Does the thought of having a tough conversation, with your elderly parent, keep you up at night?
If you’re an adult child of an elderly parent, chances are you’ll eventually need to have “the talk” with them, about a sensitive topic. These conversations are anything but easy and often times we avoid them.
I find these tough conversations are usually centered around…
- giving up driving
- bringing more help in to the home
- moving to a care community
- end-of-life decisions
Regardless of the topic, knowledge will improve your chances of having a constructive conversation that leads to a solution you can both live with. Some of these ideas will resonate with you, some wont. The key is to figure out an approach that’s unique to you and your parents.
GROUND RULES: Regardless of where you are in this process keep the following in mind!
- You are an adult not a child. Be aware of internalizing this process and filtering it through the eyes of a 10 year old. This is especially true if your parent is toxic and you tend to react versus respond to them.
- Your elderly parent is an adult not a child. Be respectful and understand that unless you’ve been appointed guardian you have no legal authority to force anything upon them, even if you have a power-of-attorney.
- Your grief is real and denying it is not a good plan. Whether it’s the first time you realize your elderly parent is in decline or you’re deciding about hospice, these conversations are sad. If you deny your grief, chances are it will come out in ugly ways!
- Your elderly parent is afraid. It may come out as anger, stubbornness or denial but most older adults (of course, not all) don’t want to be dependent on others, especially their children. They’d rather die!
If your elderly parent is struggling with dementia, I’d like you to keep these three things in mind…
- Be prepared to have this conversation over and over. I can’t tell you how many times I’ve had conversations with my clients only to find the next day they don’t remember a word of it. What I find most important is that I focus on what my client is feeling. If you expect someone with dementia to remember the specifics of your conversations, you’re both going to get frustrated and overwhelmed. On the other hand, if you focus on what they’re feeling, your empathy and support will go along way in making this conversation productive, even if they don’t remember it.
- Be prepared for your elderly parent to express poor judgement and reasoning. This is even more frustrating than short term memory loss. Your elderly parent may not be capable of problem solving a solution. If you put them in the position of “figuring it out”, they’ll probably respond with anxiety, denial and anger. What I find works well is if I give my client the solution and ask how they feel about it. I may say something like “we could arrange for someone to come in once a day to fix meals, do your housekeeping, which will be less expensive than a move. What are your thoughts of that.?”
- You may be past the point of having this conversation. For those of you further along the dementia journey, it’s okay not to have the difficult conversation. I see this usually as it relates to end-of-life decisions. If your mom or dad are scoring low on cognitive screens or don’t recognize you any more, the ability to participate in decision making type of discussions has passed. This can be sad and scary but you’ll have the conversation for them. As long as you keep their best interest in heart, you’ll be doing the right thing!
If you want in-depth understanding on this, you can follow this link over the the Alzheimer’s Association for addition information.
10 Practical Suggestions For Having a Difficult Conversation With Your Elderly Parent
- Organize Your Thoughts and Concerns – don’t attempt to have this conversation until you are crystal clear on what the issues are. Vague language and lack of clarity will frustrate your elderly parent and get this conversion off on the wrong foot. I suggest you read this article on How to Assess Your Elderly Parents Daily Needs to identify your concerns. If you think your elderly parent is open to participating in the assessment process, review that article task by task and get their input.
- Research Community Resources – once you complete your assessment, research local agencies and programs that may be able to help you. For example, if there’s a need for more help in the home, educate yourself about local home care agencies so you’ll be able to answer any questions your mom or dad might have. A good place to start locating local resources is through your local Area Agency on Aging.
- Practice What You Want to Say – I know this may sound silly but I do this all the time with my clients. Sometimes I write it out, sometimes I have conversations with myself (crazy, I know) and sometimes I seek the help of another professional. But I never, ever go in to these conversations without having an idea of how I’m going to respond to different scenarios. I also recommend you script and practice your opening sentence: “Dad, I just want to touch base with you and see how you’re doing? I’ll be honest, I worry about how you’re getting along”.
- Be Emotionally Present and Empathetic – Muster all the empathy you can so your elderly parent feels you understand. If you want them to listen to you, they need to feel understood by you. This speaks to setting the tone for this conversation. Don’t take a “know it all” attitude (I really struggle with this) and ask a lot of questions to uncover what their biggest fears may be. This could sound like “Mom, someday you’re going to need more help. What’s your biggest fear about accepting help?”
- Manage Your Expectations – Rome wasn’t build in a day nor will the solutions to your elderly parent’s challenges. It’s rare that my client’s jump at the opportunity to accept help in their home, give up the car keys or transition to a care community. If you don’t mange your expectations, you’ll find yourself frustrated and worn out before you’ve even started. This is particularly difficult for those of us who are programed to check things off our list. Patience is a virtue and the foundation for managing your expectations.
- Be an Active Listener – Sometimes my goal in these conversations, is simply to listen and observe. By listening you are showing you care AND you may find a way to move forward. I recently asked a client to move from an independent living apartment to assisted living. A move that was long over due. His initial reaction was “hell no, I’m not moving”. In one conversation, it occurred to me that he was stuck on how it would all get done. In our next conversation, I started with “are you overwhelmed with how we’ll get all this stuff moved?” I assured him that I would take care of all the details. We moved forward!
- Test the Waters and Seize Opportunities – I may test the waters by saying something like “have you ever considered moving so you wont have all the upkeep on this house?” If they say “hell no”, I dig deeper into their fears. If they say yes, I seize that opportunity to educate and identify what they would want in a new home. If I’m real lucky, I can seize the opportunity to make appointments to see retirement/care communities that I think my be a good fit (this circles back to the need to do research before hand). The key is to recognize your opportunities and act quickly before the opportunity is gone!
- Avoid Arguing. For the record, I struggle with this. Just recently my sister had to step in as I started to argue with my own dad. I know better but my buttons were pushed (I wont bore you with the details)! Arguing only leads to more miscommunication, hurt feelings and ultimately no change in the situation. Sometimes it helps just to have another person present. Fostering awareness and the ability to walk away quickly from the argument can also help.
- Decide if a Conversation is Worth It. This is especially true if your elderly parent has a long history of toxic or abusive behavior. There’s really no sense in trying to reason with someone that has no intentions of ever being part of the solution. Or worse yet, someone that’s going to pile on verbal or physical abuse. Or the narcissist, who despite all the evidence that things are not right, they insist that they are fine OR they insist that you take care of them 24/7. If you genuinely feel that you can’t have this conversation without being abused or roped in to something you don’t want to do, then don’t.
- Don’t forget sensory challenges. Keep in mind that your elderly parent may not hear what you’re saying and may be agreeing to things without realizing it. Same goes for vision. If your elderly parent is struggling with macular degeneration, don’t hand them a brochure from the local assisted living community and expect them to read it. Communicate in a setting that has little interruptions and no TV. Make sure they have their glasses on and hearing aides in.
I know these conversations can bring on intense anxiety and it’s tempting to avoid them. Trust me when I tell you avoiding them is not a good plan. These conversations are too important to ignore and sometime the stress of avoiding them can be as intense as actually having them.
I encourage you to evaluate your situation, map out your best approach and keep trying.
Which of these ideas resonate with you? I’m sure many of you have additional tips and advice that could help others. Your comment could make a difference!