Are you struggling to persuade Mom or Dad—or both—to move to a care community or accept aid at home? Are they resisting, arguing or simply ignoring you?
Thousands of boomers are walking in your shoes. Half of all 60-year-olds have a living parent, usually reaching their late 80s and showing some signs of physical or mental decline.
And it’s not just parents. My friend is having trouble persuading her older brother and his wife to stop what she feels is “risking their lives” in a home that has become unsafe and too challenging for them to navigate.
Whether falls or medication mismanagement or not having a speedy enough emergency system, elders often believe that they “can handle whatever comes up” rather than move to a more age-friendly environment.
More than that, isolation is a bane of old age as friends and family members move or pass away. It’s hard to watch your loved one getting less and less opportunity to thrive, yet still clinging to a place that no longer serves their needs. You want to help, but they won’t listen!
Many experts tell you to try as hard as you can, and if they are adamant, you should recognize that it is their life and it is their choice. But when you get that call that a loved one is lying on the floor, whether dead or alive, you regret not trying a little harder.
Here are some practical approaches that can work in the face of the toughest of old birds (which we all probably become as we head into our 90s).
Step #1: Listen before you talk. David Solie, in How to Say It to Seniors, gives us a protocol for “active listening.” Solie suggests that you should listen with patience as to why your loved one wants to stay put. Then repeat precisely the very words he/she used. Seniors feel ignored and unheard. Repetition proves you are paying attention to them, not just trying to make your point.
Reminder: It seems elementary, but when you do talk, make sure that you are talking to their good ear, there is low noise and no distractions so that they can take in what you are saying, instead of struggling to make sense of your words.
Step #2: Keep it positive. Given the physical and sometimes cognitive losses, it’s no wonder older folks fight for control. Many older people exhibit the symptoms of Post Traumatic Stress Disorder (PTSD) when faced with change. The elderly are “ordinary healthy people for whom all hell has broken loose.”
How do you cut through such deep fear with words and help them make a reasoned decision? Keep it positive.
Dr. Ellen Peters, an expert in human decision making and cognition, has found that elders focus more on positive information when making decisions. That is just the opposite of how adult children usually couch language. Don’t use apocalyptic terms such as, “This place is dangerous. You could end up in the emergency room”…or “Mom’s too sick to stay here.”
Using a positive bias also improves elders’ memory and focus. A fascinating study by Samanez-Larkin 2007 found no age-related reduction in neural activation when participants were asked to do tasks that could result in financial gain, but a relative decrease in brain function in older adults when they were forewarned that the task could result in a financial loss.
In short, talk benefit, not loss…happiness, not fear.
That means any suggestions must be couched in the positive. Wrong approach: “If you don’t get rid of those rugs, you’ll fall and end up in the emergency room.” Right approach: “Look at his great picture from Architectural Digest—bare floors are trendy. I know your rugs are beautiful, but let’s store them for a while to update the look.”
Step #3: Do your homework. If you believe your loved one should move, call on the free services of A Place for Mom. They will appoint a local expert to explain the types of housing available. Then you visit. It is a mistake to show a loved one any location before you have seen it yourself.
If you are not sure what your loved one needs—a home aid, a renovation, a move—a geriatric care manager can help. They are experts in aging and can guide you and your loved one to make the right living arrangement plan and will professionally help guide your loved one to seek the right path.
Step #4: Call on the elder’s family, friends and influencers. Talk to the clergyman, doctors and their other figures of trust, as well as other friends and family members. Elders, especially parents, are used to taking care of you. This role reversal can make your opinion carry less weight than you hope. Ask those that know your loved one if they also feel a move is warranted, and if so, ask them to speak to your loved one and share their point of view.
As for getting on the same page with family members, your siblings may be the biggest obstacle. What if your sibling believes Mom is OK and you don’t? That’s where active listening comes in again. Find out how they feel and why. If you disagree about what’s right for Mom or Dad, an expert, such as a geriatric care manager may be able to suggest the best approach.
Step #5: Become a diplomat. I have spoken to numerous professionals in the art of persuasion, including sales gurus, corporate negotiators, psychologists and gerontologists. No profession impressed me more than the Diplomats in getting to “Yes” the right way.
Here’s what they tell me about their protocols for gaining consensus…
- Present and test several alternatives. Many senior housing venues will allow a week- to a month-long temporary rental to see the living arrangement works for your loved one. He/she can try out a place and see if he feels differently about a move.
- Ask the elder to paint a picture of his future. Give him space to articulate and express his ways of coping with decline. For example, if an elder is resisting a home aide, ask what the downside is as he sees it and the upside. What feels good about it and what feels wrong. Make sure your loved one has the chance to think about his future, not just react to what you are suggesting.
- Show respect. You probably believe that you are right, and your loved one is wrong. But science says otherwise. Elders have higher crystallized intelligence—the wisdom that comes from experience—than those who are younger. Unless there is a cognitive decline, your loved one has made hundreds of right decisions in the past. Mention those and bolster his ego—don’t tear them down. Time has done that enough.
- Leave the matter open. If a loved one refuses to enter the discussion, don’t close the conversation. Drop it for the moment. Try to get an acknowledgment that you can revisit the issue in the future.
What if they won’t make the change?In researching my book How Not to Go Broke at 102, I had the opportunity to meet medical and cinical ethicists. Here is what they say about the wishes of elders if they might result in self-neglect or danger to themselves…
- Honoring the wishes of a person with capacity demonstrates respect for the individual. Ultimately, if he/she has mental capacity, where he lives is up to the elder.
- Honoring the wishes of a person without capacity is a form of neglect. As a Founder of the National Academy of Elder-Law Attorneys, I sincerely hope that life planning is tackled well before a legal issue of capacity ever arises.
At this stage of the family evolution, caring for your parents is your “new normal” job. It’s difficult to admit to yourself that they are in decline, especially when they can’t face it themselves. But don’t drop the ball because they are resistant. Claudia Fine, founder of Senior Bridge Family Geriatric Care Management, now part of Humana, said something that I will never forget, “The Old-Old are like potato chips. They look good, but they break very easily.”