The Do's and Don'ts of Communicating With Aging Parents
Edinberg, Ph.D., Contributing Editor
More About Mark...
Communication is skill and art. Skills are specific types of verbal and nonverbal actions that help you get the results you want, including cooperation, joint decision making, and finding solutions to difficult issues. The art part is taking the skills and figuring out how to apply the skills to a specific situation. Your job as a caregiver is to decide what to use and how to use it.
When you are talking with aging parents and have some concern about how the communication may go, you are most likely talking about an important topic or an emotionally loaded topic. Important topics may be things such as figuring out where older parents should live, what kinds of help (if any) they need, who needs to know about their finances, what type(s) of health care services they should have, whether or not they have an up to date will or even whether or not someone else should have some legal power to act in their behalf, such as power of attorney or conservatorship.
Emotionally loaded topics are almost anything that leads to strong emotions being experienced and communicated. In any family, there are a specific and unique set of emotionally laden topics, including (but not limited to): who spends the holidays with whom, who is the favored child, who should get possession of various personal items in an estate, who has to take responsibility for care giving, and what is a fair share to be paid for gifts or care by various members of the family.
As a caregiver, you undoubtedly have a series of specific issues that you want to communicate about with your older family member. Some of these are emotionally laden, some are not. Some are easy to discuss in your family situation, some are not. Generally, when there is an emotionally laden and important issue, the following guidelines can help you focus your efforts to get the best out of a difficult situation.
The situation changes dramatically when the older adult has limitations, including dementia. A dementia patient would need more specific guidelines and principles, some of which will be addressed in a future article in this series. However, many of the principles listed below hold regardless of the cognitive limitations of your older family member..
Do's for emotionally laden situations
Think ahead of what you need to get (vs. what you hope to get) from discussions: That is, what is your bottom line? Do you need to get your parent(s) to tell you EVERYTHING about their possessions or do you really need to get them to confer with a competent attorney? Do you need to get your family member into a nursing home or do you need them to be evaluated by a competent agency, physician or other provider who may come up with options that may work for your older relative?
Answer the following question (and its a very important one): Are you doing this WITH the older adult or FOR them? That is, do they have both a say and veto power in the discussion? If the older relative has veto power, then he or she may disagree with you or even do something you are very uncomfortable with. At the same time, if it is really their decision, then you should not try to coerce or manipulate them into the decision.
Donts for emotionally laden situations
While hardly a complete list of all the nuances of family communication, these guidelines may help you evaluate how you want to have discussions as well as be an informal checklist to evaluate how you did after a discussion about an emotionally laden topic. Lets take a look at an imaginary conversation (with some comments in parentheses about the dos and donts). Remember, these guidelines have to be applied by you in your situation. They will potentially take many forms, you have to be the final judge on how to apply these principles and ideas. Good luck!
Simple scenario and dialogue
An imaginary conversation about where mother is gong to live. Mother is 78, in fairly good health, but has had a few falls and has high blood pressure. She lives alone in the family home, a two story dwelling with all the bedrooms and the bathroom upstairs. The conversation is between daughter, age 45 (with grown children and a husband) and her mother.
Daughter: Mom, theres something we need to talk about.
Mother: What is it dear?
Daughter: Well, Ive been thinking about your house.
Daughter: Well, the house is where we grew up and everything, but I was hoping we could sell it some time. (Not clear about the topic of discussion)
Mother: What? Sell the house? Why would I do that? Where could I live?
Daughter: (becoming a little nervous): Mom, you need to think about this before you say that. (blaming)
Mother: What do you mean, I dont think?
Daughter: No, mom, its just that we want you to have what is best for you, you know. (defensive)
Mother: Have you talked to your brother about this?
Daughter: Of course not, I mean I should of, I hope he doesnt get too mad about this. (includes old issues)
Mother: Now, now, dear, you two shouldnt fight.
Daughter: We dont fight, we dont even talk. (brings up old topics)
Mother: Well, I certainly wont sell the house if it makes you all upset.
Daughter: Mom, I am not upset, its just that I find it hard to talk with you about this. (is assertive)
Mother: Why, what do you mean? Are you saying I am difficult? Cant I have my way?
Daughter: Id like to have my way, just for once. (blaming)
Mother: You can, but not with my house.
Daughter (takes a breath): Mom, Im sorry, but I really want to talk with you about your home and where you live while things are going OK for you. I care for you, I do not want to fight with you or my brother, I want us to talk together about how you can handle yourself. (assertive, clear about topic)
Mother: (reconsiders): OK, I believe you, what do you want to talk about?
Daughter: I am concerned about what may happen to you in the future if you stay in the house. (shares real concerns)
Mother: What do you mean?
Daughter: I mean that the house is designed for younger people, with the bedrooms and bathroom upstairs. If you fell and had to walk with assistance for any period of time, the house would not be a good place to rehabilitate.(Gives good reasons, is calm)
Mother: And, I think, if I had to go into a nursing home, the house might have to go to pay for my care.
Daughter: Unless you made plans in advance.
Mother: Which I havent done.
Daughter: So, where should we go from here? (Includes mother in decision)
Mother: Well, we should talk to your brother. Maybe I can talk to him first. Then we should talk to someone who knows about these things.
Daughter: Thanks, mom, I love you.
Mother: I hope so (laughs).
I hope you can see how the dos and donts of communication can influence how a discussion goes.
Some recently published books on this topic are:
Disclaimer: None of the information or declarations made in this article are intended to constitute psychological advice or counseling for any family situation. Readers are expected to make their own informed decisions about the best way to apply concepts, principles, or skills mentioned in this article.
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