How to Have "The Talk" With Your Parents

Words to Use -- and Avoid -- When Discussing Tough Issues
the-talk

Wondering how to start the conversation with an aging parent about a sensitive topic? Whether you need to talk about moving, giving up driving, or bringing in help, knowing which words to use and to avoid can improve the odds of moving toward solutions.

"Start by realizing that there are fundamentally two different types of parents," says Caring.com senior medical editor Ken Robbins, a geriatric psychiatrist at the University of Wisconsin-Madison. "Those with whom you have a relationship in which you can be straightforward and they welcome your ideas and feedback, and those who tend to be more self-conscious or private and don't welcome this kind of discussion -- and may even find it somewhat insulting."

Even if, in the past, your parent was sharing and receptive, this can change due to aging-related issues such as depression, creeping dementia, lowered self-esteem, or other frustrations. On the other hand, a close-lipped parent may be relieved to talk because he or she is worried, too.

What to say about sensitive subjects can also be tricky because you have different goals. Geriatric communication expert David Solie, author of How to Say It to Seniors, notes that adult children want to solve the problem and move on. Their parents, however, want foremost to maintain a sense of control and dignity in a season marked by many losses. Your goal in how to have "the talk": Balance both sides' needs by moving forward slowly and with care.

Do some homework

Before you say a word, take time to collect some information and research possible solutions, Robbins says. Ultimately, the goal is to problem-solve together through a dialogue with your parent (not to dictate the solution or to convince through arguments). But if you gather facts first, you'll be able to help in a way that's better informed and less stressful for everyone.

  • Moving/Assisted Living
    Check out a few places on your own so you have concrete examples to talk about. "In general, most people have more difficulty with abstract conversations about assisted living," Robbins notes. If you live in a different city, you can read reviews about options and make appointments to check them out when you're there, or consult a local geriatric care manager to get recommendations. Don't think of it as being "sneaky" -- it can be less anxiety-provoking for your parent if you present winnowed options. You can always go through the whole list of choices together if he or she prefers.

  • In-home care
    Closely observe what activities your parent is having trouble with. Look around the house for concrete signs he or she may not be faring well independently. Start to research sources of in-home care help and costs.

  • Driving
    Watch your parent drive, looking for signs of an unsafe driver. Research the alternate transportation services in your parent's area or explore other ways he or she might get around if there's no personal car.

  • Health issues
    Observe what specific kinds of limitations you're seeing: Trouble climbing stairs? Cooking? Managing finances? Grooming? Thinking in terms of specifics helps you figure out the best solutions, as well as be able to describe the problem accurately to your doctor (and your parent).

Test the waters

Also before you start the conversation, take time to get a sense of whether your parent is open to it. You can do this by first introducing an unthreatening related topic -- by phone before a visit or, if you see your parent often, in a separate visit. This isn't yet the time for hot-button topics, criticism, or anything contentious.

Stick to the positive and general. Does he or she respond openly? Defensively? Evasively? This will give you important insight into how to proceed.

Say something like:

  • "How's the house? It must be hard to keep this place in good shape."

  • "How's your health? What's the doctor saying these days?"

  • "How's the car? Still driving to the city every weekend?"

If your parent sounds interested, say something like:

  • "Is there some way I can be helpful?"

  • "Yes, I can see why that would bother you. Let's talk about it more when I see you."

Even if, in a test-the-waters chat, your parent sounds receptive to discussing a tough issue, it's usually best not to plunge in yet, Robbins says. In this first talk, you just want to float the issue, not problem-solve. You want to show in a respectful way that you can be a helpful, nonjudgmental resource.

If he or she asks you, "What should I do?" say something like:

  • "I'll be there soon; let's work on it together then."

  • "What are you thinking? Give me some time to think about that, too."

What not to say:

  • "Yup, that's a problem. I'm going to do X and Y to take care of that for you."

  • "Sounds like it's finally time to move to an assisted living place."

  • "You sound mixed up; I'm going to call your doctor."

