Start the Conversation Before the Crisis with Chelsea Neulieb — Full Episode Transcript

You don't have to have everything figured out. Just ask one simple question today and see where that takes you. I think most families tend to avoid having the necessary conversations, not because they don't care, but because they care too much or so much that sometimes these hard conversations are easy to avoid.

When caregiving feels overwhelming and the system feels impossible to navigate, this is your guide. Here, you'll learn ways to navigate long-term care planning, find real support for caregiving, and prepare you for the road ahead. I'm your host, Lindsay Friedman, and now you're not in this alone. Let's get started.

Welcome back to the Caregivers Compass. I'm your host, Lindsay Friedman. I'm pleased to welcome Chelsea Nylab, founder of Silver Linings Consulting and a care coordination specialist with more than a decade of experience supporting older adults, caregivers, and families. With a background in social work and training in senior fitness, dementia awareness, and holistic health coaching, Chelsea helps families understand what aging and long-term care really look like day to day. She's known for turning overwhelming decisions into practical, compassionate plans that honor independence, wellness, and dignity. We are pleased to have her on the show and one of our providers, partners on LT CareNav. Welcome, Chelsea.

Thank you so much, Lindsay, for having me. I'm really excited to be here today. And I'm so excited to have you because you and I've talked a lot, even off camera, about why you do this. And your motivation is so pure and genuine. And I'm sure all of your clients get to see that. But we'll just kind of start with things that you and I've talked about. Families are unprepared. They are not sure what's going on. They're confused. You're meeting them in a time of turmoil. Why do you think that they let themselves even get there? Why didn't they have a plan?

Yeah, Lindsay, I think about this a lot. I see it a lot. I think most families tend to avoid having the necessary conversations, not because they don't care, but because they care too much or so much that sometimes these hard conversations are easy to avoid.

I think talking about it can feel like naming something really hard and maybe even taking away something like independence. It can just be very scary to start talking about the conversations as we age and what our parents or loved ones might need as things change. And that is kind of, I think, part of it, right?

We see people who — especially as we're aging, we want to keep independence, right? And people are getting combative and then you end up meeting them in moments of crisis most often, is that true?

Yeah, I mean, some families I meet in moments of crisis. Some families, I'm working with a family right now that's more in the planning ahead, starting to see some changes and, you know, reaching out to try and make sure that there's a good plan in place to maintain that independence and safety in the home for as long as possible. So I meet families where they are and every family is different and what they're needing to work through.

Yeah. So this actually is a really interesting thing. Can you explain, you said you have a family who's planning ahead and you see people in crisis. What is the difference in outcomes and what that experience looks like between planning ahead versus one doing it during crisis?

Yeah, I think when we wait until a crisis, until whatever that crisis might be, everything gets compressed and decisions have to be made really quickly. And they're happening in places like hospitals or in the emergency room after a fall. Whereas if you plan ahead, these conversations can happen, thoughtful conversations, plans can be made, and then those decisions don't have to be rushed or under added pressure, emotion, stress in these times of crisis.

It's not that families make bad decisions even in those moments, but the crisis adds that extra pressure and doesn't always allow for the best decisions to be made.

And because I think everyone in our industry, right, like we've talked, they really push like crisis is not the place to plan, right? Any kind of plan, no matter what it is. And so to not do that, you really have to start these conversations earlier. So what would you tell adult children or loved ones? How do you start that conversation? What do you avoid? What don't you say? What do you say? And how do you structure that?

Yeah, that's a great question. I always tell people to try not to start with a plan in mind, but maybe just start with one question. And the conversation doesn't have to be just one conversation, right? We can start with a question like something simple, asking them what feels most important to them if their health ever changed. Starting with just one simple question, or what does it mean for you? What does it look like for you to stay independent?

Starting with a question leads to getting their true answer as to what matters most to them and helps guide that conversation — either that conversation or the next or the one after that — and helps really guide a good plan.

No, those are really good advice. What happens, do you think? How would you approach it as an adult child if you start these conversations and mom or dad gets really agitated or uncomfortable with it, even if you're coming from the right place? What do you suggest?

I think starting with the question and making sure that you're always looping it back to what's important, what matters most for that person can really help shift that conversation, especially if there are any feelings that come along with that. I think it's about how you have the conversation, right? And guiding with those questions can make sure that the individual feels safe and they don't feel like things are being, you know, they're not being told what to do or what needs to happen.

Because losing independence itself can feel very scary, right? And so it's just about how you approach that conversation. Again, I think that leading with a question about what they want and what matters most to them is going to feel better and just feel a lot more natural for everyone.

