Archive for the ‘Aging Parents’ Category
Last Updated on Tuesday, 27 December 2011 06:11 Written by David Solie Tuesday, 27 December 2011 05:19
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.
Posted under Aging Parents | 2 Comments
Last Updated on Monday, 19 December 2011 03:23 Written by David Solie Monday, 19 December 2011 03:23
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…
Tags: adult children, aging parents, Aging Parents Insights, anger seniors, Caring for aging parents, communication breakdown, David Solie, David Solie's blog, disinherited, end of life, How To Say It To Seniors, power struggles with aging parents, seniors, the stress of caring for aging parents | Posted under Aging Parents | 1 Comment
Last Updated on Friday, 25 November 2011 03:20 Written by David Solie Saturday, 30 July 2011 10:59
How do we help our aging parents consider making positive changes in their lives? We want to help, and feel we have good ideas that could improve their quality of life. For example, we would like for them to consider:
New support services to enhance their “aging in place” environment
New lifestyle changes to protect and improve their health
New living accommodations to put more fun back to their lives as well as reduce isolation and loneliness
New long-term care options to better prepare them for major setbacks
But many times our attempts to discuss these and other “change topics” are met with extreme push back that includes indifference, rejection, and hostility. Despite the constant media prompting to have “the talk” with our aging parents and despite our best intentions, we wind up sending out the wrong signals that are show stoppers instead of conversation starters. Why is this happening and what can make it better?
An extremely valuable book written for healthcare professionals may hold the part of the answer. It is called Motivational Interviewing in Health Care: Helping Patients Change Behavior. The authors offer new insights and strategies for discussing change topics in a clinical medicine setting. It appears that their approach could be equally useful to adult children of aging parents. Here are some highlights from the book that seem especially relevant for all caregivers.
The Change Dilemma
It doesn’t matter how obvious it seems that change would make things markedly better for our aging parents; it is hard for everyone, period. There is a deep inertia to change that anchors all of us to what we have always done. With aging parents, there is the added inertia to change that comes from their developmental need to maintain control in a world where all control is being lost. Change is a threat to control and is viewed with suspicion. So it is unrealistic and impractical to assume our aging parents will suddenly be “change friendly” just because they are older and have glaring issues that could benefit from something new. But as Motivational Interviewing in Health Care so effectively points out, the real six-hundred-pound-gorilla in all of these conversations is the quagmire of ambivalence.
Ambivalence
The insights and practical advice on ambivalence alone is worth the price of Motivational Interviewing in Health Care. It turns out that ambivalence lurks behind all change conversations and can be provoked by our attempts to argue away our parents objections to change. These are those unsolicited lectures we give our aging parents to inform or direct them to do something different. I call this all to common habit of adult children the “better answer” syndrome. This is code for “I know what’s best, please pay attention.”
But instead of consensus, it only provokes the dreaded righting-reflex that entrenches our aging parents into arguing against the suggested change, moving the conversation from uncomfortable to communication gridlock. Thankfully, the authors offer an effective, non-intuitive approach to work around this all too common dilemma.
Change Rapport
Motivational Interviewing in Health Care makes it clear that our goal is to avoid triggering the righting reflex and make an honest effort to understand our aging parent’s point of view. This involves finding out what they are actually experiencing and then signal that we are listening and get it. Within this non-triggering conversation environment, we can begin to test open-ended questions about issues where change might be useful to increase long-term control. Here are some simple examples:
How are you doing?
What’s worrying you most today?
What do you think would make this better?
How have you been feeling?
Tell me more…
What’s new with your friends?
What do you feel like doing?
Open-ended question invite our aging parents to choose the direction of the conversation. Once they pick the direction, we simply reflect back their thoughts and comments to indicate we are listening and understand their point of view. Although tempting, we need to resist the temptation to interrupt. Interruptions only make matters worse. We need to hear the whole story on a topic. But as the authors point out, we are listening for more than the story. We are listening for “change talk.”
This may be the most important benefit caregivers receive from reading Motivational Interviewing in Health Care. Change talk is where aging parents begin to voice some interest in change. It is a soft signal, more a preliminary musing about what if, wouldn’t be nice, I really need to, it would be better if, and I am sure I can, all examples of change talk phrasing. The most important thing about change talk is that our aging parents are exploring the other side of their ambivalence to change, speculating on how or why it might be worth considering. How we respond to these pre-change-exchanges will have an enormous impact on whether or not change actually occurs.
Motivational Interviewing in Health Care offers a detailed explanation and ample examples of how to develop these moments of change talk into positive changes. Despite its focus on clinical encounters for healthcare providers, it offers adult children a compassionate and effective strategy to explore change topics in a non-threatening, parent-centric style. It is an approach could be a game changer for adult children searching for a new way to help their aging parents make positive changes.
Tags: Aging in place, aging parents, behavior change, Boomers, caregiver, communication conflicts with aging parents, communication problems with aging parents, communication struggles, coping, David Solie's blog, death of a spouse, disability, home health care, How To Say It To Seniors, loneliness, long distance caregiving, long term care giving, Motivational Interviewing in Health Care, moving into assisted living, old age, on aging, the elderly, Unlocking the communication code | Posted under Aging Parents | 1 Comment
Last Updated on Friday, 25 November 2011 03:21 Written by David Solie Monday, 4 July 2011 08:32
This deeply moving article by Linda Kriger was published in 2008: http://www.forward.com/articles/14255/
I have read and reread this tale of estrangement, bitterness, regret, and the search for “repair” because I heard endless versions of it from friends, colleagues, clients, and audience members. I also lived it.
Below is the “comment” I posted to article’s website when I first read it in 2008. In the three years since I wote this, my opinion of my father has “expanded.” Much to my surprise, I have found a window into his suffering. This has given me new empathy for the gap between his dreams and where life finally took him.
Thank you for giving a voice to the bitter outcome many adult children experience with their aging parents before they pass away. We wish it were different but history and personalities bring the drama to its only logical conclusion. But was you pointed out, the death of the parent hardly ends the trauma of such a “poor outcome.” My father and I parted on similar terms, incommunicado and mutually sorry about our biological connection. As Joyce reminds us in The Dead, the departed usually prove more formidable after their gone. My father was not exception. I have danced for years with the guilt, anger, and loneliness of the events surrounding his death. The fact that our relationship was never right from the beginning is no comfort. Even his blatant failings, alcoholism, violence, and a perverse perfectionism are not enough for me to bid him a final and much needed adieu. Instead, my post-death relationship with has all the qualities of emotional quicksand. I scheme, struggle, and sink deeper into complexity. Like you, I find myself circling the issue of forgiveness but never getting it to stick. I think having a life with next to zero nurturing from him, it’s proving next to impossible to find the emotional release I need. This is why your story struck such a deep chord. Lastly, I don’t think it is either smarmy (wonderful word) or too late in the game to want relief. But I also think that these bitter ending are essentially Greek in nature, tragedies of accommodation not assimilation. They are familial dramas that leaves us with the task of orchestrating a “survivor’s compromise” that allows them to be who they need to be and finally gone.
Tags: aging parents, boundaries elderly difficult communication, Caring for aging parents, communication conflicts with aging parents, communication struggles, David Solie, death of parent, guilt, Linda Kriger, Nursing homes, old age, on aging, regret, Seeking Forgives, the elderly | Posted under Aging Parents | No Comments
