Crucial Conversations with Older Parents

One of the topics I explore in my book Re-Designing Your Life: A Practical Spirituality for the Second Half of Life, which will be published early in 2018, centers around care-giving, especially as it pertains to our older parents. A very helpful article written by Steven Barlam was posted recently by Will Randolph on the Boomerstock facebook page. I re-post it here in the hope that it may help you with some of those difficult but crucial conversations you need to have with your aging parents.

Broaching Difficult Conversations with Aging Parents

December 5, 2017
Steve Barlam
You’re headed home for Christmas.

Amid the airport shuffle and holiday cheer, you’re distracted by worrisome thoughts. While you’re really looking forward to seeing your mom, the prospect of having a difficult conversation with her about driving has kept you up at night. She’s likely to be crushed, in denial, or furious. How can you broach this difficult topic and not ruin the holiday fun for the entire family?

Having Difficult Conversations with Aging Parents is Tough but Necessary

With holiday gatherings naturally bringing families and generations together, they provide a unique opportunity to talk face-to-face with your senior loved ones. Yet, the dual imperative of making lasting memories and tackling the complex issues aging brings in a limited time frame can make the atmosphere seem more like a pressure cooker than a holiday celebration.

Heavy talks can feel uncomfortable and forced. They can also detract significantly from what’s really valuable – connecting in meaningful ways, having fun and making memories.

6 Tested Tips for Handling Difficult Conversations with Aging Parents

The good news is, there are approaches you can take to create a smoother backdrop for addressing the hard issues in the least traumatic way, freeing up more time for family, food and fun.

Below are 6 tips from my 30-plus years of work with families and their aging parents to help set the wheels in motion and have a meaningful, fruitful conversation with your senior loved one:

Tip #1: Set the stage and plan for a conversation. 
It’s easy to dodge an impromptu conversation; it’s harder to avoid something that has been discussed and is part of the overall plan for a holiday get-together. Thus, setting expectations in advance is key.

Before the holiday, mention your desire to have a talk. For example, “When we come out next week, I’d love to catch up with you and check in on how you’ve been feeling, and any thoughts you’re having about the coming year.” It doesn’t need to be specific or neatly tied with a bow. Simply set the stage for the conversation to happen.

Tip #2: Schedule a specific window of time. 
Planning a time for your conversation is the one point where you’ll want to be extremely specific right away. When you carve out an intentional space on the schedule for a conversation with your aging parents, it feels less like a distraction from everything else and more like a part of the holiday plans. “Let’s aim for Saturday afternoon,” you could say. “I’d be glad to take you and dad out for coffee at Starbucks.”

Tip #3: Pacing is critical. Slow down when talking to your aging parents. 
I’ve seen adult children head into conversations moving at 90 mph even though their parents may be moving at 25 mph. Due to this, conversations can feel rushed and pressured, leaving all with a sense of frustration.

Remember, you may have given a lot of thought to some of the issues at hand, but your parent may not yet have considered them and may need time to process the issues or they will be in denial. Without the right emotional preparation, he or she might feel caught off guard and defensive, grilled or barraged with questions and therefore not be able to truly hear what you have to say. Often these situations result in the parent saying no to whatever is being suggested or they flatly refuse help.

Moving too quickly might exacerbate this. It risks leaving many concerns, problems and needs unvocalized — and other stones unturned.

To prevent rushing, check yourself during the conversation. Does your pace match that of your family member?

Forcing a tough discussion or pushing for a swift decision may result in less than ideal outcomes. You may spend the entire talk de-escalating a situation that arose simply because of the conversation itself, and wind up needing to postpone the talk to another time. If a conversation cannot be finished during the course of the visit, acknowledge this and set up a time in the coming weeks to follow up on the initial discussion. Ideally, you should do so no more than 3 weeks later.

Tip #4: Create an alliance through authenticity and appreciation. 
Your job during the discussion is to form an alliance with your aging loved one. While talking, try to really dial into what he or she finds important and discuss what matters most. Communicate thoughtfully by working to understand their perspective and how they view their world. Remember that elderly people suffer daily losses, and you can help simply through acknowledging their struggles. Especially around topics your parent doesn’t necessarily want to talk about or admit to, it’s always better to approach the conversation from a place of compassion, aligning yourself with your parents against your common enemy: whatever is bothering them.

Consider these two different approaches to overcome resistance:

Common approach: “Mom, you just have to give up driving. Your eye doctor has told you that your Macular Degeneration has gotten to a point where you just do not have adequate vision to drive safely. Here’s what I think we should do to make sure you don’t get into an accident.”

Thoughtful approach: “Mom, I’m so sorry we have to deal with challenges of Macular Degeneration. Because of this, your MD has said pretty clearly that you shouldn’t be driving. I appreciate how miserable this news must be. So I was just wondering if we could put our heads together and come up with other transportation options.”

Be real. Be honest. Appreciate the impact of the discussion. Family members who are aligned, authentic and appreciative can get through difficult conversations with aging parents with amazing grace.

Tip #5: Make a practical plan. 
If you can leave the discussion with a simple plan that includes next steps… often times that in itself will create a sense of relief for all involved.

Identifying the issues. When thinking about the issues to address consider the following categories, as these tend to be the key areas of concern for most families:

  • Physical well-being
  • Emotional well-being
  • Social well-being including activities that foster joy
  • Financial and material well-being

Once the needs are identified, start looking ahead to desired outcomes. If dad has lost weight, the desired outcome may be gaining or stabilizing weight. If mom is unhappy with her current MD’s inattentiveness, the desired outcome might be to enroll her with a new MD in the new year. Go back and forth with your senior loved ones, exchanging ideas and allowing them to plan for their future and shape with you the picture of their desired outcomes.

Your final step is to get specific about who will do what and when. Will you find your mom a new doctor? Will you get her a smartphone so she can Uber to and from appointments? Will you help organize a trip to visit the grandkids? How?

Tip #6: Don’t do this alone. 
Do you have to have the difficult conversation with your parent alone? Who else could help you in planning for the conversation? No one is expected to go down the path of caring for aging parents alone. It takes a team. Reach out to your team of family, friends and trusted professionals: an Aging Life Care Manager, a physician, an attorney, a financial planner, and an accountant. Your team will work in concert to ensure that the right conversations take place.

Even with the best-laid plans, there are times when family conversations do not go as anticipated. Do not fret. This is normal and does not mean all is lost. If in the end you feel like you’re going around in circles without reaching solutions, remember, important conversations are not one-time events. They need to be revisited on a regular basis, because a “no” today, does not mean a “no” forever. Planning ahead and having the conversations today can help you can help you address the critical issues while preserving family unity — and holiday cheer.

Steven Barlam, MSW, LCSW, CMC is the Chief Professional Officer and Co-Founder of LivHOME. Since 1985, Steve has worked exclusively in the field of geriatrics, working directly with clients and their families, and developing innovative service delivery models. He has served as President of the National Association of Professional Geriatric Care Managers. Steve is a regular lecturer at local universities and national conferences on topics relating to care management, technology, and patient/client care.

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