No, and I think that is great advice that families really need to hear often — just to revisit in that kind of kindness and compassion to always go through with it. So when families are planning, there's kind of two dynamics, right? Because you said, what do you want out of your future? How do you want your long-term care? What do you want that to look like? That's one piece of it. But there is another larger piece, which I think families find to be even more sensitive, is the financial piece of it. And so how does that play into your conversations? And do you find that to be a lot more delicate of a topic with families?

Yeah, I think it's just another piece of the conversation that often gets avoided because, like you said, it is so delicate. A lot of people are more private about their financials, even with their family, which is totally fine. I think what I've seen is that once families open the door emotionally, the financial piece kind of becomes a little less intimidating and becomes more natural.

And I think a lot of fear comes from just not knowing — not knowing what care costs, not knowing what's covered by their insurance or long-term care insurance plans and etcetera. Just the whole system can be a little overwhelming, and not knowing kind of creates that fear. And not knowing what options even exist through all of that.

So I think once you bring in the emotional, open up the emotional door, like asking the question of what matters most to you, that really kind of opens the door to other things. And then once you have that financial clarity, it can give structure to that conversation. It can turn something abstract and very much unknown into something that you can actually build a plan around. And I think that that's why having partners like LT CareNav is so helpful, because families can start to understand what their options are and not feel like they're under any pressure to decide right now. So that's how I use LT CareNav with families in these conversations.

No, and I love that, and I thank you for sharing that too. But with LT CareNav, we always talk about how important the providers are, because this isn't a journey that you can do on your own. Information is fantastic and information points you in the right direction, but it truly — it's people like you who can hold a family's hand and understand it, because those are the moments that are really hard.

So when somebody gets to you, what does proactive planning look like? What is that process? How long does it take? What does that look like?

Yeah, it's a great question. It can seem overwhelming, but it's usually a lot simpler than people think. So it's not about having everything figured out. It's just about having that starting point. And that — I mean, you ask about how many conversations — again, it's going to look different for everyone depending on where the individual is, what their actual healthcare needs are, etcetera, etcetera.

But I think that it starts with just understanding what kind of care your loved one would want and what matters most to them. And then that can just be the kind of entryway point to understanding who the key decision makers are, whether that's on the care side, on the financial side. I mean, it's really about what the individual and what the family want, and everyone is different.

You did, and you answered some more, and you triggered some more questions, which is always fantastic. So when somebody comes to you — there's a lot of conversations in the industry right now about how the infrastructure is falling apart, right? We're seeing all of these things. So if you could tell a family, ideally, other than not in crisis, what is that perfect time to come have that conversation with you? Where do you think that inflection point of “this is where we should all start planning” looks like?

Well, I would say the perfect time is always now. Again, every family, every situation is different for proactive planning. I would say just start the conversation, ask the first question, and that can give you a little bit more insight and clarity into — based on what the person wants, based on their goals, based on their financial picture, their health picture — starting the conversation now opens the door to understanding how far out in advance you want to plan, what you need.

It's a good answer. There's no one answer. Every person is different. And I think that's what's really important. And I think services like what you do — finding somebody who can understand that every situation is different and you can cater towards it. It's not like somebody's going to come in with something you've never seen before, like impossible to dig their way out of.

So I think knowing that there is somebody really with a shovel that can help you get back to the top and kind of have a smooth landing is really important for families to hear — not just about what it looks like to plan, but if you are in crisis, there are people who can help you pull your way out of it.

Absolutely. And I think offering, just being able to offer a different perspective or an outsider's perspective — sometimes these conversations can get emotional, sticky. There can be a lot of individuals involved, depending on the family and the family dynamics. And so sometimes having an outside person to help navigate those conversations and provide that neutral guidance can be very helpful in the conversation.

Absolutely. I mean, family dynamics, I think, play a lot into long-term care. What it looks like, who's going to do this caregiving, everything, right? And that kind of compounds. I'm sure you've got a lot of families where you have those moments where you're like, OK, I'm playing mediator. But it's a really beautiful thing to be able to help families get from one side to the other, I'm sure.

Yes. Very much so.

And I appreciate all that you're doing, and I know your families do too. So if you could tell listeners one thing, right, what would that be?

I would say just start the conversation. You don't have to have everything figured out. Just ask one simple question today and see where that takes you.

Again, maybe it's asking what matters most to your loved one, or what would they like to see to help them remain independent and safe as things change. And just remember that you don't have to solve everything all at once. It doesn't even have to be one conversation, but just start the conversation. Ask the question.

And that's such important advice. So anyone listening, start the conversation. And you can find Chelsea at LT CareNav, and LT CareNav is here to help start that first step, and she's here to meet you and take you the rest of the way. So we thank everyone for listening, and we will be back next week. Thank you.

All right, that's a wrap for today. Until next time, remember you're not alone. Take things one step at a time, stay centered, and trust your compass. See you next time on the Caregiver's Compass.