40-70 Conversation Starters . . . For Sensitive Senior Subjects
To help adult children of older adults know what to say, following are various scenarios of common senior topics. Each is backed by Home Instead Senior Care research conducted in the U.S. Responses were developed in cooperation with Jake Harwood, Ph.D., communication professor and author from the University of Arizona.
Topics covered: (click links below to jump to that specific topic)
When Health Changes Lifestyles
Your 70-year-old widowed mother has just been diagnosed with macular degeneration, a disease that causes deterioration of eyesight. How do you begin a conversation with her about the possible ramifications of this disease on her life? Many seniors in this situation might begin the conversation with family themselves. If not, then it would be good to think about her personal circumstances and important areas to address. For example, if your mother lives in a remote area, transportation is probably the most immediate issue. Approach the conversation with the goal of trying to resolve this one issue, rather than multiple issues.
Timing is the key. There are rarely urgent deadlines that have to be met immediately—give yourself and your parent time to think about issues. Your mom would likely be receptive to a conversation that begins: "Let's figure out a plan for how you can get around town if you no longer feel safe driving."
Research: Nearly one-third (31 percent) of Baby Boomers said their biggest communication obstacle with aging parents is continuation of the parent- child roles that emerged in childhood, making discussion of sensitive issues even more difficult.
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Did Dad Hit a Light Pole?
A neighbor of your 83-year-old dad has called to tell you he saw your father back his car into a light pole. What do you say?
If the damage is visible, you could ask, "Hey Dad, what happened to the car?" Or you could bring up the phone call from his neighbor. "Fred from next door called and said he saw you run your car into the light pole." This is an example of a situation that calls for more general observation. Take the opportunity to drive with your parent. Even a short drive would help you gauge your dad's skills and deficits. For instance, an older adult who consciously reduces driving at night because of vision issues or who drives a little slower to account for reaction time is probably safe. On the other hand, an 83-year-old who insists on driving icy highways at night while doing 75 mph is probably in need of immediate intervention. Then gear your comments accordingly. If you're concerned that your dad is unsafe on the roads, make his safety and that of others your focus. "Dad, I'm worried that you're no longer safe on the roads and that others could be at risk as well."
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You're Going to Wear That?
You're planning a birthday party for your 85-year- old mother and she insists on wearing her favorite blue dress. Because her eyesight is poor, she can't see that the dress is stained and worn. What do you do?
It's important to determine whether this really is an issue—that the stains are worth addressing with your mother. If so, be direct: "Mom, did you know that your party dress is stained?" Then offer to have it cleaned or, better yet, suggest a shopping trip: "Mom, this is a really special occasion. I'd love to buy you a new outfit. Let's go shopping." If she still wants to wear the dress, then a family council or a fight with your mom is simply not worth it. You may need to figure out a way to overcome any embarrassment that you feel at your mom's appearance, but ultimately what she wears should be her choice. The embarrassment that you feel is your problem, not hers. Chances are, though, if she knows you are apprehensive about the dress and willing to help her find a new one, she will agree.
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When the House Is a MessYou find that your 77-year-old mother's house is often in disarray when you visit. You believe it's time for her to make a change in her living arrangement. What do you say?
Observation and careful attention to the problem should be your first course of action. Avoid diagnosing a problem and deciding on a solution quickly. Approach your mother with a sense of working together to find a solution rather than telling her what to do. The specific circumstances—such as financial constraints—may be relevant. Is the problem simply that your mother is physically challenged by strenuous housework or is she deteriorating mentally? Does she just need help tidying up around the house or are other aspects of her personal care, such as bathing, going downhill?
Assuming that the problem is physical—where activities such as vacuuming or bending are becoming issues—then begin the conversation with an offer: "Mom, I have some extra cash. What do you say we find someone to help you with the heavy stuff, like vacuuming? It will be my treat." Seniors are often very willing to accept help around the house. And most communities have ample resources such as cleaning services and companies like Home Instead Senior Care that can help.
Research: The most difficult topic for adult children to discuss with their aging parents was that they have to leave their home. That conversation was a problem for more than half (53 percent) of those who were still in the parent- child role, as well as more than one-third (35 percent) who didn't have that communication obstacle.
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A Senior Moment or Something More?You've just stopped by your parents' house and for the second time in a month, noticed that your 70-year-old mother has forgotten the name of a close friend. Is it Alzheimer's disease or dementia, a senior moment or just a passing phase? More importantly, how do you find out?
Make sure you consider your mom's history and personality so that you can determine if this is a change. Some people have always been bad with names, but if your mom is forgetting a close friend's name and you notice signs of disorientation, you might say: "Gee Mom, perhaps you should see a doctor and get checked out. I'm sure it's nothing, but it would really put my mind at ease if you'd let a doctor make sure your memory is O.K." Such a conversation starter focuses on the positive not the negative.
Research: A parent's cognitive condition was a topic that 50 percent of Baby Boomers wanted to know more about.
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The Medication Quagmire
When visiting your 85-year-old dad, you see bottles of medication on the kitchen counter, on the bathroom counter and on his nightstand. You wonder how he is keeping all of his medications straight. What do you ask?
It's good to use humor and, in a situation like this, to assume that he is keeping them straight (innocent until proven guilty). There may be good reasons why some of his medications are in the kitchen (he's taking them with food), while others are on the nightstand (he's taking them before bed). Pointing to a bottle and asking, "How the heck do you keep all these pills straight, Dad?" would be a good conversation starter. If the response includes the reasons you suspected above, then it sounds like things are under control. If, however, he says, "I don't know. I do my best. I'm not even sure what some of them are," then the situation probably needs more attention. If he's having a problem, talk to him about a pill organizer, which could help him keep his medications better organized: "Dad, I've heard about organizers that can help you keep all your pills in one place and make it easier for you to keep them straight. Why don't I check into it?" In addition, one service that Home Instead CAREGiversSM provide seniors is medication reminders to assist them in managing their daily medications.
