Saturday, February 04, 2012

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Where Do I Start? Coaching Aging Parents

Be who you are and say what you feel because those who mind don’t matter and those who matter don’t mind.
Dr. Seuss

For the last twenty years, my work has involved helping adult children find a new rapport with their aging parents. This work was the outgrowth of my own search to find a better way to partner with my mother after my father died in 1989. It has been a fascinating and deeply rewarding journey, but I would be the first to admit that it has been predominately helping “us” speak to the “them.” While I considered and ultimately reframed the psychological developmental tasks of aging parents, my coaching was clearly for adult children. But that has changed, and here’s why.

I recently received an email from a colleague regarding a palliative care presentation he attended. The presentation included expert panelists, (physicians, attorneys and researchers) discussing palliative care and family issues. He said all the experts concurred there was a significant communication problem with aging parents and their families, especially regarding end of life decisions. Based on these comments, he said I needed to consider writing a book about how elderly parents can say it to their family.

I surmised he was suggesting a book that might be entitled “How To Say It To Adult Children: Closing the Communication Gap with the Next Generation of Elders.” It was an intriguing and eye opening idea. Based on my own experience, my assumption has been that all the heavy communication lifting was on the adult children side of the conversation. They were the ones that didn’t get it. They were the ones that needed to change their hearts and their words. But in retrospect, it was a narrow and limited perspective that missed the complexity that aging parents have to overcome to communicate with their families. Simply put, this was not easy for them, and it was time to consider communication coaching for the elders and, as important, for those boomers about to become elders.

So I have begun working on a new project to create a “How To Say It” communication coaching book for elders. The goal will be to provide elders with insights and strategies for working with their adult children. Part of the work will be to educate elders about the development tasks of middle age and, based on these tasks, which words and themes are the key to effective communication with their adult children. Part of the work will be to map out openings, scripts, and settings for conversations about the predictable dilemmas of aging especially at the end of life. These prompts won’t make the choices any less painful or messy, but they will offer a perspective and context to start and sustain conversations, a critical starting point to engage dilemmas that are here to stay.

Bad Parent Connection: Now What?

It’s one thing to have a decent connection to our aging parents. We may not be close, but we still feel compelled by love and loyalty to come along side them in the in last years of their lives. But what if we have a bad connection from all those things that poison the parent-child partnership? This can be anything from irreconcilable personalities to abuse and neglect. Are we beholding to step back in or is it better to call it day?

To be clear, many “disconnected” adult children don’t step back in. For them, there is no going back. The outside world may judge them harshly, but it matters not. I have a friend who walked away from his family at an early age, and refused the urgent call in his fifties to reconcile with his dying mother.

Cold hearted? Depends on whose reality you choose to inhabit. In an unusual moment of transparency, he shared with me his childhood trauma. It was raw and left me distressed. He broke away in his mid-teens and never went back. Understandably, he spent many non-linear years trying to outrun his demons and scars, but finally, with help, righted his thinking and his life into a stable success story. Then he got the call.

His mother was dying. She wanted to see him. He refused. “I barely survive her once,” he told me. “I can’t take a second round.” And he didn’t. Her deathbed request went unanswered. His family condemned him. He has no apparent regrets.

But others change their minds. Unlike my friend, they see an opening that allows them to return and lend a hand. Some find their ability to forgive is big enough for both parties. Some find an all too familiar disappointment they recognize from their childhood. I think all of them hope for some form of a better ending for their story about their earthly parents. And that, I think, is the key to those who return and those who won’t.

At some point in the parent-child disconnect, you decide its time to let it be. It’s over and probably for the better. That point may be death, but for many, it comes much earlier in the saga. These early adopters resign their affiliation and call it a day. It’s not a case of good or bad, but what is necessary given the players and the circumstances of the family drama. Those who leave but don’t disinherit their family keep the door open for some form of reconsideration. What is important for adult children is to recognize that both choices get the job done. Bad connections are one of life’s nasty dilemmas, leaving all parties unsure of what to say, do, or expect. In the end, we all wind up doing our best, as we understand it. Nothing more. Nothing less. Accepting that, proves to be another matter…

The First Cousin

I grew up amid a herd of cousins, surrogate brothers and sisters who were embedded in my childhood. Operating as life scouts, they lived a few years ahead of me on the dangerous and uncharted perimeter of the adult world. One by one we all transmuted into adults with careers, families, kids, and aging parents.

In most cases, our aging parents passed on when we well on our way in middle age. With each loss, our world became more sober as the reality of being “next” in line collided with the world of sixty-something. But a new emotional tipping point in the drama of being older occurred with the unexpected death of the first cousin.

It’s not that we hadn’t experienced the loss of peers in childhood or as young adults. And then after fifty, the news of friends, friends of friends, and people we simply knew about being suddenly gone began occurring with a prophetic regularity. While it was disorienting and disturbing, it initially spared our family network of adult children. But when the first cousin of the surviving herd died at sixty-something, all that changed.