Choose the best messenger

What if your parent resists any talk about his or her future? Pause to consider whether this conversation is best had by another party. Robbins says that a neutral third party -- a doctor, a family friend, a cleric -- is often better suited to bring up tricky topics like driving or whether to live independently.

These people can lay the same groundwork, explaining what seems to be wrong and suggesting options for fixing it, without risking a strained relationship in the way an adult child does when a parent is especially resistant or feels manipulated.

Set the right tone

So you've done some homework and gotten a sense of how ready (or indifferent) your parent is. How do you take the plunge? Plan to start the conversation on a different day from your test-the-waters chat, in person if possible. This feels less threatening and overbearing, and more natural.

"Don't get critical the minute you walk in the door. Focus on connecting and having fun," Robbins says, "while also using this time to observe." You may be on a mission to resolve the problem, but you'll have a more ready audience if you first take the time to enjoy one another's company before diving in.

Try opening with compliments -- say something like:

  • "I like how you've . . . "

  • "Wow, looks like . . . "

Look for an opening

The best time to segue into a serious conversation is when your parent brings it up first and asks for your help. Failing that, look for an opportunity when everyone is relaxed. Then take the plunge. Describe what you're seeing.

If a direct approach feels welcome, say something like:

  • "I see the steps are a problem for you and you almost fell this morning. Is that happening a lot?"

  • "It looks like you're having trouble getting off the couch, and you seem a little lonely and mixed up when you're tired. You know they say that people do a lot better where there's a lot of activity going on, and things to enjoy."

  • "Mom said you got another ticket, and I noticed the rear fender of the car is bent again. What do you think is going on?"

If an indirect approach feels better, say something like:

  • "I read about this man in the paper who lost control of his car and killed some kids on the sidewalk. He was about your age. It made me think we should consider what's in your best interests with the car now."

  • "Lauren's parents just sold their house on Elm Street and moved to a retirement community -- you should have heard her mom rave about not having to do any more yard work."

  • "Remember Jack, my friend who became a doctor? He told me that his whole family has living wills and I'm thinking we should all do that, too."

What not to say:

  • "The house was a mess last time I was there. You need a housekeeper."

  • "Mom, Dad looks awful! We need to go to the doctor when I get there, because you obviously are having trouble looking after him."

  • "When are you going to give up driving? I heard you had another accident."

Listen and Follow Your Parent's Cues

Use reflexive listening, an effective communication technique for difficult conversations. Rephrase what your parent says, as a way of playing back that you understand -- making your parent feel supported -- and then move the conversation forward.

Say something like:

  • "I hear you saying . . . but it's also worth thinking about this. . . ."

  • "Yes, I agree that . . . on the other hand. . . ."

  • "I know you're really worried about. . . . Me, too -- but if X doesn't happen. . . ."

  • "That sounds upsetting for you. . . . Have you thought about. . . ?"

Realize that some older adults can't articulate the real issue. They may shy from change, perhaps because they fear what it would be like or they lack the energy to deal with it. Often they avoid making a change not because of their own preferences but because they worry about upsetting someone else.

If she's anxious, say something like:

  • "You're right that moving is a huge hassle. But we'll help you sort and pack and you won't have to do much. We'll set up your new bedroom to look just like this one."

  • "I know we've always spent the holidays in this house, but we'd love to have Thanksgiving at our house this year. You can still make your special pies there without having to worry about all the getting ready or cleaning up."

  • "You may call them ugly old grab bars, and that's what they used to be. But I was reading how universal design is really trendy, attractive home design right now."

Find ways to be reassuring, talk up the positives, or stress how the solution is good for everyone.

If she's resistant, say something like:

  • "Bob says he'll pick you up for Breakfast Club every morning so you won't have to miss it, and I'll get your groceries."

  • "Let's make a list of pros and cons."

