10 Tips for Having Difficult Conversations with Aging Loved Ones

Having tough talks can feel impossible, but with a little bit of strategy, support, and a lot of patience, you can move forward for the benefit of your loved one and yourself.

Having tough conversations with our aging loved ones can be daunting. Topics like long-term care, financial management, and housing are difficult to broach for older adults because it may signify a loss of autonomy or independence, or more, remind them of their own mortality. Often, these challenging conversations are postponed until a crisis erupts, making decision making even more strained. A 2019 survey from Caring.com found that only half of all people have even talked to a loved one about personally needing a will or living trust. Despite the necessity of these conversations, they are avoided.

Yet, we know that thoughtful conversations help us identify what matters most to us, which we can then share with our loved ones. To help your conversation with your loved one get off on the right foot, we’ve curated some tips you can keep in mind.

Tip 1: Start Early

After interviewing more than 230 experts on our Glowing Older Podcast, the common theme is “start early and plan, plan, plan.” No one makes good decisions under duress. Taking a proactive approach to addressing difficult topics with your aging loved ones,

when they are not injured or stressed, will make it easier to explore tough topics and make sound decisions. Don’t wait until a crisis occurs to begin your conversation. If you wait until there is a health or financial crisis, there may be fewer choices available, or you may have

to make decisions quickly. Being proactive rather than reactive also prevents some of the

conflicts that occur in families when everyone is scrambling to find a quick resolution.

Tip 2: Choose the Right Time and Place

Determine the right time and place when and where your aging loved one will be most receptive. Introduce hard topics in a private, quiet, and comfortable environment. Avoid having in-depth or important conversations in settings where there is competing noise or distracting activities. Face the person at eye level as you talk to them so that they can pick up on your facial expressions. If the older adult is living with any cognitive impairment, studies suggest conversations earlier in the day will be more productive as they may experience sundowning, which is restlessness, agitation, or confusion later in the day.

Tip 3: Acknowledge the Discomfort

Acknowledging the discomfort at the beginning of the conversation allows your loved one to mentally prepare. Start by saying, “I need to have an uncomfortable conversation with you.” "By stating what’s about to happen, the person will be prepared and a little less defensive,” says author and inspirational speaker Simon Sinek. Be prepared for rejection or avoidance. “There are many ways to respond to that discomfort,” adds Sinek. “We can run away from it. But that’s not the best option, because avoiding an uncomfortable situation just perpetuates discomfort or breaks relationships. The better way to deal with it is to lean into the tension.” Focus on the long-term gains that the conversation will create. When your attention is focused on positive outcomes and benefits, it will shift your thinking process and inner dialogue to a more constructive place.

Tip 4: Enlist Conversation Starters

A conversation starter is an introduction used to begin a conversation. Start with some

open-ended questions to plant seeds and get your loved one talking. (People usually love

to talk about themselves!) Then build on those to lead to bigger, more decision-focused

conversations.

Some examples:

• What has been the greatest joy in your life?

• When you think about a perfect day, what does it look like? Who are you with, what are you doing, and where are you?

• Imagine you’re at an event when you’re 75. The room is packed. You are receiving an award. What would you want that award to be? Who is in the room?

• What information is most important for you to share with your loved ones?

• What is the biggest risk you have ever taken? How did it go? What did you learn?

• What is one quote or piece of advice you have received that has stuck with you?

• Finish this sentence for me: “People would be surprised to know that I... (fill in the blank.)

  
  

Tip 5. Do Your Homework

Being prepared with well-researched suggestions will drive your conversation from hypothetical thinking to concrete planning. Help your loved one find the tools and resources that can improve their current quality of life. Find out what options and local care resources are available. For example, if it looks like they will need ongoing assistance, explore how in-home care services can help them with their daily routine and maintain their independence. Furthermore, be open to exploring options beyond what YOU might think are best. Listen to what your loved one is asking for and follow-up with researched options.

Tip 6. Involve Family Members

When appropriate, bring other family members, such as siblings, into the discussion. Pre-conversation, get all the issues on the table with siblings and other relatives, and assess their level of interest and involvement. Determine whether these other family members have different opinions that could undermine what you are trying to accomplish. When there are significant differences, try to work these out before bringing it to your aging loved one. A unified consensus among the adult children is always a more supportive environment than a divided and contentious family.

Tip 7: Be Empathetic

Empathy is the ability to understand and share the feelings of another. When initiating

difficult conversations, be empathetic by focusing on listening, reflecting, and observing.

Be compassionate and address their concerns openly. Really listen to what is said. Don’t

interrupt or feel the urge to fill periods of silence that often occur during conversations. A brief pause could mean your family member is contemplating a response and thinking through the conversation and how to reply. Genuine attention and a calm demeanor will encourage your loved one to elaborate and avoid being defensive. For every statement the other person makes, mirror back what you’ve heard them say, to validate that you understand them correctly, and so they know they’ve been heard.

Tip 8: Practice Mindfulness

When initiating an uncomfortable conversation, emotions run high on both sides. When the sympathetic nervous system is triggered, heart rate and breathing elevate and your emotional intelligence plummets. Under stress, you may also lose access to the prefrontal cortex, the part of your brain responsible for rational thinking (think ‘fight or flight’). Your loved one will notice signs of stress and will likely respond similarly. Before you know it, the conversation has derailed, and the conflict intensifies. The way around this unpleasant scenario is mindfulness. “Being mindful allows us to gain awareness and consciously make new choices,” says Berit Lewis, author of Ageing Upwards. “We become more compassionate and treat each other better.” In times of heightened stress, welcome silence, take deep breaths, or revisit the conversation when the tension has subsided.

Tip 9: Create a Life Plan

“A Life Plan that doesn’t explore and exploit knowledge and tools is like an airline without pilots or planes - it won’t take you anywhere.”

– Dr. Bill Thomas

The product of your difficult conversations should be a plan that serves as a map towards your loved ones living their best possible life. According to gerontologist and aging expert Dr. Bill Thomas, a Life Plan is a living document that changes over time. “We make plans because we sense a gap between the way things are and the way we want them to be. Something’s not right and we feel a need to fix it. But what exactly is it that needs fixing? Only you know. Only you can decide where the next chapter of your life will take you, and how you will get there.” Planning takes creativity, focus, and participation.

Tip 10: Enlist Expert Help

There is no substitute for having access to the knowledge and tools that can speed us on our way. A skilled advisor is the best way to help you reach your goals. An experienced, objective voice to guide, such as a social worker, coach, or life care manager, will provide the best possible chance for success. Find experienced attorneys or legal counsel to help draft important documents like power of attorney in case of medical emergencies. These professionals work with diverse clients and have the experience to provide helpful guidance on the best plan of action.

What Matters in the End

"Merely being safe and living longer. We must grasp the idea that the chance to shape one’s story and elevate the quality of one’s later years will become all the more important across our nation in the years ahead.”

– Atul Gawande, author of Being Mortal: Medicine and What Matters in the End

Having difficult conversations can feel impossible, but with a little bit of strategy, support, and a lot of patience, you can move these tough talks forward for the benefit of your loved one and yourself. Above all, remember to go into these conversations with love and empathy.