How Can We Help Seniors and Their Adult Children Communicate?

Dear Benchmark,

I am a nurse practitioner in a physician practice that specializes in geriatrics. We rarely have a day go by that we don’t find ourselves in the middle of a tough conversation between a senior and their adult child. We can see and empathize with both sides of these conversations. The older adult wants to maintain their independence and make their own decisions; while the adult child is frightened something bad is going to happen to their parent.

Since families turn to their doctor for advice on everything from how to tell if an aging parent is still safe driving to worries about a senior’s safety at home, we think the time has come for us to get some help ourselves. We really need guidance on what we can do to help our patients and their adult children have more productive conversations.

Can you offer us a few tips?

Best Regards,
Bethany

Helping Adult Children Empathize with their Aging Loved One

Dear Bethany:

I can easily see how you and your colleagues wind up in these situations! Most of us see our primary care physician as the authority on all types of wellness issues, and this is definitely true for older adults. The physician may be one person who represents the voice of reason and objectivity to both the senior and their family members. I think I can offer some insight that may help.

Here are a few pointers for navigating difficult conversations with empathy and understanding:

• Consider the Setting: If an adult child lets you know at the start of a parent’s appointment that they want to discuss an issue such as driving safety or senior living, consider changing the setting for that part of the visit. While I know a busy physician practice might not always have the luxury of time, moving this talk out of a sterile exam room to a more comfortable setting might help everyone relax.
• Give the Senior Control: Don’t talk over or around the older adult. They are the elder in the room and it is important for them to feel in control. Because control and independence are intertwined with a senior’s pride, if you fail to take both in to consideration you may encounter strong resistance. Encourage adult children to keep in mind that older family members must deal with what intergenerational communication expert David Solie refers to as “layers of loss.” While younger people typically encounter single losses at a time, seniors usually experience loss after loss. Each new layer of loss hits them harder. This can reinforce a senior’s need to feel as if they are in control of their life.
• Listen and Observe: How is the older adult feeling? Do they think the adult child has a legitimate concern or that they are “worrying too much?” One of the best ways to discover that is to ask open ended questions. Then step back and allow the senior to talk. It is important to see the situation from their perspective and to explore any potential solutions they might have.
• Timelines May Differ: For many adult children, the lack of urgency on a parent’s part is difficult to cope with. An adult child might be overwhelmed trying to juggle their parent’s care with their own family and career. Their goal is to make a quick decision and move forward. In many cases, the adult child may have researched the issue and believes they know what is best for their parent. The senior, however, often wants to move more slowly and to make their own decision. They need time to process the change and come to terms with what it means for their life. If you push the senior to move too quickly, you will likely encounter resistance that sets the conversation further back.

My final tip is to help the family realize and accept that these difficult issues are rarely resolved in one conversation. It might take multiple family meetings in a variety of settings to reach a decision.

One resource the team at Benchmark finds helpful is a book by the expert I referenced earlier. How to Say It to Seniors: Closing the Communication Gap with Our Elders by David Solie might be good for your staff to read and keep on hand.

I would also like to offer your patients the support of one of our Family Advisors. The senior or their adult child can call our advisors and ask to schedule a Home Visit. One of our experienced team members will visit the senior’s home, assess the risks and offer solutions to help them stay safe.