To help with resistance, focus on the solution. Or, look for the underlying cause. Some people push back for a specific unmentioned reason, which may be emotional, physical, or cognitive. Maybe Dad doesn't want to talk about moving because he thinks he can't afford it. Maybe Mom lacks the cognitive ability to realize she can't live alone. If the person is very resistant, "the most successful person to have the conversation is not usually the adult child," Robbins says. A family friend or doctor may have better luck.

If she's interested or agreeable, say something like:

  • "What would it mean to you if you stopped driving/had someone to cook meals/moved?"

  • "What would be the most difficult thing about. . . ?"

  • "Let's make a list of what you can do about this."

  • "Let's think through the pros and cons of each situation."

  • "Why don't you try doing X for a couple of months and see how it works for you?"

The goal is to encourage more input and to keep the discussion positive and collaborative.

If you want a parent to consider an assisted living option, Robbins says that with some people, one option is to casually drive by the best place you've identified through prior research, and suggest dropping in together to have a look. Better yet if you have a logical pretext -- visiting a friend's parent, stopping to see a "friend" who works there, participating in an activity or meal you've prearranged. Make sure it's a place you've prescreened so that you're pretty sure your parent will find things to like.

Even if there's not much choice, lay out the options and their pros and cons, strategize solutions to the biggest problems, and let your parent draw his or her own conclusion (assuming dementia is not an issue).

Follow Up

Let it percolate awhile

Whatever you do, don't launch an aggressive "sell" on your favorite option the minute you get back home or the next time you talk. Don't push for making a decision right away. Try not even to hint or nag at first.

What not to say:

  • "I hope you've been thinking about our idea of bringing in some help."

  • "So, selling your car -- have you done anything about it yet?"

  • "Wasn't that place we saw nice? We need to get you out of here!"

Be ready to continue the conversation at any time

If your parent mentions the conversation at all, use this as a wedge to revisit the matter in a supportive way.

If he or she offers something positive, say something like:

  • "Yes, I could see you being happy there. What do you think it would be like to live there? Let's think about what we'd have to do to make that happen -- I can help."

If he or she expresses a concern:

Take it as a positive sign that he or she is at least aware of the issue and thinking about it. Go over the facts as well as the solutions again in a nonthreatening way.

If he or she says something negative:

Don't fall into an argument. Be patient and try to get at the underlying concern. Is it fear of running out of money? Is it a feeling that admitting help is necessary is also admitting failure of some kind? Look for ways to address and support the concern. Maybe you give a weekly cleaning service as a Mother's Day gift "because I don't know what else to get you and you deserve to be treated like a queen," for example.

Test the waters (again)

After some time passes, if your loved one doesn't give you an opening, you can try bringing up the issue again in a test-the-waters way.

Say something like:

  • "How's the car?"

  • "What did the doctor say?"

Know when to bring in help

Total resistance means it's time for a third party (not the adult child) to try, Robbins says. "This conversation may need to be more direct," he says. "It may have to include a discussion of the risks and the possibility that if they don't voluntarily yield, say, their driver's license or residence -- there is a risk that others will take over because of the dangers involved, and then they may have less say in what comes next. They can be told it's better to work on it voluntarily with someone who loves them and only wants to help them get what they need."

If the issue is critical and the person still won't make a safe choice, it may be time to get a family doctor and lawyer involved to evaluate competency and, if appropriate, activate a power of attorney or appoint a guardian who can make safe choices on the person's behalf. See How to Make Difficult Decisions When Your Loved One's Mental Capacity Is Failing.

Make it clear that you're comfortable with any decision

If your parent is of sound mind but just making decisions that you disagree with (not endangering ones), all you can do is continue the conversation in a positive way. Any choices are ultimately his or hers. You may not like the choice, or you may end up needing to revisit the matter later, but you can't make the decisions for him or her in that case.

What you can do, Robbins says, is to remain upbeat and supportive, even if you're frustrated or worried. This keeps you a welcome sounding board as your parent moves, however slowly, toward resolution.

