Many of us tend to avoid difficult conversations only to later regret having delayed the inevitable. Confronting issues with aging loved ones about money, driving, safety, housing, home-based services, and end-of-life wishes are often put off for fear of hurting feelings or even our own difficulty accepting the realities of the aging process. How can we prepare ourselves for these difficult but important conversations?
Prepare
Write down your opening statement and your key speaking points. Some people find it helpful to write what needs to be said in the form of a letter that would not be sent. Start with your observations: “I noticed that you don’t seem to be paying your bills on time.” Give concrete and factual examples: “I know that bill collectors have been calling and I can see the bills mounting up in that basket.” Next, state your concerns about the situation: “I know that you want to keep living alone, but I’m worried,” or “I’m afraid that your utilities will be shut off.” Then, give your suggestion: “Why don’t we talk with your doctor about assistance available for you?” or “It may be time to consult with an eldercare specialist.” Finally, have some closing comments handy, “I’m glad that we talked,” “Thanks for being open to talking about this,” or “I’d like to continue this conversation soon.”
Rehearse
Once you have it down on paper, try role-playing with an EAP counselor, another family member, or a friend. Ask for feedback about your delivery, which will help you to refine your presentation. Practice until you are comfortable with the words.
Execute
Decide when you will have the conversation and whether anyone else should be included, such as another trusted family member or friend. Choose a quiet time of day when you are both at ease and your schedules are free. Expect that you will have the conversation several times so you are prepared if it doesn’t go well at first. See each conversation as a building block and recognize that there are underlying beliefs and emotions on both sides that will impact these discussions.
Additional Ideas
Elicit the doctor’s support. Many elders have great respect for their doctors; likewise, if the elder attends church the same might hold true for a clergy member. If you can obtain the doctor’s backing on topics such as driving, safety, or bringing in extra help, you may have an easier time. Putting your concerns in writing can sometimes encourage a physician to take an active role in restricting their patient’s driving, advocating for a tracking device, or going to bat for their patient’s housing needs, for example.
Ask for the elder’s help. Some older folks will cooperate in order to please someone whom they respect or love. A sentiment like, “Please do it for me,” or “I wouldn’t be asking this from you if it didn’t mean a great deal to me,” might prove to be a powerful tool in influencing the elder to comply with your wishes.
Tell a “fiblet.” This approach isn’t for everyone, but might prove effective should a situation become dire. Sometimes you may need the strength of a white lie to motivate your elder. For example, a caregiver tells her father that the assisted living programs are full as she guides him toward a nursing home, or a son tells his mother that her car is no longer operable and the repairs are too costly. Another told his mother that the homeowner’s insurance would be discontinued without a caregiver in the home.
Don’t give up. Each conversation may help to chip away at the denial or preconceived notions your elder may have about their situation. Practice empathic listening and, when possible, give the person time to move toward a decision so they feel they have made it on their own volition. Regardless of the outcome of each talk, you may be glad you took the chance rather than not broaching the subject at all.
The later stage of life is not easy for most, whether it is the elder whose faculties are declining or the loved one who is watching it take place. Be sure not to lose sight of your own well-being as you embark on this process with your elder. There are many forms of caregiver support available in addition to direct services for the elderly. Contact your Employee Assistance Program for further guidance.
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