How-To Tips for Having a Conversation About Senior Living

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daughter having conversation with senior mother

We've all gotten into a comfort zone where we don’t want to change or move on—so much so that we minimize problems. Our aging parents are no different. When we observe their situation it may be obvious that there are safety concerns. But when we try to address them, they may say things like “I’m fine,” or “I’m not ready,” or “I don’t want to talk about it.”

This leaves adult children feeling baffled. I often hear questions like “What should I say if a parent says they are not ready, or does not share the concern, or does not want to move?” Or any number of similar questions. Bottom line, what should I say?

And it hit me — how many times have I advised that you start the conversation but have not talked much about how to do it? So I thought I might teach you a few coaching tips. I am a certified wellness coach and have used coaching techniques in my personal as well as professional life. They are simple but not always easy.

Behavior Changes

Let’s start with a basic idea. Every behavior change carries with it some degree of ambivalence. We can make both sides of the argument. Depending on where we are in our readiness to change we may say things like, “I know I need to (insert needed change), but I don’t know how, don’t want to, don’t have time, don’t think I can afford it, am not ready" — you name the objection.

Now imagine you're an adult child of a parent who you know needs to make a change. The temptation is to go at it head on and tell them what you think would be best. In other words you make the “good side” of the argument. This is a well-meaning approach but is often counterproductive because the tendency will be for the parent to make the “bad side” of the argument. It goes like this:

Adult child: “Dad, we need to talk about making a change in your situation. I'm concerned for your safety and think we should look at senior living.”

Parent: “Well, maybe I'll need that someday but I'm doing fine. I'm not ready.”

What has just happened is that the parent has reinforced their reasons for not making a change by saying them out loud. And, we tend to believe what we hear ourselves say out loud.

The remedy here is to resist the temptation to tell the parent what you think needs to happen—tough as it is—and instead to make statements and ask questions that lead them to “change talk.”

Alternative approach: “Dad, when you fell last week it really scared me. How are you feeling about what happened?”

Parent: “Well, I don’t know — I guess it was a little scary. It was a good thing Joey stopped by. But, I'm fine now.”

Here, you ask an open-ended question to get them talking about the situation. Then you can continue to make reflective statements and ask questions to lead the discussion forward.

A Framework for Difficult Conversations

The other skills that go along with asking open ended questions are affirmation, reflection, and summary. These skills form the acronym OARS:

Open-ended questions — a question that does not have a yes or no answer
Affirmation — this requires empathy—affirm what is being said-especially when you hear someone saying what they need to do to change
Reflection — simply saying back what you heard so the person knows you heard them and understand
Summary — at the end of the conversation, summarize what has been discussed to be sure you're on the same page.

Let’s see how these are applied. Here's the conversation we started last week:

Adult child: “Dad, when you fell last week it really scared me. How are you feeling about what happened?” (Open-ended question)

Parent: “Well, I don’t know. I guess it was a little scary. It was a good thing Joey stopped by. But, I am fine now.”

Here it would be tempting to tell the parent that there needs to be a change for their own good. Resist that temptation! We can hear the ambivalence—on one hand the parent is fine, but the incident was scary. Affirm what you hear them saying and reflect the conflict.

Adult child: “I'm so glad you are feeling fine now—and thank goodness for Joey! (Affirmation) But the fall was scary and could happen again. Joey is going back to college and I work full time so you could be hurt and alone. Where does that leave us?” (Reflection and open-ended question — putting the conflict out there for the person to resolve)

Parent: “Well, it's true that I could fall again. I'm not sure what I'd do if that happens. Joey is going back to college. My friend has one of those emergency pendants. I suppose I could try that. What do you think?” (Resolving the conflict, coming up with a solution)

Adult child: “An emergency pendant is such a great idea (Affirmation). How would you like to go about looking in to that? I am happy to help if you need me.” (Continuing to empower and keep the parent in charge)

Parent: “Let me talk to my friend and see what she has and how much it costs.”

Adult child: “Dad, the fall was scary, but it's a good thing you're doing fine now. I am so happy that you are going to look into a safety measure that will help you get help quickly if it happens again. I want you to stay independent, but it will help me to worry less if you have that in place. I'm always here to help.” (Summary-Affirmation)

These techniques are simple but not easy. It takes mindful attention to resist taking control. Practice them in your daily life. They work well in many conversations. When you get the hang of it you will find it to be freeing as you are not the one who owns the problem.

Notice we didn't even get near talking about senior living! But using this method of communication opens the door to future discussions. Helping an aging parent is a marathon, not a sprint. Keep up the good work and know that you are doing the best you can.