How to Have Difficult Conversations with Elderly Parents

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Maybe you’ve been there as a parent: that moment when you realize you must have a very difficult conversation with your child. If you don’t have children, at some point you’ve likely had  to approach dear friends or other family members about a sensitive issue.

Caregivers of aging parents will find themselves in this position too, and probably more than once during their caregiving experience. But when it’s the adult children who need to talk to their parents about a touchy topic, the rules are different. The approach should be too.

Consider these common scenarios to help you be more sensitive when starting a difficult conversation with a family member. (Every family is different, of course, and there are certainly more right and wrong answers than what’s listed below.)

Your mother has Alzheimer’s. Your stepfather is her primary caregiver and he seems to be in denial about how the disease is progressing. Last week, Mom left the stove on and set off their smoke alarms for the second time in two weeks. She also wandered out of the house and was missing for a half hour. Your stepdad doesn’t seem concerned.

Wrong response: You don’t care about Mom! She needs to be in a secured Alzheimer’s unit but you just want to keep her at home to spite us.

Right response: I’m concerned about Mom’s safety and yours. She seems to be getting more confused. What can we do to make things better for both of you?

Your father does not want to go to a nursing home, but the doctor has recommended an advanced level of care given the state of his health.

Wrong response: The doctor said so and he knows best. You have to go whether you like it or not.

Right response: We want what’s best for you and if the doctor thinks you need help, we need to take that seriously. But that doesn’t mean we can’t look into other options. Do you have any suggestions?

Your mother-in-law recently lost her husband. She does not seem to be managing well on her own and you think she should move in with someone (whether it’s your family’s home or that of a spouse’s siblings).

Wrong response: You should move in with your daughter. The house is a mess and you seem helpless without your husband.

Right response: It must be so hard to lose someone you’ve been with for such a long time. How are you feeling? Is there something we can do to help?

In all of these scenarios, expressing your concerns is the first step. A simple conversation starting with, “Hi Mom, I’m concerned about you. Is everything OK? Can I do something to help?” may be more well-received than, “Mom, you’re lost on your own. You need to move in with us because you just can’t manage things without Dad.” That implies that your mother is incapable of managing her life, which could be a hurtful and perhaps completely inaccurate assessment. It’s better to say “I’m concerned” and “how can I help you” instead of making “you” judgements and assumptions.

No matter what the scenario or who is involved, use affirming language and don’t ever assume something about the person or situation without asking them directly about it first. Never send your Dad brochures about a local senior living community without talking to him about what he wants or where he’d like to be. Never assume that your stepfather doesn’t care about your Mom just because you don’t like him. Caring for someone with Alzheimer’s is extremely difficult; even the very best caregivers have moments of frustration and weakness.

Navigate the conversation in a way that unites rather than divides. Don’t take sides or pit family members against one another. Remember the heart of the conversation is finding the best solution for your family member, regardless of whether he’s your stepdad or husband’s dad. Keep the focus on what he wants, not what you and your husband think is best. Respect their role as the parents, even if they have become more dependent on you to meet daily needs. Empower them to make a decision that will benefit everyone, rather than ordering them to do something they would rather not. Try to reach compromise instead of forcing them by coercion.

Adult children need to listen to their parents, even if they think they know what’s best for Mom and Dad. Before forging ahead with plans and preparations, i.e. “Mom, I arranged a visit to the assisted living down the street today. We’ll be leaving at 1pm,” listen to what they are saying and not saying about what they prefer in terms of care and housing. Maybe you recently visited an older relative in a nursing home and Mom said, “Please don’t ever put me in a place like that.” Or, maybe a neighbor has brought in home care for their aging parents and Dad has commented on how the arrangement has worked out well for them. Listen and look for these cues as natural lead-ins to the conversations you need to have.

If you’re having trouble drawing out a response from your loved one, call up one of their best friends. See if Mom has spoken to her about what she’s thinking and feeling. Sometimes parents feel more comfortable talking to peers about what they want rather than talking to their children about it, because they still want to appear strong and capable. (Remember what that was like when you were a teenager? There were certain things you’d rather talk to your friends about instead of your parents, right?)

Be patient. Be supportive. Show you care instead of trying to show you’re in charge. And above all, speak with compassion and respect.



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