HAVING DIFFICULT CONVERSATIONS
WITH SENIOR LOVED ONES 101
Difficult conversations are unavoidable. We have them with friends, love interests, spouses, partners, children, colleagues, and senior parents.
Difficult conversations often bring about anxiety that can be minimized by following a few simple approaches. If done right, these dreaded talks can not only lead to positive outcomes but bring loved ones closer together.
For this particular post, I will focus on talks adult children frequently have with senior parents regarding long-term care options.
Select a quiet, soothing place to have a Difficult Conversation: Make sure the location is familiar to everyone. If possible, select a location filled with loving memories. (Ex. If you had a tradition in your family to discuss important issues over tea in the backyard, have tea in the backyard.)
Schedule a specific time for the discussion: Ask your loved one to schedule a time that best meets his or her schedule. Be flexible and adjust your time accordingly. (Ex. If your loved one is most open to talking after breakfast, plan a discussion for late morning.)
Take your time: Keep in mind, that some difficult conversations may require several talks before a conclusion is reached. Your loved one may have a difficult time taking care of themselves, but he/she is still an individual who should not feel pressured. Plan to revisit the topic if a conclusion is not reached. Ask your loved one when a good time to discuss the issue would be. Do your best NOT to ambush your loved one with a Difficult Conversation.
NOTE: When painted into a corner, most individuals feel agitated, and compelled to say ‘no’ to any suggestion. The same individuals may feel genuinely hurt at what he or she will experience as a lack of respect. Use accurate empathy to anticipate what your loved one may say, do, and FEEL.
TIP: Allow the individual to have as much control over the environment as possible. Give him or her the power position around the table. (Ex. Head of the table or four corners). Ask if he/she needs more time to think. DO NOT RUSH
Be prepared: Do your research before bringing up any sensitive topic to a loved one. (Ex. “Dad, Home Care Services can be brought in and discontinued at any time. You always have control no matter what.”)
NOTE: People fear LOSS OF CONTROL the most. Make sure your loved ones understand that they will be in control at all times.
Active Listening Tools:
· Restate: “So, Dad, what I’m hearing you say is…”
· Reframe: “I see what you mean. In my mind, I was seeing the situation from this perspective.”
· Accurate Empathy: What is the person you are having a conversation with seeing, hearing, smelling, experiencing physically, and experiencing emotionally? Try your best to see the situation from his or her perspective.
· Summarize: End on a positive note. Quickly summarize what was discussed. Mention that it was good to have an honest discussion.
CASE VIGNETTE
Mr. Smith’s adult children became concerned after their father’s recent hospitalization. He had passed out while driving but luckily was stopped at a red light. No one got hurt in the process. After many tests, his loss of consciousness was attributed to a stroke that also impaired Mr. Smith’s speech, eyesight, and the use of his right arm. Mr. Smith’s family decided that a temporary caregiver would be helpful to assist him with shopping and minor household chores. The family requested a time to meet with their father to discuss long-term planning. At the suggestion of his family, he agreed to meet after Church on Sunday afternoon. Mr. Smith saw it as a good opportunity to have his children and grandchildren over for dinner. Family dinner after Church was this family’s tradition for many years. Having a low-key discussion while grandkids watched television after the meal and adults had their coffee was the selected time to have a difficult discussion.
OPPOSITION: “I don’t want a Caregiver in my house. I don’t want someone to see my things. I need my privacy. I was always independent. Even after your mother died, I managed to do everything myself. I’m not an old man yet.”
FAMILY RESTATES CONCERNS: “Dad, what we are hearing and feeling you say is that you do not want to have a new person in the home. You feel strong and want to continue remaining independent. You have always been an independent man, even after Mom died, and you want to keep that independence.”
REFRAMING: “Dad, independence can mean different things. Can you talk a little about what independence means to you? Is it being able to shop for yourself and cook meals for grandkids? Is it residing in your own home? Tell us what scares you most.”
EMPATHY: “Of course having a Caregiver in the home is not easy. It is a huge change and can feel uncomfortable at first. No one wants to take away your independence. We feel our goal is to keep your home for the rest of your life. This is where you belong. We also feel our goal is to prevent further medical issues from arising. A caregiver is NOT permanent and can be canceled at any time. But a caregiver can ADD TO YOUR INDEPENDENCE.
Adding a caregiver to the home will lead to more time you can spend with grandkids. Extra assistance will help you attend social functions. You may feel good about doing your shopping instead of ordering food to be delivered. Having a person in the house to assist with very minor housekeeping, may create more time for rest, more time for a fun hobby, and maybe even time to visit us more?”
GIVING CONTROL and ENDING ON GOOD NOTE: “Dad, you don’t have to make any decisions now. We can start slow. Why don’t you think about it? We did some research on top Home Care agencies in the area. We can talk about this some more next week. It was a joy to get together as a family and we feel the kids truly enjoyed seeing you. Just like the good old days.”
ANCHOR: The conversation ended with a group hug. That group hug will later be used to open the next discussion. The group hug becomes an Emotional Anchor.