Remember that transitions involve an ongoing dialogue. Difficult as that first conversation about a sensitive topic is, it's only the first of many you're likely to have as you strategize your way toward a solution that everyone can feel better about.


almost 2 years ago, said...

My mother, and alas..her mother (grandma) were both controlling, and physically abusive to my sister and I when we were children. So one unfortunate situation/question that can come up is: "Do yo have a responsibility to care for an aging parent who was unloving and unkind to you?" It is a toughie. Over the years however, mom has mellowed and also, she has expressed, on many occasions the desire to talk about this issue. She never forgot that years ago, I blurted, "you robbed me of my childhood. You ambushed me - period!!". She told me tearfully that she so deeply regretted that, and that she would do anything to try and make it right. Well, amazingly enough - from THAT regret of hers, our new friendship as adult women was born. Over the years mom has helped me financially in two cases when my back was to the wall, and I was grateful for the assist. She did the same for my sister. Her willingness to talk, and to 'try and fix it' has helped us enormously since, she now (at 92 with her dementia progressing) calls upon me for help. And I will say things like, "I know things have been painful and difficult for us in the past. But I really believe you feel badly about it and though we can't go back - we CAN go forward with understanding." Believe it or not, even with her dementia, she comprehends that. I tell her, "I want to make sure you are safe and comfortable, and remain here in your home as long as possible." My unhappy childhood has also helped me to understand the needs of other adults who were also ill-treated as kids and now have an aging, elder parent, in similar straits. If we learn from what happens, we are empowered to act in ways that can be helpful. Please note: I am not speaking for all - some abuse it simply too deep to forgive - incest for one. But I am saying that sometimes we can gain insights and use that knowledge to address the present problems we have, in bringing up sensitive issues with aging loved ones, and then behaving in ways that will benefit them, and..us.


almost 2 years ago, said...

My husband has picks dementia and he is in a moderate stage but the disease is escalating. As you will know this is such an emotional time and frightening because of the various steps that have to be taken. Your information about "the talk" is helpful, but of course different from a spouse's ability to have that conversation. I am certainly appreciative of any advice.


over 3 years ago, said...

Reading this thoughtful article to prepare myself for necessary transitions. Children, don't pluck your aged and perhaps frail, but still very much feeling, parent from an environment they feel comfortable and at peace in, just because you're "worried" about them -- be willing to arrange for whatever - but no more than necessary - outside care will keep them safe and reasonably sanitary. Don't make them eat or keep them alive just because you'll feel guilty if you didn't do all you could to keep them from dying.


over 3 years ago, said...

I found this article helpful in giving advice much needed around the issue of speaking with aging parents about their living conditions . what to say & what Not to say... very helpful, Thank you, Sophie


almost 4 years ago, said...

Being honest and having a talk an suggesting solutions sounds very good unless you have a parent with a very controlling nature that refuses suggestions and just wants to tell you what to do even it is unrealistic. The article says to be honest. We tried that with our Dad about having Mom go to a nursing facility and we were told that he would rather die than go to a "nursing home" and that he felt Mom felt the same way. He shut us down and would not discuss it. He is getting forgetful, has COPD, and just wants everyone to come there as a group like it is fun to pull on an invalid and nurse my mother. His thinking is in the "days of old" when they didn't have good nursing facilities. We can't do a thing with him. None of those suggestions works. He's very alert to watching out for the nursing home or nursing facility phrase & ready to fight. As far as getting a doctor or outside person to suggest it, the doctor told him and then told Mom and they didn't budge & told us NO even though they want us to run & do and we have figured out that Dad may not want her to go to a nursing home because she planted that in his head for years and he's abiding by that even though she is an invalid and has to be taken care of like a baby since she's also partially blind. A big challenge! Part time caregivers were finally accepted but it took a long time even for that. It has given us some relief.


almost 4 years ago, said...

what about having all of the above problems plus insolvency and foreclosure.....


almost 4 years ago, said...

