Managing Difficult Conversations About Care



You’ve confirmed your role as caregiver. You’ve assessed your loved one’s needs and weighed your concerns — and determined it’s time to talk. But how do you bring up the conversation without conveying a desire for control? How do you express your concern without condescending? When it comes to broaching thorny topics like how will we afford long term care, or emotionally charged ones like what happens when you can’t drive any more, how do you have a measured, thoughtful discussion?

In many instances, the mere mention of senior living or subtle hint at home care puts your loved one on the defensive. Emotions run high; conflicts arise; a battle of wills begins. Difficult family and sibling dynamics bubble to the surface.

Because these are difficult conversations that often happen in tense circumstances and settings, it’s critical not to rush them, and to have as many of these discussions as possible before a health or life emergency.

Be Prepared — and Patientblog-11-hands-image

No matter when or how your family enters this process, prepare for these conversations to be complicated and uncomfortable, but necessary to ensure your parent or older loved one is involved in the process from the beginning. Also, one discussion will not be enough: this is a gradual and often non-linear process which eventually leads to tremendous life changes and a significant period of transition for the older adult.

As a loss of independence occurs, the older adult will likely move through stages of grief, anger, denial, sadness, resistance, and acceptance. As the caregiver, you may also move through your own stages of grief about the changes in your parent or relative. There may be nagging feelings of guilt on your part — a feeling that you’ve failed because you are considering support or a transition. Your parent may also feel guilty about becoming a burden.

Acknowledge these feelings of guilt, but don’t let them direct your conversations. Approach these changes together and with openness, compassion, and concern.

Consider the Other Side

This powerful video from Wish of a Lifetime is an excellent reminder of why we must put our own preferences, fears, and hopes aside to focus on the person who’s at the center of these conversations — and why his/her preferences, fears, and hopes must be the driving force behind the decision-making process:


Yes, there may be times when it feels easier to say, “Let me just take the wheel.” Yes, you may be faced with resistance. Yes, you may feel anxious about making a care decision, especially if you have a strained relationship with your parent, or if your siblings are uninvolved or critical. But when we think about transparency — and about what really matters and why in the senior care search process — openness and honesty consistently provide a better foundation than domination.


3 Tips for a Successful Conversation

Consider these tips for a more successful conversation with your loved one:

1Proceed with grace and patience. Don’t rush these discussions, or pressure your parent(s) with a deadline or ultimatum. Give them time to process the enormous changes they’re facing and may not be able to acknowledge, although they know it. Steer clear of patronizing language or attitudes and of reminding them you had the conversation already. Each time, take a deep breath and answer like it’s the first time. Yes, it’s tiring, however focus on being respectful, compassionate, and consider how you would feel if you were in their position.

2Listen to learn. Sometimes what your parent is not saying tells you something. If you’re constantly interrupting or prompting the next question, you might miss an obvious nonverbal message. Read your parent’s body language to gauge how the conversation is going. If she seems anxious, offer a break (you can revisit the conversation later), or ask what would make him feel more comfortable. Take notes on their preferences. Show a genuine interest in what she shares. You may be surprised by his priorities and what he shares as the things he values most.

3Let them lead. A conversation goes two ways, but in this case, it’s about what’s best for your parent, not just you. Where your parent wants to receive care. How your parent wants to receive care. What he can afford. What she envisions as an ideal end of life plan. You can guide the conversation, but you shouldn’t railroad your parent or give unsolicited advice. Break the ice with these conversation starters from DailyCaring:

  • Say something like “I’ve noticed some things take more energy these days. What are the important things you really want to do?” Or “What are your priorities? Is there a way we can make it easier for you to do those things?”
  • Mention how much you admire the way they’ve handled retirement and ask for advice on what has worked well for them so that you can learn from them.
  • Use an event in the news or a story about an aging family member or friend. Say, “We never talk about these things. I don’t want to pry, but it would give me peace of mind to know there’s a plan if we need it.”

Stay tuned for more tips and insights at Open Conversations
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Content for Open Conversations was developed in partnership with Caregiving Advice,


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