Do you wonder how to begin a conversation with your aging parent regarding a sensitive topic? Whether it's needing to speak about giving up driving, moving, or bringing help in, you can improve the odds of coming up with a solution by knowing which words to avoid, and which ones to use.
"Start by realizing that there are fundamentally two different types of parents," says Caring.com senior medical editor Ken Robbins, a geriatric psychiatrist at the University of Wisconsin-Madison. "Those with whom you have a relationship in which you can be straightforward and they welcome your ideas and feedback, and those who tend to be more self-conscious or private and don't welcome this kind of discussion -- and may even find it somewhat insulting."
Even if, during past times, your parent was receptive and sharing, that can change from an age-related issue like lowered self-esteem, creeping dementia, depression, and other frustrations. However, a parent that doesn't say much might find it reliving to speak since he or she is scared, too.
Breaching a sensitive topic might also be tricky since you have different goals. Adult children try to solve problems then move on. Their parents, though, first and foremost want to maintain some sense of dignity and control during tough times. Your goal in having "the talk" is balancing the needs of both sides by moving ahead with care, and slowly.
Get your homework done first
Before saying a single word, being by collecting some data and researching possibilities for a solution. At the end of the day, your goal is problem-solving by opening a dialogue with them, (not dictating solutions or convincing by winning an argument) By gathering your facts, you will be able to offer help in a fashion that is less stressful and better informed for all parties involved.
- Health Issues
Note which specific type of limitations you've seen: challenges trying to climb stairs? Trouble with finance? Personal grooming habits? When you think in term of specific issues it'll help you with figuring out a better solution, along with being able to accurately describe issues with doctors (and your parents)
Watch your parents driving, looking for unsafe driving signs. Research senior transportation services or think about other ways for them to travel without a personal car.
- In-home care
Observe closely which activities your parent is struggling with. Search their home for specific signs they aren't doing well independently. Begin researching sources of in-home care help and costs.
Testing The Waters
Also prior to beginning your conversation, take some time getting a sense of whether or not your parent is open to the topic. This can be done by the introduction of related topics - over the phone before visiting, or if you visit your parent a lot, during a separate meeting. This isn't time for criticism, hot-button topics, or anything contentious.
Stay positive and generalized. Does she openly respond? Is she defensive? Evasive? That will bring important insights into proceeding in the right direction.
Say one of these things:
- "How is your health? What is your doctor telling you these days?"
- "How's your car? Do you still drive to the city each weekend?"
- "How is the house? It must be hard keeping this place in good shape."
If your parent appears interested, follow up with:
- "Is there something I can do to be helpful?"
- "Yeah, I can see how that would be bothersome to you. Lets discuss it more next time I see you"
If they ask you "What should I Do?" answer by saying:
- "I will be there soon; we can work on this together then"
- "What do you think? Give me some time to think about that, too"
Do not say:
- "Yes that is a problem. I'm going to do A and B taking care of that for you."
- "You sound confused; I'm going to call your doctor"
- "It sounds like it's time finally to call an in-home caretaker"
Pick the best messenger.
What if your parent offers resistance to any talks about her future. Stop and consider if this conversation is best had by another person. Sometimes neutral third parties,family friends, doctors, a pastor.. are often better suited to bringing up a tricky topic like driving or independent living.
People like these can lay the same foundation, suggesting what seems to be wrong and offering suggestions for solutions, without the risk of a strained relationship in the ways adult children do when their parents feel manipulated or offer lots of resistance.
Starting the Conversation
Setting the right tones.
So you did your homework and got a sense of how ready (or indifferent) your parent seems. How do you jump in? Plan on beginning the conversation on another day after the testing-the-waters talk, and do it in person if it's possible. That makes it feel less overbearing and threatening, and more natural.
Do not get critical of them the second you walk in the door. Stay focused on having fun and connecting, and also use this time for observing. Your mission might be solving the problem, but you will have a more connected audience by first taking the time to enjoy their company before plunging in.
Try beginning with a compliment - say something such as:
- "Wow, it looks like..."
- "I like how you've ..."
Search for an opening.
The best time to segue into a serious conversation is when your parent brings it up first and asks for your help. Failing that, look for an opportunity when everyone is relaxed. Then take the plunge. Describe what you're seeing.
If your direct approach seems welcomed, say something such as:
- "I see the steps are a problem for you and you almost fell this morning. Is that happening a lot?"
- "Mom said you got another ticket, and I noticed the rear fender of the car is bent again. What do you think is going on?"
- "It looks like you're having trouble getting off the couch, and you seem a little lonely and mixed up when you're tired. You know they say that people do a lot better where there's a lot of activity going on, and things to enjoy."