If your parent is of sound mind but just making decisions that you disagree with (not endangering ones), all you can do is continue the conversation in a positive way. Any choices are ultimately his or hers. You may not like the choice, or you may end up needing to revisit the matter later, but you can't make the decisions for him or her in that case. What you can do, Robbins says, is to remain upbeat and supportive, even if you're frustrated or worried. This keeps you a welcome sounding board as your parent moves, however slowly, toward resolution. Remember that transitions involve an ongoing dialogue. Difficult as that first conversation about a sensitive topic is, it's only the first of many you're likely to have as you strategize your way toward a solution that everyone can feel better about.


almost 4 years ago, said...

both of my parents were in their eighties when they died. neither ever had to stop driving or go to a nursing home. i learned from them what to do. they accommodated their progressing situations nicely all by themselves. even in their final dying process, they took care of their situations by hiring the help they needed and in my mother's case, she moved from a waterfront home and used the extra money to buy a condo on one floor that was easier to do laundry in and closer to town. it had a pool and graduated care that she never needed to tap into but it was available. both parents had home health care workers come in to take care of their meds and do heavier housekeeping chores and make sure the kitchen and bathrooms were tidy. when my dad grew weaker, he moved a hospital bed into his living room next to the tv, and had an overhead triangular bar hung from a chain so he could hoist himself from his bed to a sitting position. he also had his phone enhanced so he could hear clearly his callers. i use a tenant caretaker for heavy chores and to drive me when i am not feeling up to it. i would not consider giving up my car. it's very comfortable to drive around instead of waiting outside at a bus stop or waiting hours to get a ride in a service shared by others. i go to my garden club monthly and dine out with a companion driving me at a restaurant to enjoy the football games with others cheering also. i put in perennials like strawberries and blueberry bushes and grapes and apple and pear and cherry trees and raspberries and ligonberries and elderberries. as i age, i will make the grounds easier and easier to care for without gardeners necessary. i still keep a garden, but hire help to till and fertilize the grounds, am getting those new hoses that are lighter and shrink when not in use. and sprinkler systems can take care of watering needs. i also hire people to weed. i do the fertilizing and inspect everything daily, and do much of the planting, though i prefer these days to transplant instead of growing a lot from seed. still, it's good exercise. i take a low seat along for comfort and ease planting seeds and plants and for hand weeding. using cloths to avoid weeds works. costs a little more, but cuts way down on the work. fresh vegetables and fruit you raised yourself insures good health, when raised organically. i use bird nets and marigolds all around the beds. you can age in place through your nineties and one hundreds if you set it up right. i also use meals on wheels for healthy heatup delivered meals in the winter. there is a truck delivering food in the area, which i use also for my sushi that is not carried locally in grocery stores, for chicken drumsticks and breast meat, prepared meals low in calories and salt, high in nutritional value. i eat a lot of chinese and japanese food and the mediterranean diet, french food that excludes butter and cream, and tons of seafood of all kinds. nuts, seeds, water, flavored crystal light water, no caffeine of any kind, getting up and sleeping whenever i darned well feel like it, exercise daily. it's a good life. my father exercised twice daily out of doors and my mother used a contraption to keep fit in her own living room. both kept out of really cold weather. dad exercised in the warmest part of the day and had a hot tub and sauna. mom went south for the coldest four months of the year. florida, mexico, california, arizona, the islands. come on, it's not hard to figure this out! unless your parent suffers from alzheimer's, they don't need to be institutionalized or in a retirement home. if they forget their keys, get them to the gym and get a complete scan of their bodies and heads with mri's, the newest ones that can detect mini clots, and find out where they need medical help unclogging things. if they have suffered heart attacks they can usually get better unless it was massive, same with minor strokes. with major strokes paralyzing half their bodies, they need a full time caretaker who lives in to help them get around, which is cheaper than a retirement home and keeps them getting individual attention. they're not just one of a crowd. i explored various places myself and decided where i would go if i needed to go and let my kids know which ones i liked and why. kids can take their parents around to preselect places they would like if they were ever incapacitated temporarily or permanently by strokes or heart attacks. long term care insurance for up to two years of care can help them in temporary situations, and often lasts until the end of life. temporary disabilities due to stroke or heart attack can be addressed in a short term stay at a residential facility, but home is the best place for most people, regardless of age. don't get greedy and sell it out from under your parents. they'll be gone soon enough and you will regret not having treated them better than that. they are irreplaceable. houses they have set up and paid for are theirs for the duration of their lives. so keep your grubby hands off!


almost 4 years ago, said...

