Making the Difficult Conversation Easier

Martin’s driving was getting more erratic and dangerous. His wife, Gwen, 81, was in the car when Martin, 83, failed to see pedestrians crossing the street until she yelled at the last minute. It was clearly time to take his car keys away, but Gwen wasn’t sure how to do that without causing Martin distress.

Whether baby boomers need to talk to their parents about assisted living, parents need to talk to their children about end-of-life issues or a wife needs to talk to her husband about not driving anymore, these conversations can be difficult. Most people avoid them as long as they can, at which point it’s sometimes too late to handle the issue easily.

Those in the caring field who have been through this offer ways to best approach these delicate but serious discussions.


Techniques to Smooth the Discussion

Plan ahead: Schedule a time and place that works for all to be focused and not distracted.

Validate others’ feelings: When feelings are acknowledged, the person starts to calm down, because they feel they’re being understood.

“Normalizing”: Letting the other person know they’re not the only one going through these emotions or this experience make people feel safe and takes the focus off an individual.

Be open: Explain your concerns specifically and clearly. Share your own feelings.

Think before responding: Don’t speak when you’re angry or upset. Silence can often be effective.

Ask for advice: Asking questions rather than telling people what to do is always a better way to start conversations.

Use “I” statements: Explain how you feel rather than what you see as wrong with the situation.

Working with Denial

In confronting difficult situations, most people first encounter denial: From children it might be that their parents are never going to become incapable of taking care of themselves; from aging adults it might be, “my driving is not that bad; I know what I’m doing” or from the husband it might be that his wife can stay at home rather than go into assisted living.

Loved ones don’t want to see that the situation or person has changed, and a lot of emotions are attached to the way things were. “Everyone wants to go back to the way it was,” says Viki Kind, a clinical bioethicist, medical educator and hospice volunteer (“Facilitating Difficult Conversations: Getting Through the Barriers”).

While denial might work in the short term, in the long term, it can cause problems. It could mean that adult children won’t know how to handle their parents’ finances when they’re unable to or that a bad driver could cause an accident or worse. Providing adult children with end-of-life wishes can make the inevitable process easier, not more difficult, in the long term. Denial can also occur when someone has the wrong or not enough information. Therefore, it’s important to make sure both parties have all the facts.

When confronting someone about big changes, it’s important to let them emotionally process the new information. It might take time and patience. Kind suggests not rushing the other person to make a decision. Seniors, especially, might want to sit and ponder the question, and see how the issue affects their life and future. You can also ask if there is a better time to talk about the topic.

 The Real Issue

We need to truly listen, Kind says, to hear what someone is really saying and what the real issue is behind the fears and resistance. The key is to be present and feel the other person’s suffering. “Compassion is the ability to feel your pain in my heart.”

For instance, someone might not want a caregiver because they don’t want to lose their privacy, they think they can’t afford it or they worry their house is a mess. In another example, perhaps the real reason an older adult is resisting using a walker is because it makes them feel old and awkward. “Once you explore the real issue, the better chance of solving it,” Kind says.

Younger adults might not realize that their parents (or loved ones) want to have control over their lives, Kind says. Trying to take away that control—by taking away their car keys or moving them from their homes—will likely only bring resistance. It’s best to give that person some authority.

 Dealing With Control

David Solie, a geriatric psychologist, CEO and medical director of a life insurance brokerage corporation, wanted to move his mother to assisted living, because he felt she would be safer there, but she resisted. At some point, he started seeing the situation through her eyes:

“In 20 years of working with seniors, I’ve come to know how deep the need for control is in that age group, how little they ultimately wind up with and how closely control is tied to dignity and hope, not hope that you’re going to be young again, but hope that you’re going to get some good days. . . .

“That’s what I found out when I sat down in my mother’s old, worn-out La-Z-Boy with the tuner with the larger buttons and the Collier’s magazine from 1946. I realized that in a world of great instability—her friends had passed, my dad was gone, her neighbors were gone—this house was her anchor. Looking at that, I felt it was profound hubris on my part to be all-knowing and righteous about where she should live” (“Talking With David Solie: Caregiving Mistakes and Lessons Learned,”

In the end, Solie, author of How to Say It to Seniors: Closing the Communication Gap With Our Elders, honored his mother’s request until she had a massive stroke and had to go into skilled nursing for the last ten months of her life.

 Failure to Communicate

“Parents and kids don’t talk the way they need to talk,” says Donna Quinn Robbins, author of Moving Mom and Dad! Why, Where, How, and When to Help Your Parents Relocate. “The kids don’t really understand how their parents are feeling, what they’re going through or what they want because they’re afraid to ask—or if they ask, they don’t get an answer. The parents don’t want to be a burden, they don’t want to tell their kids what’s really going on and they don’t want to let them know they’re sliding, because then they’re afraid the kids are going to want to do something about it” (“Talking With Donna Quinn Robbins: How to Discuss Moving With Your Parents,” ).

Robbins, who has worked with seniors for 20 years as the owner of Ultimate Moves, a relocation and transition service, has seen what happens when different generations don’t communicate. One adult son, a doctor, told his parents if they didn’t move closer to him, he wouldn’t be able to take care of them. When the parents reluctantly left their retirement home in Florida, leaving most of their possessions behind, they found that their son had only once a month to see them. Within a year, both parents died.

“When people bring their parents from a distant place to where they live, I see catastrophes all the time because they haven’t talked about the expectations they have—the children’s or the parents’. . . . The expectations have to be discussed up front because, otherwise, the parents have moved from their home, their friends, their whole lifestyle, to a place where they don’t know anybody.”

Confirming that view is Bruce Nemovitz, senior real estate specialist and Certified Senior Advisor. His advice to adult children: “Learn what are their [seniors’] greatest fears and talk about them. Understand the power of memories and their feelings of deep loss and sadness as they think of giving up their home. For each senior, moving elicits a different set of issues both mentally and physically.” His advice to seniors: “You cannot expect [your children] to truly understand what you are experiencing as it is new to you and to them also. They cannot feel the pain of a loss of spouse or the fears of moving to a completely new environment after so many years in their familiar surroundings. Your kids will someday have to face the same issues, so know that they hold their own set of emotions, fears and concerns” (“Having Difficult Conversations,” June 04, 2013, Laureate Group).

Beyond the bigger issues of denial and control, experts offer tips for making the difficult conversation a lot easier (see sidebar).


Article found on www.CSA.US