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How to Tackle Difficult Conversations Around Care

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Helpful communication techniques to alleviate stress and frustration

Change is a constant and has a strong presence, but we typically only notice change when we are confronted with new technologies, life changing events, or results that we believe to be negative. And then there is aging. If we are lucky, we age gracefully and independently. The ideal scenario for passing away is falling asleep and not waking up, but this scenario is becoming less common. In all likelihood, we will require additional help and care as we age or become ill.

Confronting the evolving challenges of aging and being able to effectively communicate specific needs and issues is among the most difficult and sensitive of conversations. Losing capacities related to self care, household maintenance, driving, handling finances, etc. are all difficult issues that can be complicated by feelings of loss, shame, and fear. As a caregiver and/or child bringing up this type of conversation requires patience, planning, an ability to listen carefully, and a very large dose of perspective.

Perhaps, on your last visit with Mom or Dad some red flags started waving wildly in your head. You noticed that Dad is not taking his medications as prescribed, and he insisted on climbing on the roof to clean or fix the draining system despite the fact that he tripped and fell on the golf course last week. And Mom, well, she has lost weight and couldn’t remember the name of the family cat all morning. Once you have been triggered and are thinking about approaching your parent or loved one about care options, there are a few things to keep in mind.

Asking them about their future and addressing certain challenges can become very sensitive territory. Here are a few pointers to use prior to engaging in conversation.

Approaching Difficult Conversations

Time and Patience. Always begin slowly. Lead with love and concern. Let your parent know what you have noticed, but limit it to one thing. “Mom, I noticed that you have lost some weight. Are you feeling well?” Listen to her response as there a several possibilities and solutions for a situation like this one. Perhaps she is tired of cooking or she no longer enjoys eating. Or maybe the weight loss is due to a lack of appetite and she needs to meet with her physician.

Be Respectful and Loving. That anxious feeling that presents itself when you think of approaching your parent stems from love and concern. Always use respect and love as your compass when it comes to engaging in conversation. Be a friend. Be a safe person that your loved one can confide in, leave the judgment at the door.

Keep the Communication Clear. Listen, listen, and then listen some more. This is their life, their experience. They developed successful lives and raised you and (if applicable) your siblings. They have developed habits, proficiencies, likes and dislikes, and they have gained and lost. They have taken risks and they may be up for a bunch more. Just because they are slowing down in certain ways does not mean that they want to race to a zone of perceived safety and care at the cost of their independence. Remember that as one ages he or she has the right not to move, not to see the doctor, not to take that medication, or not to hire someone to come in to clean. All of this is true, as long as the individual is mentally competent enough to understand the risks involved.

Acknowledging Fear and Anxiety. All of the above also requires that telling the truth about fears and uncertainties about aging is something that everyone would benefit from understanding. In doing so, some of the resistance may loosen to a more honest, safe, and real conversation. But again this requires being sensitive to who you are speaking with and knowing how to communicate with a loved one who has Alzheimer’s or another form of dementia in any given situation.

Maintaining Perspective. Your loved one may not be as fast, sharp, or responsive as they were in their prime. They may not fit the picture of how they should be in your eyes. That is why it is vital that you take on the simple but challenging practice of meeting them where they are. Not where you want them to be, but actually where they are. Are they really at risk? Or are they simply more lax in their ways? If it really doesn’t bother them to leave their dishes in the sink for a day, why should it bother you? Is this the sort of issue that you want to challenge? It might be more important to ask them about their friends and what they have planned for the coming week. Paying attention to the quality of your parents social life is much more important. Don’t get caught up with the petty things.

Keep all of these things in mind and if you think that your parent has difficulty in understanding the risks before them or you are concerned that they are experiencing early signs of dementia, seek help. Ask your physician for a referral to a Geriatric Care Manager, a professional that can guide you and your parent through the myriad of change that is showering down on your lives.

Navigating the difficulties of aging is a process that needs to be approached with love, curiosity,  and respect. Focus on listening to the ones you love. Be patient and don’t try to avoid having difficult conversations. You will need to cultivate an environment that is safe and caring so that you and your loved one(s) can make changes easily and as stress free as possible. Finally, make an effort to expect a positive outcome from these conversations. Why not? There is always the possibility that what is difficult can bring you closer in level of appreciation, community, and love.

About The Author

Audrey Meinertzhagen

As a Volunteer Caregiver to the Zen Hospice Project and a Course Manager at the CareGivers Project, Audrey is passionate about improving the standards of care for older adults and educating caregivers on the principles of mindfulness and self-care.

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