How to Make Difficult Conversations Less Stressful
How to Make Difficult Conversations Less Stressful
Recently I talked to two different family caregivers about their frustration over incontinence – "accidents" was the term each used. For each woman, the issue wasn't "How do I know when there's a problem?" or even so much "What do I do about this problem?"
The thing each caregiver was grappling with was how to broach the subject with the affected parent. The prospect of a tough talk – whether it's about incontinence, driving, moving, or something else – can be tougher than the topic itself. And caregiving is fraught with one difficult conversation after another.
What makes it easier? Here are seven steps to try:
1. Appreciate why it's so hard.
You're probably not a coward or a procrastinator; you're a person who's in a very tough spot. Acknowledging this helps you not beat yourself up over the issue. Just look at all the reasons we find it hard to talk to our parents about delicate matters:
-
It's not our "place." Old family roles endure, and many adult children are conditioned to consider it inappropriate or unseemly to call our elders on certain topics, like their unsafe driving or slipshod finances.
Concerns over privacy. Many of us don't discuss money and personal hygiene with anybody, let alone a parent.
Lack of knowledge. It's challenging to talk turkey when you don't really feel comfortable with the material. Many adult children have little experience with financial power of attorney or hospice care until the topic emerges with our parents.
A close-lipped history. Weighty conversations of any kind are especially a challenge if you've never been on open-mic terms with your parent in the past. Makes it hard (though not impossible) to start having serious chats now.
Squeamishness. Some topics are simply ones we'd rather not think about – ever. Exhibit A: "Mom, you need to start wearing diapers."
Fear of consequences. Maybe Dad will hate you if you initiate his moving to assisted living. Maybe you'll be lonely. Taking action can lead to uncertain outcomes.
*Willful ignorance. Denial (you kindasorta know there's a big problem but, just for today, it's easier to ignore it) is an ever-handy way to avoid thorny issues.
And, drumroll please: There's the problem of not knowing how to start.
2. Remember that the consequences of not speaking up are usually worse than the talk itself.
Your parent with the erratic driving could kill someone. Your grandparent who forgets to turn off the stove could burn her house down. Your house will soon stink of urine 24/7. Focus on the worst that could happen if you said nothing and let that vision fortify you a little.
3. Consider that the person you're caring for might be having similar concerns.
Often people know when there's something wrong but have their own reasons to be reluctant to speak up. Result: A conspiracy of silence over that big white elephant knocking about your living room. Open up to the possibility that expressing your concerns might come as a relief to the other party -- because the first step in solving a problem is acknowledging it.
4. Think gains, not losses.
Another reason these are hard conversations is that they tend to be benchmarks for some kind of loss (driving, independence, autonomy, health). The grief and guilt over that colors our emotions deeply. Acknowledge that, but also focus on how you'll be making life better for the other person. Even in the grimmest of situations, there are small improvements that result, and that's part of what you're aiming for: to help the other person be more comfortable, safer, happier, and so on.
5. Get your ducks in a row.
Before you blast headlong into a potentially awkward discussion, prepare yourself with lots of facts. Learn all you can about the topic and the options. Talk to other caregivers, post questions on discussion groups. Have a vision of the outcome, or a couple of possible outcomes, you hope to work toward. This will help you seem knowledgeable and therefore more trustworthy. You'll feel more confident, too.
6. Pick the right moment.
I know. There can never seem like a "right" moment to discuss adult diapers or the possibility of elder scams. In general, though, pick the person's best time of day (often mornings after breakfast). Watch for a relatively good mood. Bracket the discussion with pleasant activities (breakfast and a foot rub, say).
7. Be candid.
When you finally plunge in -- use candor to keep things warm. Sample starters: "This is really hard for me to talk about and it's also probably hard for you to hear. But I've been really worried about…" Dad, I don't know how to talk about x, so I'm just going to dive in and tell you what I've been thinking…" Mom, I kind of feel like we've been ignoring something that we can’t ignore any more…." Self-deprecating humor can help, with the right person, too: "I know if I were your nurse in a hospital you'd fire me, but since you’re stuck with me, I was thinking…"
A wise nonagenarian I know likes to say, "We live in ages and stages." You can borrow that line, too, and explain that new stages aren't always fun, but there you are, and you want to make the best of it together.
