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Tough Conversations with Aging Parents & Family

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How to make them easier

When families are giving more support, there are many things to talk about. Sometimes these tough conversations with aging parents do not go so well.

Families provide the major source of support for older persons living in the community and in facility settings. As adults age, they may become more dependent on their families for day-to-day support. For those with dementia (cognitive impairment), this dependency may be quite pronounced as the adult child takes on more responsibility for decision-making. 

Some people say that when aging parents need the care of their children, the roles become reversed; that is, the parent becomes the child and the child becomes the parent. Although we are respectful to those who feel this way, we believe that is not helpful.  How we label a role is important and the phrase “parenting your parents” can become demeaning. 

In fact, when the older adults are treated like children, it increases the tension between the generations. We encourage the adults to maintain their relationships as sons/daughters while at the same time accepting more responsibility for the aging parent who may be losing capacity.   

As people age, their needs may change, and their grown children may be called upon to provide more assistance. The adult children may also have needs, which the parents can help them to meet.

Principles of communication

Try using these approaches to improve communication

  • Listen actively to what others are saying. Give them feedback about their opinions. Ask others if they understand what you are saying.
  • Suspend your own judgments when listening.
  • Pay attention to what is said. However, consider also how it is said and what is not stated.
  • Watch body language (facial expressions, posture, tone, gestures) that might add to the meaning of the message or contradict what a family member actually says. This is easier said than done because body language is often done instinctively or habitually rather than consciously.
  • Show that you are paying attention – maintain eye contact, nod, respond.
  • Remove barriers to listening – distractions, preoccupation, and self-talk.
  • Ask open ended questions – these are questions that cannot be answered with a simple “yes or no.” 
Talking with your parents

Do you want to have an open conversation with your mother and/or father? Let them know that you understand their views and values. Here are some ideas:
Mom and Dad … I want to say that you

  • have experienced major changes in society.
  • hold views that are different from mine and that’s okay.
  • grew up in a more traditional time, and I value some of our family traditions.
  • worked hard to achieve what you have gained, and so have I.
  • can make decisions and choices.
  • respect authority, but I don’t to the same degree.
    AND
  • I really care about you and want to do the right thing.
Talking with your adult children

If you are the “aging parent” you might want to have an open conversation with your adult children. Here are some ideas:
To my adult child (children) … I want to say that you –

  • are driven by different things than I am, and I am trying to accept that.
  • care about work-life balance, and I wish I could pay more attention to this.
  • are self-reliant and do not want to be controlled and I try not to give you advice.
  • don’t care for too much structure or unnecessary rules, and I can see your point.
  • are serious about life, and I am proud of your adult accomplishments. AND
  • I really care about you and want to do the right thing.

Four Challenges Many Families Face

There are four common situations that family members often encounter.

How do I get help from others in my family?

Usually, one person in a family assumes more responsibility for providing more support. Often, this is the adult son or daughter who lives closest. Siblings who are geographically distanced may feel guilty for their inability to help.

Consider having a family meeting, including everyone, to explore everyone’s concerns. Establish an air of open acceptance and honesty. Set an agenda for the meeting and don’t forget to talk about things that are going well. 

What do I do if my parents will not accept my help?

Initial discussions can be difficult, especially if your parents do not see the need for help, or because they don’t want to be a burden. People need to feel that their relationships are two-way. Find ways to show your mom and dad that they are giving you something in return for your assistance. Then, they may be more inclined to accept your help. 

They may be worried that getting help means a loss of independence. Try to discuss this topic when it is a “future possibility.” Ask them how they want to handle future needs for support. You may need to obtain more information about services available in the community.

Some individuals refuse help because of mental or emotional disorders. Those with addictions to alcohol or drugs, may not willingly accept your advice. If there is a long-standing mental health disorder, advice for treatment may be rebuked. If you are caught in one of these distressing situations, you might find help through professional counselling.

As noted earlier, it is important to involve others in these discussions. When someone else notes the need for help and confirms what you have been saying, your mom or dad may be more inclined to agree. They may listen more closely to their peers or prefer to have friends help out rather than ask you to do so.

Ultimately, you must respect your parent’s decision even if you do not agree with it. Unless there is a major risk to others, or the individual is not competent to make decisions because of a medical diagnosis, your parent has the right to choose. 

How do I set limits?

Another challenging situation occurs when your mother or father has unrealistic expectations that you are unable to meet. When this happens, it is important to be clear about your role, and specify what you can and can’t do, when and where you can provide help, and how much time you can spend. Once you set the limits, stick to them. Don’t be persuaded “just this once” because your indecision will be evident, and the unrealistic expectations will continue.

Be aware of the impact on your other relationships and roles, especially with your spouse and children. Give them permission to tell you when you are becoming too involved. Let them warn you before you burn out. 

If you are still working, you may need to talk with your employer or the human resources department to see what kind of support and assistance might be available in your workplace. Check out your employment benefits to determine if these include the provision for elder care. Depending on your job, you may have other options for increased flexibility in your work role. You may need to let go of some of the things that can wait. Focus on the really important things in your life. 

