When seniors need a little extra help around the house ... oftentimes it’s the folks around them that notice it first ... Families notice changes:

• Mom or dad seems to be slowing down a bit
• Losing some weight
• Not keeping the house as neat as prior
• Changes in mobility
• Changes in personal hygiene
• Changes in functioning
• Changes in cognition / memory / judgment
• Changes in personality and social engagement

With these changes, due to past relationshipsand patterns of communication, old patterns are hard to change! 3 typical approaches:

SCENARIO 1:  The retreater 

Having the conversation is not always easy ... how will it be perceived by the senior? Will it strain the relationship? Will it make the senior feel bad? Will it scare the senior ... or push them to edge?

Is this the first time that the conversation has taken place? What are the communication patterns? Is this putting the concerned family member in a new role? ... telling a parent what they may need to consider? Is there any ambivalence about addressing the issue?

Due to these kinds of thoughts, oftentimes families back down and avoid the conversation until the situation turns into a crisis situation.

SCENARIO 2:  The bulldozer

There are other family members who may want to jump in and address the issue to "deal with it" “be responsible” “take care of business -- they are sometimes perceived as a bulldozing. Pacing is all off / alignment is off, and this approach while being fast may not yield the long term results desired.

SCENARIO 3:  The engager

There are others who broach the subject in a manner that leads to the senior being more open to the ideas expressed. Most concerned families often agree that they would like to approach the conversation in this kind of style in order to achieve their desired outcomes.      

So what  needs to take place? – ten tips listed below with 2 caveats: Different approaches when one has the mental capacity to engage in rational discussion vs. when one lacks the mental capacity. Focus of our discussion: Seniors who have capacity. No one approach works well all of the time!

TEN APPROACHES TO ENGAGE SENIORS SUCCESSFULLY IN THE CONVERSATION ABOUT AT-HOME CARE

1. Invest on the pre-conversation plan

2. Making some deposits ... building up some ego strengths: Make positive statements about the current situation, prior to making suggestions for change.

3. Stay connected to what is important to that senior: I know that staying at home is really important to you, and that’s why I want to do everything I can do to support you to that end. Or, I know that you never want to be a burden to your family. Or, I know that you have been an amazing parent to me all of my life, and that you’d do anything for me.

4. Start small: Is there one little tiny thing that the senior might accept help with? If so, start there and build from there. The senior who clearly needs help with meal preparation, and bathing – yet only perceives need for someone to help her by providing transportation to the bank and market 2x week, may be willing to accept the driver as opposed to the entire “package” of care. 

5. Acknowledging the feelings: I know that this isn’t an easy conversation, but I still feel it is an important conversation. 

6. Be direct / respectful: How does it feel that I’m asking you these very personal questions? How does it feel that we’re discussing your driving? – the responses often times allow the person to acknowledge their feelings and often it serves as a opening into the core topics that need to be discussed. For example, How does it feel that we’re discussing your driving? It makes me feel uncomfortable, since I’ve been driving for close to 70 years. Have you ever thought about if you weren’t driving how you might get to the barber or to the market? REMEMBER there is a tremendous difference between being the “engager” versus being a “bulldozer.”

7. Reframing: Accept the care for me – taking the spotlight off of the senior. Accepting care doesn’t have to be related to the senior’s compromised abilities, but rather based on the need of the concerned family.

8. Trial period: Short term - Try it and we can always re-evaluate and adjust accordingly.

9. De-escalate vs. having to be right: If situation escalates, don’t stoke the fire, back down and reintroduce later.