It’s not an easy conversation to have. It’s charged with emotions, expectations, and difficult decisions. It’s tempting to avoid the conversation rather than address the issues head on. And yet, we know that when our loved ones are facing chronic diseases, limiting injuries, or end of life challenges, we need to talk about caregiving and the path ahead. With the help of some of our partners, we are offering tips to starting the difficult conversation to facilitate smooth transitions ahead.
Before you even approach your loved one with this conversation, set in your mind the priorities that lie ahead. Consider what is making this conversation necessary now. Make a list to keep your conversation focused on the most important issues. When emotions and denial comes into play, you’ll be able to return to and emphasize the main reasons it’s time to talk about caregiving.
Before you have this difficult conversation, decide who needs to
be part of it. Your loved one’s spouse as well as your own, as well as siblings or children, can be necessary to the decisions that need to be made and may bring important points of view. In an article about Driving and Dementia conversations, the Alzheimer’s Association recommends bringing diagnoses and recommendations from your loved one’s physician, to reinforce your concerns.
Make It a Conversation
When you approach a loved one about caregiving, “we need to talk” is a good place to start and a good mantra to remember. The “We” emphasizes that the discussion needs to be open among all parties involved. While you may have a list of things you want to address, your loved one and the others involved may have other concerns and priorities. Be ready to talk and listen, to hear all sides, and to keep the conversation accessible.
Making a Plan
Bring a calendar and notebook to the conversation and be ready to assign tasks and delegate responsibilities. Don’t put all the duties on your plate or on the plate of your loved one. Using your priorities list, decide which tasks need to be done first and who is best able to tackle them. Does your loved one need to move to your home or to an assisted living home? Does your loved one need to stop driving and start arranging rides to appointments? Do you need to find an in-home nurse or hospice care? Create a Lotsa Community to get others involved in these roles. Designating tasks now and setting expectations avoids confusion later.
When you tell a family member or friend “we need to talk,” bring your own concerns and emotions to the conversations. The Caregiver Action Network recommends breaking through denial in these difficult conversations by being honest with your emotions and expressing them clearly to your loved one. Explain your fears and concerns in detail. Tell them about how you worry that they may injure themselves or may need more around-the-clock care. Explain how intervention now can improve their quality of life as well as ease your concerns. This vulnerability gives your loved one insight into your decisions and gives them an opportunity to be involved in allaying your fears.
Don’t Forget the Logistics
With all the emotions surrounding these caregiving conversations, the administrative decisions can be lost in the midst. AARP offers a helpful list of questions that need to be asked and paperwork that needs to be addressed while you’re having this difficult conversation. Specifically don’t forget to talk about a Living Will and a Health Care Power of Attorney. Make sure your loved one knows who is appointed in these documents and who needs to sign them. These will ease caregiving transitions and help you make important decisions when your loved one can’t.
Bring in a Mediator
If you feel uncomfortable having this conversation or you think that you might meet resistance, invite a third party to help facilitate the conversation. This might be a clergy person, a lifelong friend, or a professional counselor. This mediator can hear both sides objectively and translate viewpoints, without additional emotional entanglements. He or she can help each side understand the other and present the issues in a way that everyone can feel comfortable. They can also keep notes or just remember which decisions were made so later denial or frustration doesn’t cloud them.
One Step at a Time
As with many things in life, this conversation may need to happen multiple times. The caregiving conversation will need to be ongoing and will evolve over time. You don’t have to make every decision during the first difficult conversation. Don’t overwhelm yourself, your loved one, or the others involved with all the issues in one day. Use the first conversation to open the door to a trusted, open discussion. Choose to make certain decisions at a later date. If needed, you can put a date on a calendar to have a formal conversation about certain issues. For instance, you may decide at the first conversation that it’s time to move to an assisted living facility, but you can use the next conversation to choose which one.
Starting the conversation is sometimes the hardest part, but once you break that barrier the discussion and decisions become much easier. Approach your loved one and everyone involved with patience, compassion, and honesty and be ready to return to the conversation often.