While it was a single loss, we knew it was a cautionary tale about our generational position and predicament. Despite the density of our modern lives, we could no longer afford to ignore this new vulnerability, a realization that haunted our awareness. We knew we were never going to reclaim the frequency or closeness of childhood. That was another life that had served us well, but was gone. We also know that the meaning and import of our early years now took on legacy proportions with the threatened loss of its primary players. We felt compelled to undertake a “cousin audit” of the history that defined so much of our early family life.

We spoke out loud about what meant the most to us and why. We disagreed about chronology but respected personal importance. We confessed our bias, preferences, blind spots, selective memory and the out and out rewriting of history. But most of all we saw, from the end of middle age, how complicated life was for our parents, like it or not. We didn’t gloss over the unsavory and pathological events we would have gladly avoided, but the easy assessments of “they could have done better” lost its steam. Life turned out to be hard for everyone, including us.

Boomers Arriving at 65: The Stability Survey™

We neither get better or worse as we get older,
but more like ourselves…Robert Anthony

The boomers are landing on the shore of old age at a rate of 12,000 a day. While turning 65 is officially classified as “young-old,” there is little doubt this is a quantum shift in the boomer lifecycle. As important, this transition is not just leaving behind middle age bodies; it is also about leaving behind middle age psychology. The developmental tasks of fifty-something are being replaced by the tasks of seventy-something. Adding to the complexity of this transition is the persistent turbulence of post-meltdown world. Now what?

What would be helpful at this juncture is a simple way for boomers to assess personal stability, a tool that could provide them with:

1. An overview of the status of key personal resources
2. Feedback about strengths and deficiencies
3. Insights to set realistic expectations and goals

I have created a new self-inventory questionnaire that does this called “The Stability Survey?.”

The Stability Survey? is a yes-no questionnaire that provides a snapshot of boomer transition assets. There are no right or wrong answers or scoring, just a “holding its own” (stable) or “not doing so well” (unstable) assessment of six broad sectors that impact both quality of life and optimal aging.

Here are the six survey questions:

How is your health?
How is your family?
How are your friends?
How is your career?
How are your dreams?
How are your finances?

Here are some of the implications of the answers for each sector:

Health Status
Stable health usually means no medical issues or medical issues that are under control. Unstable health usually means emerging medical issues or existing medical issues that are either drifting or officially out of control.

Family Status
Stable family usually means normal or abnormal family issues that are under control. Unstable family usually means normal or abnormal family issues that are either drifting or officially out of control

Friends Status
Stable friends usually means close friends who provide comfort and support. Unstable friends usually means issues with close friends that are undermining comfort and support

Career Status
Stable career usually means implementation of a personal retirement plan including post-retirement work. Unstable career usually means unresolved work issues or unsatisfactory retirement planning.

Dream Status
Stable dreams usually means the emergence and pursuit of longstanding or new passions, interests, callings, or pursuits. Unstable dreams usually means the loss of deeply personal dreams or the belief they are attainable.

Financial Status
Stable finances usually means implementation of a pre or post personal financial plan Unstable finances usually means unresolved financial issues or unsatisfactory financial planning.

The Stability Survey? is both a look back at where boomers have been and a look forward to the mission that lay ahead. In developmental terms, it shows which transition assets are in alignment with the tasks of the final phase of life: control and legacy. Conversely, it quickly highlights which of the six resources could potentially undermine them. This “big picture” view at the gateway to the next twenty and possibly thirty years could prove invaluable to boomers who are searching for clarity and direction to help them preserve quality of life as well as promote optimal aging.

 

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Communicate

No Money: No Comment

I was recently asked what to do about aging parents who had little or no savings but refused to discuss any aspect of their “money issue.” It reminded me that our role as adult children is not necessarily about problem solving; it is about compassionate containment. So many of the issues we feel compelled to “fix” have no clear answers. The best we can do is sort out what to accept from what we can actually change. Here was the advice I offered:

The issue of money, like so many other issues in the last phase of life, is about control. The best way to approach it is to reframe money as means of maintaining control. Lack of money takes away control. This link http://www.dsolie.com/articles/reframing.html will take you to an article I authored on “communicating touch choices” that offers a practical strategy for how to do this.

You may also want to consider three strategies that will help you “hedge” your parent’s financial risk:

1. Buy a long term care policy with a two years home care/two years nursing home benefit. This assumes they will cooperative with the process (i.e. signing the applications and answering questions).

2. Start funding a dedicated “side fund” for expenses that a long term care policy will not cover.

3. If you parents own their home, become familiar with how “reverse mortgages work and when they make sense.

Lastly, you need to began discussions with local area agencies on aging to determine what, if any, community resources can assist your parents if they run out of money.

This is a tough end-game, especially if you parents don’t want to talk about. The article will help you frame your conversations. Be patient but persistent in your discussions about control and your desire to help them maintain it.