Talking About Care
Imagine as an adult child you are starting to notice signs that your aging parents are having difficulty performing daily tasks like driving, cleaning, bathing, managing medications, and finances. More and more you notice signs of diminished health, mental or emotional acuity, limited resources, and signs that they may be vulnerable in their own home. You want to sit down and speak with them about your concerns and potential care solutions, but you find it too difficult…Why?
One reason is that we understand change is difficult. Even when that change is for the better. Adult children often fear that while they have the best of intentions for their loved ones, parents may view these discussions as the first step in a series of difficult life-impacting changes that ultimately include the loss of self-autonomy, a potential move from a cherished family home full of memories, change in financial expenditures, and a fear of spending the remainder of their life isolated in a senior facility. Other times the aging parents may want to start the conversation but find that the adult child struggles with impending changes and becomes intent on maintaining the parent’s perceived former lifestyle—even when that may not be a viable or appropriate option for either the adult child or the aging parent.
So, the question remains, how do you begin these difficult conversations? Whether the conversations are initiated by the adult child or the aging parent, there are steps that make these conversations less stressful, and more constructive, and lead to a practical solution for all involved.
Understand the Purpose of This Initial Conversation
• This initial conversation is to be a starting point—a time to share concerns and to open the door to more in-depth conversations. Do not expect to end this conversation with all the answers and solutions in hand. This is the first step of a life-impacting process that requires much time and consideration.
Prepare Yourself Prior to Starting the Conversation
• Take time to write a list of concerning behaviors or actions that you have witnessed. Be specific about how these behaviors or actions are different than before and why these changes concern you.
• Do a little bit of research to determine what potential solutions and options may be appropriate and available to your loved one. If you feel overwhelmed or confused by all the options you find, seek out a professional referral service that can help you navigate through the process.
• Consider your audience, be it parents or adult children, and determine who needs to be part of the initial conversation. You may feel more comfortable having an additional person join you to support your concerns, but some people respond better to an initial one-on-one conversation between one child and one parent that is then followed up with multiple participants. Others may only respond to a full group intervention approach made up of concerned family and friends.
• If you are meeting as a group, either designate a primary spokesperson with others to offer support as needed or plan a strategy that allows all to participate in the conversation at appropriate times or to specific issues. You want to come across as a united front but do not want to be speaking over one another.
• If there is a difference of opinion regarding concerns or solutions, be sure to discuss those as a group prior to speaking with the parent. Then, when the group does come together to speak, be sure to share all opinions in a respectful manner. Most importantly, you don’t want to add stress to an already stressful situation.
• Set a time and place that is comfortable and conducive to conversation. Pick a time when you and your loved one will be mentally and physically well-rested. Select a meeting place where you both feel comfortable, are free of distractions, and are able to speak for an extended period if necessary. Set your phone aside to assure your loved one that this conversation is important enough for your undivided attention.
Having the Conversation
• Start your discussion with a general overview of what you have witnessed or experienced and why you are concerned. Avoid spending too much time discussing any one behavior or action. Instead, focus on your concern for their general well-being and not a few isolated issues. You can come back to discuss multiple details of specific concerns in future conversations.
• As you start to share your concerns, remember aging adults may be very much aware of their diminished abilities and feel a sense of anger, fear, and even embarrassment. Be respectful of their situation and speak to them in a way that shows genuine empathy and concern.
• Remind your loved one that this conversation is simply intended to share concerns and discuss potential options. Assure them that no decisions have been made and that they will be part of the process.
• As you share your concerns, you do not want them to feel they are being lectured to. Periodically ask them how they feel about what you are sharing. Doing so will ensure they have an opportunity for equal participation and will validate their feelings.
Be prepared for conversational roadblocks. No matter how well prepared there is a good chance that your loved one will be reluctant to speak in-depth on the topic. In fact, they may not want to speak at all. Don’t take it personally—remember, this is a difficult conversation for all parties. Do not force them to engage in the conversation. Like many things, the hardest part is taking the first step. If they are initially reluctant to speak, respectfully share a brief overview of your concerns and then ask them a few open-ended questions about how they feel regarding what you have shared. Remember, this is an initial conversation. You may have knocked on the door but will have to come back a few times before that door is finally opened.