Communicating with Your Elder Loved Ones: Challenges and Blessings

Brenda Wilson, LCSW, CEAP, Geriatric Care Manager

Faculty and Employee Assistance Program, Charlottesville, Virginia 

As a Geriatric Care Manager and Clinical Social Worker, I frequently hear adult children lament the difficulties in generating productive conversation with their elder loved ones about touchy issues such as health decline, driving concerns, health care, finances, the future, personal care needs and funeral plans.

Some elders plan ahead very well and only need to be asked what their preferences and plans are while many others age in place and resist the discussions. As you anticipate having discussions with your elders about these and other potentially emotionally laden issues, please review the principles outlined below for the best outcomes possible:

1)  Get your facts together. If several adult children are involved in the same concerns, it is important to compare notes ahead of time to be sure your facts are indeed, facts and not assumptions. Try to quantify anything that can be such as fender benders, falls in a particular time period, alerts from the neighbors, etc.

2)  Organize the pertinent family members but don't gang up. Try to identify who in the family can best discuss these issues respectfully and patiently with your elders vs the people who tend to lecture, argue, provoke or be provoked.

3)  Know your boundaries - once your elders tell you they don't want to discuss a topic, let it go for now. Remember too, that as long as they are of sound mind, they can make decisions with which you don't agree.

4)  Decide on what needs to be discussed 1st, 2nd,3rd - Pick the priorities for this time frame whether it is to start some discussion about the future in a general way or to address a more pressing concern such as a recent vehicle accident. Don't try to address everything in one sitting. You can consider yourself successful if you open the door to respectful communication and convey that your motivation is from caring.

5)  Set the stage - Make sure your discussion takes place in an environment that encourages good communication such as a quiet place, with the TV off and distractions to a minimum. Ask to talk together rather than springing the various topics on your elders when it suits you.

6)  Use "I" statements. Stating what "my perceptions", "my feelings", "my concerns" are is more effective than starting with "you" which suggests a strong "should" exists and no one likes to be told what they should and should not do. "I" statements lead to negotiation, clarification and understanding.

7)  Respect their rights - to individuality, independence, respect and direct communication.

8)  Respect their wisdom - adult children DO NOT know what it really is like to age, face mortality and suffer the multiple losses sometimes associated with aging. Hold your judgements on this for when you are there yourself.

9)  Stay away from a right or wrong stance. Remember that it is OK to disagree and that disagreement does not mean lack of love.

10)  Avoid old baggage, anger, and hurts. Stay focused on what you both can achieve in this discussion going forward.

11)  Offer objective people with whom they can have further discussion. This might include their clergy, their physician, a financial planner, an attorney or an eldercare specialist. Using outside experts can diffuse a point of disagreement very quickly.

12)  As the adult child, don't avoid difficult topics like death, $, or health decline. With information and a discussion of preferences, together, you can develop better plans and better understanding. Not everyone will agree to discuss these issues, at this time, so if that occurs, remember #'s 3, 7 and 8.

13)  Explain how their choices are affecting your life too. Some elders become fairly isolated and self focused and may not have considered this aspect. If you have young children, work and other responsibilities, you may need to clarify what you can and cannot do to more practically help your elder. This is a statement of fact, not about devotion or love.

14)  How will all of you know "when it's time" to make a change? What would that look like physically and cognitively? This is a good opening question and one that can help the elder put themselves in shoes that one day will fit. If you have other family members or neighbors who have declined, become frail or made lifestyle changes, they can be examples for the question of "what would we do if X happened to you, like it did to Aunt Sue?'

15)  Start and end from a position of love and caring. That is what really matters.