My Dad cares for Mom and they live in the first floor of my house. I try to keep their home clean and fresh, but Mom is always cold so Dad won't put the air on or a fan. The place has a musty smell from cooking and humidity and I keep telling him to circulate air but either forgets or he ignores me because she's cold. I don't know what else to do.
Okay, now I don't feel so bad! I'm working with a 81 year-old mother who is in and out of situations which cause me concern, and I've backed off because don't want to deal with the vicious responses. I know now that it doesn't matter how she responds...I have to create a positive conversation if I can. THANK YOUU
Very informative and helpful article. I just want to add another dimension to painful conversations with our parents. What if you have a parent that has been a rageaholic all their lives? If you bring up any topic that is sensative, a rageaholic parent will make you pay the rest of your days. I understand wanting to keep them safe and protected as well as others, but I also know from experience that self-preservation is also very important.
this is one of those articles i'll file for future reference. thanks. -karen
Thanks all for your input. I love that pullups story! And Anonymous, I hope you'll look for some caregivers in similar situations with relatives in our discussion groups (click "Groups" above) -- more people than you know can relate to your hardship, and may have other supportive insights for you --
This is one of the best articles I have read. Very practical and right on point. In a keynote I gave yesterday, I talked about the very same thing and the need to find you power. We need to be strong to address these issues, but it is a absolute necessity. On this long journey there are indeed "ages and stages". And thank you Rob for that funny story which brought humor and solution to the problem.
Paula, you're doing a terrific job answering these caregiving questions from frustrated relatives! I wanted to say that most of them would benefit, I think, from support group meetings, even if they have to pay someone to be with their care recipient during that time. I learned so much, from the young man who solved his problem with pullups for the incontinent father who simply would not accept the idea: the son took off his pants, put on a set of pullups, got his father to do the same, and after a while they looked at each other and laughed. That broke the ice - the barrier so many close relatives and spouses have in caregiving. There is no intimacy like the caregiving intimacy, and shame and embarassment have to be put aside in order to make things work.
i am taking care of my mother at my home,she has end stage liver diesease and advanced dementia and brain damage.she has to have her diapers changed ,bathed fed, supervised 24 hours a day.my father died almost two years ago from cancer and he and my mother wanted me to be her power of attorney.well she was staying in a nursing home for 5000.00 a month and i didn't like the way they cared for her as much as i thought i could.i needed a job also (i knew it would be hard caring for her and being p.o.a. but she has been here for 9 months now.so i decided to bring her home, but also instead of paying a nursing home i would pay myself half of what she was paying from my fathers pension and social security.My brother was living at my dad and moms house when he passed but my father kept telling me to sell the house and the 3 children (us) would share the money .but my brother says he cant pay rent since he really wanted to keep living there and so i said either pay rent or i will sell the house.well 2 years later not one cent has been paid he was supposed to give my sister and me half of the renteach month.now my sister and husband are having hard times and she "says" she wants half the money i make so i said fine we can take turns a week or two at a time.Now she says she cant do it at her house so she will take her to my brothers house and watch her there except she wanted to go home at night and come the next afternoon and stay till she goes to sleep.I told her i didn;t think that that was right i thought she should spend the night also cuz mom wanders around alot at night plus my sister in law is having a baby in 4 days.she got all put out and acts like i am ripping my mom off!! When neither of my siblings rarely come visit her here except x-mas b-days etc.She my sister says she feels like shes not getting anything since my brother dont pay rent and i get paid for caring for her and buying diapers ,wipes ,clothes,baby food or pureeing everything she eats.And she thinks after my dad died my mom is still getting the full retirement they were getting bt after he passed she gets an annuity which is half of that.I really feel hurt by her comments i told her call the pension plans ans soc. security to see how much she gets.anyways things sure get out of hand and all they keep asking is if i could get money out of her cd's my grandmother and my mom had together but i explain to them thats my moms money until she pases then we are the benificeries I CANT BELIEVE THIS!!!