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Talking about Long Term Care with an Older Adult

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Date: 1999, Oct 04
From: Marianne Ewig septewig@execpc.com

So you are about ready to tackle some major aging issues with your parent(s) and you just don’t know how to begin. Here are some CONVERSATION STARTERS. Not all of the suggestions may work or be appropriate for the situation. Try a few!

PLAN AHEAD. Prepare your parents ahead of time so they can give you their full attention. Not while your mother is preparing dinner or your father is watching Wheel of Fortune. “I’d like a chance to talk to you about _____, when would be a good time?

ASK ADVICE. Seeking your parents’ counsel can be a great way to open dialogue. “I am trying to plan my own retirement, how did you both begin the process? or, “I saw this article on Advance Directives, do you have one?

HAVE A GOAL. Decide in advance what you want to leave the conversation with. It can be a simple as agreeing to talk again or as advanced as laying out a plan for seeking alternative living arrangements with them.

EASE INTO THE CONVERSATION. First, remember the common deficits many older adults have: Decreased hearing, sight, and loss of sustained concentration power. If you present a relaxed approach and present only one idea at a time the conversation will have a clear focus.

LISTEN CAREFULLY. If your parents believe you are REALLY listening to them, they may give you some important information you would never have known and be ready to compromise on some emotional conversations that may lie ahead for all of you. P.S. Often parents don’t feel they are asked enough for their opinions and may reflect, “ You mean you want to know what I want?”

USE I STATEMENTS. This one is well known to many people but worth repeating. I statements are not judgmental while you statements often are. This is similar to the “should” statements. As an example if it concerns driving, stating, “I am concerned about night driving and I would be happy to take you to the Sunday night circle suppers” is more effective than, “You shouldn’t be driving at night.”

DON'T INTERRUPT. It may be difficult based on dynamics of the past but curb your need to argue, make judgments or offer immediate solutions. The backbone here is respect for the decisions they make for themselves. Your role is to guide your parents through the plan realistically, asking them to consider alternatives if the plan doesn’t work out.

OFFER LIMITED ASSISTANCE. As above, yes you can offer your opinions but don’t give advice. Acknowledge their competence and offer to get information based on your common ground around the issue.

SEPARATE YOUR ISSUES FROM YOUR PARENTS’. It’s the old “whose problem is it- yours or theirs? If you no longer feel safe in their neighborhood say so but don’t shift the concern to them unless it is really an issue of protection.

STEP BACK IF THERE’S A FIGHT. Take that deep breath, stand up, get some water and realize as you step back that you don’t have to respond immediately to every objection. And don’t view it as an attack. Nod your head and continue listening, reflecting, “Where do you think we should go from here?”

ALLOW TIME. After stepping back give time for more reflection and to adjust to the content of your conversation. Issues are rarely settled in one meeting. (Is there any company that has only one staff meeting?)

RECOGNIZE LIMITATIONS. Sometimes parents may just refuse to answer. Don’t take this as closed topic forever. Try again, and again, perhaps at a different time and place.

FIND OTHER HELP. And of course the punch line is------Hire a Professional Geriatric Care Manager as the mediator, resource bank, and planner. But, you can also go to other family members who may have more influence or fewer emotional issues than you have with your parents.