Well, the holidays are upon us and time has passed, with our Mary doing very well in the assisted care facility where she will remain. But my other senior, Joseph is starting to show some deterioration: I visit him weekly to take care of housekeeping, which he now seems unable to do. I usually bring a home cooked light meal for him, and the joke between us is, "You sit and eat, and watch me -- while I swing the mop!" And it gets to be fun, in an odd way. But when I looked for silverware to set his table, I found nearly all of it -- in the refrigerator. One of the symptoms of growing dementia is often the inappropriate use or location of objects to the wrong places, such as utensils. I washed everything and put it back in the drawer, but I know I'll find Joe's knives, forks and spoons strewn all over the inside of the fridge again when I come back in a week or so. And, I will, as I did with neighbor Mary, "stop minding my own business", and contact his family, telling them in the kindest way possible that they need to visit Uncle Joe in NY - soon!


almost 4 years ago, said...

Hi Jim's wife, Please visit the "My Caring" tab at the top of this and other Caring.com pages. In that tab, you'll see an "Edit Your Profile" link. You can change the email address for your account on that page. If you encounter any issues, please use the blue Feedback tab (right edge of this page) or the Contact Us link at the bottom of Caring.com pages to contact our customer service help desk. Thanks!


almost 4 years ago, said...

Does anyone know how to change one's email address on this site? I have been "off" for a week because I changed carriers and have a new address. I have missed you all, but have to tell you that Jim seems to be adjusting very well to the Nursing Home. We had 4 lovely visits last week, one of which was a Christmas drop-in at which we became friends with a man who has Parkinsons, not dementia, but is in Jim's unit and will talk with him. The wife and I have friends and interests in common. God at work again!! Thank you all for your prayers this week. Mary R


about 4 years ago, said...

Great article! Sometimes easing into transitions dictating by aging can be accomplished through sporadic visits from a home health aide. As they become accustomed to a bit of help with activities of daily living, they begin to see that allowing others to help them remain in their homes affords them the chance to maintain their dignity and still satisfy loved ones that they are safe.


about 4 years ago, said...

Someone once said that you could tell a great deal about a society - by the way it treats its elders: respect for their years of accumulated knowledge, lending them patience and a kind of accommodation to their changing needs, and seeking them out for the history they carry. Or, shunting them aside, being angry and short tempered, and endlessly asking each other 'whatever will we do about Mother/Dad/Aunt Hepzibah?" I believe also, our throwaway/soundbyte length attention span/instant this and that culture too, is reflected in the way we treat age as a factor of life's forward motion. This is a real easy one. I have frequent conversations with both Mother and my neighbor Mary (now in assisted care) and I often will begin, "We had this chat before, and I think when we did, we talked about.." as much as I am guilty of being a little curt on occasion, tempted instead to say, "Oh, why are you always forgetting?" And then, out of the blue one of them will tell me a great, detail filled story about Pearl Harbor/Frank Sinatra at the Paramount/the Kennedy White House..and I'll suddenly remember that when talking with a senior, it is like strolling through some magnificent library. However, you are not able to enjoy it...unless you love to 'READ'!! On this Thanksgiving day, maybe we might all of us be grateful for the wisdom our elders possess, and use it perhaps to make us all a little bit wiser, as we go about our respective days.


about 4 years ago, said...

This was very helpful. It reminded me that these changes must occur over time and require patience and respect. It's a process.


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