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The critical conversation: six tips to consider

by Kathryn Kilpatrick, M.A. CCC/SLP

At one of my presentations, I asked adult children of aging parents what their particular interest was in the topic of critical conversations. Most of their concerns were about how to bring up the issues of driving, moving, hiring additional help and the safety of a loved one. In the audience was a much older woman who shared she was planning to move into an independent living residence within a few weeks. Her interest in the topic was unique. She wanted to see if there was anything else she could do to make this transition easier for herself and her family. She truly brought a refreshing perspective to the topic.

When you decide you are ready to have such a conversation, whether proactively, or because of a specific concern, there is a series of issues to consider. Because each situation is unique, you need to be prepared in advance to have difficult discussions. 

Six tips for having a critical conversation

1. Get to really know your loved one

Knowing a person's story is important. There are hopes, wishes, fears and concerns that can influence what a person feels about the road ahead. Trying to learn that information is much harder when you are in the middle of a crisis. You may have no idea that what you are saying might be pushing a button for your family member. There may be a story in someone's past that can impact the reaction you see from your loved one.

    2. Conversations and time together are important

    Spend quality time with your loved one and learn how to meet them where they are. It is the greatest gift you can ever give both to yourself and to them. When a bond has been created around issues of importance, an older adult may feel more comfortable having you involved in important decision making when the time comes. Speaking infrequently, superficially or spending a few moments with them here and there can make discussions about tough topics like money, the car keys or a living situation more difficult.

      3. Assess the situation

      When you are noting changes, the best thing you can do is try and face the reality of a situation early. The earlier you address a concern, the more likely the older adult will have some choices. Waiting too long often means not being able to take advantage of all available resources. Many older adults of this generation remember when families were closer and times were less hectic. Understanding what their previous experiences were like can help you understand what some of their expectations might be for assistance.

      Most people do not like change, and for an older adult facing decreased independence, there may be a tendency to just wait and see, hoping for the best. One of the goals is to support a loved one staying in the preferred setting as long as the person is safe. It is about quality of life. When this is no longer possible, it is time to begin the process of assessing options.

        4. Listen to them with your heart

        Listening to what they are saying and not saying is important. Meeting older adults where they are in the process of change can make all the difference. Think it through before you have a conversation about a difficult topic. Make sure you are in the right frame of mind when you begin any discussion.

        Attitude is all in the wording. Listen carefully to what you say and how you say it. You are not their parent and should seriously consider what you are going to say and how it might sound to them. Finally, honor their journey. This is a conversation that is likely to continue over a period of time so it is important to continue to be aware of your approach and modify as necessary.

          5. Hearing, vision and memory concerns

          Make sure you do everything you can to maximize the communication process with your loved one. Here are some practical steps to consider during the conversation:

          1. Eliminate any background noises and distractions. Turn off cell phones and electronic devices.
          2. Give the conversation your full attention. If you cannot, then do it at a later date.
          3. Make sure information is presented clearly. If a person suffers from hearing or vision loss, they may have trouble understanding the information, and your discussion can become upsetting or confusing.
          4. Go slow. When there are memory problems, speak more slowly and keep it simple. Do not overload them with too much information at one time.
          5. Write it down. Writing down some of the basic information that has been shared and discussed can provide something for them to review and read over as needed.

            6. Be informed

            Seek input from those professionals who can help you better understand the various aspects that might apply to your particular situation. Consider attending seminars, programs, or support groups that can teach you more about certain health care, legal and community programs related to your concerns. 

            Information sharing with others that are involved in the conversation is important. If there are more serious issues, seek the assistance of a mediator if necessary.

              Successful aging: know where you are at

              By confronting a situation earlier allows the older adult more options for an improved quality of life. When safety becomes a concern, it is time to take things to the next level. A proactive move may help to enhance the quality of those later years for a loved one and reduce some of the decision making if there is a crisis necessitating some major changes.

                Do not interfere with your loved one's situation when the concerns you have are more for your convenience and peace of mind. Your parent or loved one is not the only person with whom you may experience these situations with as you go through your life. Each experience can help you learn how to handle the next one a little better.

                You can take what you've learned through the process and share with others about the journey you took with a loved one.