Don’t try to do everything alone. Sometimes, this situation requires a family meeting to talk about options and ways in which others can share the load.

How do I handle family conflict?

Sudden changes in health, hospitalization, or a move into a long-term care centre can create a family crisis. Crisis situations are turning points. Families either negotiate the challenges and move on, or fail to negotiate with resulting distress. The crisis is caused, not solely by the problem, but also by the inability of the family to cope effectively using their usual problem-solving methods.

Crisis

Taken from the Greek work “krinein,” crisis means “to decide.” From the Chinese characters, crisis means “danger” because it threatens to overwhelm and “opportunity” because during times of crisis, individuals and families may experience growth and increased competence.

When an aging adult is thrown into a crisis, the whole family is involved. This is a time when siblings may experience the “opportunity” to rally around each other and rely on their strengths to cope with the crisis in a way that serves everyone’s best interests. Unfortunately, a family crisis may mean “danger” for some adult children who are in long-term conflict with one another. Or the situation may provoke old feelings of rivalry and competition. How can brothers and sisters heal old family conflicts when they are forced together to help the older generation? The first step is to recognize and accept that you and your siblings do not necessarily share values, beliefs, and experiences.

Two sisters were at a dinner party. As the conversation went on, a guest noted that the two women did not seem to agree on anything and asked “Are you sure that you are related?” One sister replied: “Definitely – we share genes but we do not share many opinions.”

If your family has open communications and strong, healthy family ties, you can manage the changes and the challenges. But what if your family has a long history of difficult relationships, or communications are difficult because of mental health disorders, or clashes in personalities? What can you do if you are caught in family conflict, either between yourself and your parents, or among your siblings? 

Communicating when there is conflict
First and foremost, acknowledge unresolved family issues

If you did not get along well with your parents and/or siblings in the past, it would be unreasonable to expect this to change because they need your help. Try to identify and address unresolved issues in an honest and realistic manner. If possible, engage in respectful discussions about things that are troublesome. Become aware of your own reactions. You may need to lower your expectations about the extent to which change is feasible and accept your family members as they are. At times, families need professional counseling to help them work through their unresolved issues.

Avoid roadblocks or triggers

Triggers may be rooted in automatic responses by family members, and have little to do with the present situation. Most families develop repetitive and predictable communication patterns – an automatic response that comes out in stressful situations. Some patterns can be helpful; others can be unproductive, especially when one member does not have his/her needs met. 
Here are some responses that block communication:

  • False reassurances – “Everything will be okay”.
  • Giving advice – “If I were you, I would …”
  • False insinuations – “What you really mean is …”
  • Moralizing – “It is wrong to …”
  • Value judgments – “That wasn’t the right way to …”
  • Superficial social responses (clichés) – “That’s nice.”
Manage on-going issues

If possible, deal with issues one at a time. Sometimes you need to start with issues that are easiest to resolve, or break down a big issue into manageable chunks. Try to find a solution that meets everyone’s basic and legitimate needs.

Follow the steps of cooperative problem solving

This approach is helpful in finding solutions that are acceptable to everyone. No one loses and everyone benefits.

  1. Define the problem in terms of needs.
  2. Brainstorm possible solutions. Don’t shut out any ideas at this stage.
  3. Select the best solution that will meet the needs of all.
  4. Make a plan (who, what, where, when) and implement it.
  5. Evaluate the outcome, and make adjustments as necessary.

Take Action

Learn more about the different generations in your family.  Talk with family members about values and experiences.

Recognize when conflict arises because of old and unresolved issues.  If you cannot resolve these problems, seek professional help. 

How to find professional help for your family, or for yourself

o   Check with your physician.  Some primary care medical clinics have therapists available.

o   Contact your local health authority. Some cities have free walk-in mental health services for a single session of therapy. And often, that is all that is needed to help a family get started on a new plan of action.  

o   Visit Canadian Association for Marriage and Family Therapist. You can search for a therapist specialized in working with families.  https://camft.ca

o   Check Canadian Counselling and Psychotherapy Association for a professional near you.  https://www.ccpa-accp.ca

Try to develop these characteristics when you talk to your parents or your siblings:
  • Listen carefully: try to understand even if you do not agree.
  • Accept differences: it is very likely that each person will have an individual opinion.
  • Be patient: your family is facing some major decisions and transitions  (i.e., moving from the home, going to see the doctor, adapting to chronic illness). Very few dilemmas will be resolved in one conversation.
Consider some of the following suggestions for connecting the generations in your family: 
  • Make an unexpected telephone call. Focus on checking in, not checking up.
  • Send a gift card to pay for long distance phone calls.
  • Write a letter. With today’s high-speed world and increasing use of digital technology, we forget the pleasure of finding personal mail in our box.
  • Take a trip together. Use the time to get to know each other in the present moment. Enjoy the surprise of finding out new things about each other.
  • Teach your parents to use technology to remain connected (if they are not already computer users).

Want to print this article? Download the pdf of chapter four,
Family Dynamics.

Check out the following activities. They may help you discover a new point of view and to understand your family better.

Get to Know the Generations in Your Family

Know Your Family’s Strengths and Weaknesses

Reflections on Your Family’s Communication Style

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