If your direct approach seems welcomed, say something such as:
- "I read about this man in the paper who lost control of his car and killed some kids on the sidewalk. He was about your age. It made me think we should consider what's in your best interests with the car now."
- "Remember John, my friend who became a doctor? He told me that his whole family has living wills and I'm thinking we should all do that, too."
What you should not say:
- "When are you going to quit driving? I hear you had another accident."
- "The house was so messy last time I was there. You need to hire a housekeeper."
- "Dad, Mom looks awful! We need to go to the doctor when I get there, because you obviously are having trouble looking after her."
Listening and Following Cues
Try using reflexive listening, a technique that helps with challenging conversations. Rephrase what your parents tell you, as a way of showing that you understood them - which makes your parent feel you support them - and then move the conversation forwards.
Say something like:
- "I know you're really worried about. . . . Me, too -- but if X doesn't happen. . . ."
- "That sounds upsetting for you. . . . Have you thought about. . . ?"
- "I hear you saying . . . but it's also worth thinking about this. . . ."
- "Yes, I agree that . . . on the other hand. . . ."
Know that some older adults cannot articulate the real issues. They might shy from change, maybe since they fear what it might be like or don't have the energy to deal with it. Oftentimes they will avoid making changes not because of their own preference but since they worry about upsetting somebody else.
If your parent sounds anxious, say:
- "You may call them ugly old grab bars, and that's what they used to be. But I was reading how universal design is really trendy, attractive home design right now."
- "Yes I know we have always spent the holidays in your house, but we would love to have Christmas at our house this year. You can still make your special pie there without having to worry about all the getting ready or clean up."
Find a way to reassure them, talk about the positives, and reiterate how the solution is good for everyone.
If he seems resistant say things like:
- "Let's make a list of pros and cons."
- "John says he will pick you up for your Breakfast Club each morning so you will not miss it, and I will get your groceries."
Focusing on the solution helps with resistance. Or figure out the underlying causes. Sometimes a person pushes back for a specific reason they don't mention - this might be physical, emotional, or cognitive. Maybe your father doesn't want to talk about moving because he thinks he cannot afford it. Maybe your mother doesn't have the cognitive ability to know she cannot live alone. If that person is very stubborn, the adult child might not have as much luck as a doctor or family friend.
If he agreeable or interested say things like:
- "What would be the most difficult thing about. . . ?"
- "What would it mean to you if you stopped driving/had someone to cook meals/moved?"
- "How about we start a list of solutions for this"
- "Lets think about the pros/cons of each situation"
- "Why don't you try doing X for a couple of months and see how it works for you?"
The goal is encouraging more inputs and keeping the conversation collaborative and positive.
Even if there's not much choice, lay out the options and their pros and cons, strategize solutions to the biggest problems, and let your parent draw his or her own conclusion (assuming dementia is not an issue).
Let the idea set in.
No matter what, you shouldn't start aggressively "selling" your favorite options the second you return home or the next time you visit. Do not push for deciding right away. Try not to nag or even hint at first.
Don't say things like:
- "So, selling your car -- have you done anything about it yet?"
- "I hope you've been thinking about our idea of bringing in some help."
Always be ready to continue having the conversation whenever.
If your parent brings the conversation up at all, you can use it as a wedge for revisiting the issue in a way that is supportive.
If they offer something positive say something like:
- "Yes I could see this making you much happier. What do you think it would be like having someone around to help you? Lets think about what we would have to do to make this happen - I'm willing to help."
If your parent expresses concern say something like:
Recognize this as a positive sign that she or he is at least aware of the issues and thinking them over. Revisit the facts and the solution once more in a way that is non-threatening.
If they express something negative:
Do not start to argue. Remain patient and try and get to their underlying concerns. Is it fear that admitting help is a necessity equates to being a failure? Are they scared of running out of money? Try and find ways to support their concern and address it. Maybe you give them a weekly cleaning service for a Father's Day gift "since I don't know what else to get for you and you deserve to be treated like a king" for example.
Testing the waters (again):
Once time has passed, if your love one hasn't given you an opening, you can try to bring up the issue again in a testing-the-waters way.
Say something like:
- "What did the doctor say?"
- "How is your car?"
Make it clear that you are comfortable whatever their decision:
If your parent is thinking clearly, however they are just making a decision you disagree with (not endangering him/herself) all you can do is continue the conversations in a positive way. You might not like their choice, or maybe you'll have to revisit this matter again, but you cannot make the decision for them in this case.
What you can do, is remain supportive and upbeat, even when you are worried or frustrated. This will keep you as a welcoming source of advice, as your mother/father moves, however slowly, towards a resolution.
Remember that a transition involves an open dialogue. As challenging as the first conversations about sensitive topics are, it is only the first of many you are likely to have as you move you way towards a solution that everyone will feel better about.