Research: Forty-nine percent of adult children said they were interested in learning more about their parents' medication management.
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Sibling CommunicationAfter finding many of the light bulbs burned out in your 86-year-old parents' house, you believe that they're beginning to need more assistance. As the oldest of five children in the family, how do you approach your siblings? What other resources can you tap into?
Siblings can be a good reality check. You might say to a brother or sister, "I think that Mom and Dad may be having problems changing their light bulbs. Have you noticed anything?" But it's important not to get involved in a group-think cycle where the siblings all start seeing problems and building grand disaster scenarios. If a parent needs a little more help around the house, that shouldn't result in siblings picking out a nursing home and putting their parents' house on the market. Perhaps all the parents need is a little extra assistance. Go to your Home Instead Senior Care office or Area Agency on Aging for resources that can help. A geriatric care manager also can be of benefit.
Research: Nearly three- fourths (71 percent) of respondents said it would be helpful to involve siblings in talking with parents, while nearly half (49 percent) said seeking counsel from a senior-care professional would be useful.
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Mom's Not Safe at Home
Lately when you've been visiting your widowed 83-year-old mother, you notice bruises on her arms and legs. She said she's just clumsy, but you suspect she's been falling. You know she's too independent to ask for help. How do you find out?
Bruising is a complicated issue. On one hand, bruising occurs more easily in older people; sometimes (especially with certain medications) bruising can occur without any injury, fall or impact of any kind. So depending on your relationship with your mom you may be able to believe her if she says that she's not falling. On the other hand—and at the other extreme—repeated bruising might indicate either falling or some other form of physical trauma (e.g., physical abuse of some kind, perhaps). Of course, these two considerations lead to completely different solutions. In the first case, there's no cause for concern. However, if the bruising is significant she might want to consider medication adjustments. Ask her to consult her doctor. In the second case, intervention is clearly needed. It's another case where considering the entire context is important. Has the increase in bruising occurred at the same time as some other change in her life? For instance, noticing significant bruising soon after your mom started working with a new home health care assistant, or after she moved into an assisted living environment, would be a red flag. Similarly, seeing bruising after she's started on some new medication also might be a reason to attend carefully to the issue (e.g., certain medications might cause disorientation that leads to falls). Why not start the conversation like this: "Mom, that's a nasty-looking bruise! Where did you get that?" And then probe with another question if she gives a generic response such as "I'm just clumsy." For instance: "Sure Mom, this whole family is clumsy, but we aren't all walking around with big bruises on our arms and legs. So how did it happen?"
Research: Health (28 percent) was among other difficult topics for Baby Boomers to broach with their senior loved ones.
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The Money Talk
Your parents have always been very independent and private about handling their finances. Lately you've seen that they've been cutting back on food and other necessary products. You're concerned that their staples are in short supply. How do you broach this subject?
This is a tough one and probably a situation where you need to "bite the bullet" and talk about it, no matter how uncomfortable. Some reasonable conversation starters might be, "Boy, there's not much food around the place—what are you guys eating?" Pay attention to the tone you use. This sentence could be said in an accusatory or a humorous fashion. Obviously the latter is more likely to get a positive response. If this is too informal, try a more straightforward approach: "Mom, I'm a bit concerned about whether you and Dad are eating enough." Malnourishment can be a significant problem with older adults, and can be a sign of other issues that might need attention over and above finances—such as poor-fitting dentures or even depression. If the other evidence points to a financial issue, ask about that directly or simply make an offer: "I know you're pretty private about money, but you know that if you ever ran into problems I'd do what I could to help, right?" And don't forget about different communication channels. Sometimes, it's easier to at least start the discussion of emotional or private issues in a less personal communication medium, even if it's only to say that you want to talk to them about the issue. For some people, raising this kind of issue can be easier on the phone, or even in an e-mail. Once you've said what you want to talk to them about in an e-mail, it'll be a lot easier to raise the topic in person. You may even find them doing it for you. For example, "What's with this e-mail you sent us, eh?"
Research: Money (21 percent) also was near the top of the list of challenging subjects for adult children to broach with older adults.
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When Dad Starts to Date
Since your mother died a year ago, your 77-year-old father has started dating a widowed family friend. You'd like to know more about what's going on, but how do you begin the conversation?
If you want to introduce the topic, a gentle inquiry like the following would be fine: "So it seems that you've been seeing quite a bit of 'Fran' recently." After this, you should probably see whether your dad wants to share additional information. If he doesn't, that's his prerogative. One exception would be if you have some information that there is abuse or exploitation in the scenario. For instance, if you sense that your dad's love interest may be taking advantage of him financially, some additional probing might be justified, depending on the specifics. If your dad has money and this friend doesn't, and suddenly the friend shows up driving a new luxury car, you might ask your dad, "Do you know who bought her that car?" If the friend moves in with your dad and a lot of new things appear around the house, which don't fit your dad's style, you might ask, "This doesn't look like your kind of thing, Dad. Did you buy this?" Otherwise, be happy that your dad has a girlfriend and don't force him to disclose more than he's comfortable telling you.
Research: Nearly half (47 percent) of adult children are "not very" or "not at all" comfortable speaking to their moms or dads about their parents' romantic lives.
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