One of the most difficult things a person may have to do, is to talk to an aging parent about personal concerns for their safety and welfare, especially if one or both of the parents is suffering chronic illness and/or dementia; both of which create many scenarios for real concern. Most of the time our concerns for aging parents are based on “subjective” versus “objective” data. We have to be very careful in expressing understanding and compassion in helping our parents deal with any fears, uncertainties or doubts that they may or may not be able to express themselves. While having a genuine desire for your parents to “age well,” it’s also a bit of a “tender trap” you can easily fall into, when one or both parents is not willing to participate in such discussions concerning their level of self-care. It’s a tendency many adult children seem to have in stereotyping older adults before adequately assessing a situation from different angles and perspectives. Adult children also run the risk associated with trying to problem solve for their parents when they don’t quite know the real or underlining issues. Let’s face it, caring for aging parents is not something we learn or know by heart. Although, our concerns may be heartfelt.
The older population in the United States- compromising individuals who are 65 years of age, or older, is projected to increase to 55 million persons by 2020 and to 72.1 million by 2030. At that point, nearly one out of every five Americans will be classified as a “senior citizen.” As the number of Americans aging increases, it’s time to start looking at how so many families are likely to experience the challenge of communicating effectively with aging loved ones. One of the first things family and friends can do about expressing concerns for older persons they care for is to assess first what possible stereotypes they may have themselves about aging, and combine that with a further assessment of whether the concerns that they have may be more subjective than objective. That’s a good place to start.
Once you assess that many of your concerns are in fact per observation, or are objective, these concerns need to be journaled and discussed with other family members (or close friends of family) in a respectful manner and tone. Think of how you will want your own relatives (and friends) to be speaking about you one day, as a way to help stay focused on the particular issues about an aging loved one. And when you do speak with family members, write down their concerns as well. Typically, in most families, there is a family member who takes on the primary caregiver role, and in this role, gathering objective data from friends and relatives in a positive way as early as any concerns come about is better for desired outcomes in problem solving, and/or care planning. At some point in the near future in concert with your aging loved ones consent, a more formal discussion with all combined concerns in writing will be discussed in detail with your aging loved one’s primary care physician, in which you should attend or hire a geriatric care manager to help you with either scheduling or attending; or both. As long as all concerns are ultimately brought before a physician, the idea is to obtain a desirable plan of action that will need to be continually monitored for compliance and needed resourcing.
When a sufficient amount of objective data has been compiled, the next thing to do is to plan a scheduled meeting with your older parents to obtain subjective data; whereas this information that your parents share will either confirm the objective finding or the subjective data may indicate new concerns. The meeting should be a time when other family members who are also concerned may be involved and the environment should be as friendly and relaxed as possible. A planned Sunday dinner and dessert talk is sufficient to get the ball rolling. Keep in mind, all of the issues don’t have to be brought up and discussed since it’s a starting point to see how well any communication is either effective or not. It’s a whole different ballgame when one or both parents refuse or deny that there are any issues, and do not want to share any personal information about their safety or health or well being- conversations that appear to be lopsided must always be approached very carefully, since every human being has a right to defend his/her own dignity. In most cases, when parents are unwilling to “have the talk” about other’s concerns, or real concerns about aging well, it’s only natural to be defensive, whether this is expressed or not. We need to prepare for potential negative feedback in any case when sharing concerns about aging with older persons for many more reasons. Let’s look at a few:
Check to be sure your aging loved one can hear well. As we age we go through typical and a-typical sensory impairments. We all will at some point as we age, have less ability to hear, and this is very frustrating to many seniors in and of itself; there have been so many times in my geriatric care management practice when I need to explain to caregivers that an aging loved one is not being fussy about the content as much as they are just fussy about not being able to hear the content! This also includes impaired vision. It’s good to always be sure to see if an older person can see you well! Maintaining good eye contact withing a close but not too close range is good measure.
Check to be sure your aging loved one is not experiencing any significant pain or discomfort. Most older adults have at least one chronic medical condition (e.g, hypertension, arthritis, cardiovascular disease, diabetes), and many older persons make nearly twice as many medical office visits than do other adults. Interactions with aging loved ones can be impaired when a loved one forgot to take their pain relief prescriptions or other comfort seeking remedies before trying to be able to focus on conversation. Always assess the comfort of an aging loved with any length of visit or conversation. Let them know you care. It’s true that older persons are like most people in that they don’t care so much as to how much you know; they need to know how much you do care!
Keep in mind, aging persons are condescended upon in the public sector as it is, and they may have a stereotype about you confronting them. Whether at the local post office, driving on the local roads, or in the local grocery store, seniors are not always treated with respect, especially if they are slower than other seniors, or have built in defense mechanisms that we cannot always see or see through. It’s important to assess an aging loved one’s perception of how they think they are actually perceived by others! One’s perception is their reality after all. So is yours and mine!
Older persons are slower in general to process information, and have increasing difficulty with memory loss associated with decreased cardio-vascular status (oxygen getting to brain). Communication with older adults is often further hindered by not facing them and making good eye contact, as well as assessing an aging person’s ability to see well, as stated earlier. I want to reiterate the importance of maintaining good eye contact with a positive facial expression that evokes warmth and compassion when talking to an aging loved one. It may sound easier for a professional to do when your an adult child of a parent, but it’s good practice nontheless to assess your own presentation to others at times. And talking with an aging loved one is as good a time as any.
Many senior citizens are sad. Some are not. Imagine you lost the love of your life that you had spent the majority of your adult years with. Such is the case with many seniors who are still trying to get along without the love of their life. Perhaps your aging loved one has been grieving the loss of independence or even loss associated with not being presently able to go and do things they used to, and they may have told you about it already or they have not told you at all. Do we know what’s really going inside the mind of our aging loved ones. You better be extra special prepared if you go into an aging loved one’s home and start discussing your concerns before you have assessed their concerns about life in general, or you just forgot to ask about how they are feeling today. Seniors are oftentimes very sensitive and needy, although this is not what they would prefer to be like.
Once you have made an honest attempt- or not, and you feel as if a non biased- professional approach would improve the chances of an aging loved one’s ability to participate in the initial assessment(s) of issues or concerns you have, then it’s a good time to call a geriatric care manager. There are cases where in due diligence or for the sake of preventing one from harming self or others, it will take more than communication to get the ball rolling, and for this reason, if you suspect there are legitimate reasons to get seek professional geriatric care management family mediation, than go with what your gut instinct tells you. And don’t wait until things get out of hand with either an aging loved one or a family member about an aging loved one, when in just an hour or two, a professional can have your family on track as much as possible, in realistic terms. The goal for caring for an aging loved one needs to always be directed by their needs. Our job is to clearly define those needs. Geriatric care managers are always client focused and outcome driven.