rely on paying for care from income and assets or, if they were lucky enough to purchase ahead of time, Long-Term Care Insurance. LTC News Cost of Care Calculator shows how expensive all levels of long-term care are today and the projected cost in the future.
• Canada: Publicly funded healthcare provides some long-term care support, but waitlists are long, and families often pay for private help. Some people have private LTC Insurance, so they ensure they have access to the type of care they desire.
• United Kingdom: Local councils provide means-tested support. Public care is accepted, though care quality varies.
• Australia and New Zealand: Government-funded home care packages are common. Retirement villages are popular and often integrated with healthcare.

Why More Americans Are Looking Abroad for Care

The high cost of care in the U.S. is pushing retirees and families to explore overseas options:

• Thailand: Private retirement homes with medical staff, full board, and recreation for a fraction of U.S. prices.
• Philippines: English-speaking caregivers, low cost of living, and familiarity with Western healthcare standards.
• Mexico, Vietnam, and Costa Rica: Growing reputation for expat elder care communities.

“My dad gets round-the-clock care, fresh food, and a sea view in Thailand — for $1,800 a month,” says Lisa, 52, whose father relocated from California.

That wouldn’t even cover half a shared room in the U.S.

International Benefits Available from Some U.S. LTC Insurance Policies

If you have a U.S.-based Long-Term Care Insurance policy or are considering purchasing one as part of your retirement planning, you might be surprised to learn that some plans offer international coverage.

This can be especially valuable if you plan to retire abroad, have aging parents living overseas, or simply prefer receiving care in another country. Certain traditional LTC insurance policies will reimburse care received outside the U.S., often up to a percentage of the full benefit—typically around 50% to 75% or for a period of time, like one year.

Some hybrid Long-Term Care Insurance policies include international coverage, and one insurer even offers full cash benefits that can be used to pay for long-term care anywhere in the world.

Countries like the Philippines, Costa Rica, and parts of Europe are increasingly popular with retirees due to lower care costs and established expat communities. Having international benefits can help you stretch your policy dollars while staying in a location that feels like home.

• The Unique Appeal of International Benefits in Long-Term Care Insurance

For multicultural or geographically spread-out families, international LTC benefits offer peace of mind. Maybe your loved one prefers the familiar language and customs of their birth country—or perhaps you have a trusted care provider overseas.

• The Unique Appeal of International Benefits in Long-Term Care Insurance.

Culture Still Shapes Care

In Southeast Asia, caring for parents is a duty passed down through generations. Moving someone into a facility can trigger guilt — and backlash. In the West, independence is prioritized, and residential care is often seen as a planned life stage.

Understanding these dynamics can help you frame the conversation in ways that align with the values your family holds dear.

The Next Step Starts with a Talk

Whether your loved one stays in Singapore, moves abroad, or gets more support at home — the path begins with one conversation.

Take a breath. Come from a place of love. And remember: you’re not trying to take something away. You’re trying to give them safety, dignity, and peace of mind.

Meanwhile, the time to plan for aging and the future impact of long-term care starts before you get older. In the United States and Canada, most people purchase LTC Insurance between the ages of 47 and 67.

Conversations should always start early, which helps avoid crises later in life.