Time to Have Some Tough Conversations with a Loved One about Their Declining Health? Start Here.
Most of us will reach a point in our lives where we need to provide some level of care to an adult loved one. Between ailing spouses, aging parents, differently-abled adult children and others, it’s no wonder that 1 in every 7 Americans are taking care of someone over the age of 18 right now.
Caring for a friend or family member can be a rewarding experience. It can also be a stressful and exhausting one. Both caregiver and care recipient benefit by having early conversations about finances, housing arrangements, and other big decisions related to care. That said, more often that not, these conversations never happen because they tend to be so emotionally charged.
There are a variety of reasons why it might be hard to have a dialogue with a friend or family member about their care needs. So, there’s no one-size-fits-all solution that will ensure a productive conversation. However, there are different strategies that you can leverage to improve your chances that those talks go smoothly and produce the information needed to move forward with care:
1.) Don’t attempt to have the entire conversation at once.
Often, someone who’s preparing to provide care for a loved one envisions sitting the care recipient down and having one long, somber conversation with them about their care. Successful conversations can happen this way, but more often than not, attempts like these result in both parties feeling awkward, and the conversation gets cut short before any real decisions are made. Instead of a single discussion, try having several shorter talks instead. You can even have these talks while doing something else, to further normalize the discussion and ensure that both parties feel comfortable in the interaction:
I find that going out for a walk or a drive can be a good way to have these small conversations instead of doing it all at once. When my husband and I are doing something active and are out in a different setting, it feels so much easier to talk about things. Finding a way to get out of the house, even if it’s just sitting in front [of our house] or walking down to the end of the sidewalk, can be a great opportunity to talk. Don’t forget… you’ve had the luxury of thinking about the point you want to make for a while. When they hear it, it’ll be the first time, and they wouldn’t have had the same amount of time to process it. Doing it in pieces can be a much gentler way of approaching something that is difficult for the both of you.
–Charlotte Bayala (she/her/hers), spousal caregiver and Founder of Love Your Caregiving Life, a podcast and coaching program that helps friend and family caregivers find easier ways to care for themselves.
2.) Allow them to save face.
Admitting that you need help, or hearing that you need help from someone else, can be a humbling experience. That loss of power and control can be scary, and some care recipients may resist conversations that are all about them and their care needs. In cases like this, tailoring the conversation in a way that allows them to save face can be extremely effective:
My sister and I cared for our aging parents for a total of 8 years, one right after the other. Our dad had Multiple Sclerosis, and our mom had Alzheimer’s. Our mom was particularly resistant to any conversations about her care. The only way that she would talk with me about her health was if I told her that I was ‘paranoid’ about her getting sick. I told her that I knew that I was being ‘irrational’, but that it would really make me feel better to simply get a Power of Attorney in place now, secure in-home care now, e.t.c. In reality, I was neither paranoid or irrational. My mom was deteriorating quickly, and my sister and I knew it. That said, framing those conversations in this way allowed her to save face and be the mother who was simply humoring her daughter’s unreasonable fears. It also allowed my sister and I get the information that we needed to provide for her. Depending on your family dynamic, this might not work for everyone, but it worked for me.
–Alyse Dunn (she/her/hers), former caregiver and CEO of CareCopilot, a web and mobile app that saves you time and money when taking care of adult loved ones.
3.) Acknowledge that the worst may never happen.
Depending on your loved one’s diagnosis, their decline may or may not be guaranteed. If there’s any possibility that the worst case scenario may never happen, and your loved one is having trouble accepting what may be coming, it can be effective to meet them where they are and acknowledge that the worst may never come to pass:
Discussing your loved one’s declining health and establishing a long-term care plan is kind of like emergency preparedness. You hope the worst never happens, but you try to make sure you’re covered if it does. If I could go back in time and talk to my mom about establishing a care plan for her when we first began to see signs of Alzheimer’s, I would have said something like: “I love you, and it’s so important to me that we are prepared to care for you in a way that allows you to feel valued. Hopefully we’ll never even need to use this plan. But IF we do need it, we will have greater peace of mind knowing that we’re taking care of you exactly how you would want us to.”
— Ve’Lyn Crosby (she/her/hers), caregiver and Spiritual Life Coach specializing in helping women establish the boundaries and practices needed to thrive.
4.) Be vulnerable.
It can be tempting to approach an emotional conversation from a purely logical place, and rely solely on data like diagnoses and symptoms to gain buy-in. Conversations about health are more emotional than they are practical. So, approaching these discussions with vulnerability is often more effective than approaching them with data. The person needing the care is already in a vulnerable position. Matching that vulnerability can help level the playing field enough to have an effective discussion.
My father’s health is deteriorating. It is hard for him to walk, and this creates safety issues in his current living situation. When I offered solutions like moving to an assisted living community or a single-story home, those solutions were met with resistance. Then, I got vulnerable and shared my fears with him. It was not easy since I was talking about his mortality, but he listened. Then, he shared how concerned he was about losing the life he knows and loves, and I listened. He was more open and honest with me after I led with vulnerability. Once all the concerns and considerations were on the table, it was easier to come up with a solution. While the solution may not be the level of care I desire for him, it works. His safety needs are being addressed and he feels seen, acknowledged, and understood. At the end of the day, isn’t that what we all want?
- Jessica Zemple, daughter of a neurodivergent parent and founder of Life Shucker, which helps people open their shells of fear to shine their pearl even brighter.
5.) Articulate the impact of their inaction.
No one wants to hurt someone they love. Unfortunately, sometimes, when someone refuses to accept the help that they need, their friends and family suffer. Clearly (but kindly) articulating the impact of of a family member’s inaction can sometimes be the catalyst needed to get them to act:
After my dad passed away, my mom was living on her own, hours away from any of her six children and their families. Her decision to live at a distance was taking such a toll on all of us (her kids), and our families were suffering. I remember the day that I tearfully told my mom that it ‘was time.’ I told her how we (her kids) needed to be around her just as much as she needed us for physical and mental support. I told her how hard it was on us, having to commute in to support her while taking care of our own kids and jobs at the same time. This [telling her how much her inaction was hurting her kids] finally got her to respond.
–Elizabeth Miller (she/her/hers), caregiver and founder of Happy, Healthy Caregiver, a digital repository of resources and support for friend and family caregivers.
Having early conversations with your loved one about their declining health is the most effective way to ensure that the care journey is as seamless as possible for everyone involved. The only wrong way to have a conversation about care is to not have it at all, which leads to increased stress, various misunderstands, and a lower qualify of life for everyone:
I wish I would’ve been proactive about having conversations with my parents regarding their wishes. My dad and I discussed his wishes in 2014 AFTER he was diagnosed with multiple myeloma, but not before then. It’s hard to have a conversation with someone who’s cognitively incapacitated. That’s where I found myself with my mom. She suffered a brainstem stroke in 2018 and I was stuck having to make life decisions for her because she could not make them for herself. Now that her cognitive capacity has improved significantly, I’ve learned that some of my wishes for her were not her wishes. We MUST have those crucial conversations; even if it feels uncomfortable. Those conversations are not morbid. They are meant to make life much easier for everyone.
–Dawnita Brown: Caregiver, host of The Selfull Caregiver Podcast, founder of the caregiver lifestyle brand Hey Caregiver!, and founder of The Binti Circle support group for black daughters caring for their parents.
If you have more questions about how to talk to a loved one and want to learn how others have approached this problem, join CareCopilot’s anonymous online community today. You can connect with dozens of others just like you who are preparing to take care of someone, currently taking care of someone, or who have already completed their caregiving journey and are eager to help others who are doing it today.