Posts Tagged ‘eldercare’
Last Updated on Saturday, 16 March 2013 12:59 Written by David Solie Saturday, 16 March 2013 12:48
I have been studying how to unlock the communication code of older adults for the last twenty-three years. My first breakthrough came early on with developmental psychology, a model based on age-specific tasks that are easy to understand, easy to use, and highly effective. As a result, the two tasks of the final phase of life, control and legacy, have earned their way into the vernacular of how to communicate with older adults.
However, in the last few years I have discovered two additional elements that combine with the developmental tasks of older adults to complicate rapport. Understanding what they are and how to engage them preserves effective communication in even the most trying circumstances.
One of these elements is the invasion of dilemmas in the second half of life. Dilemmas resist heroic attempts to keep everything together. Like an unruly Rubik’s Cube, alignment in one caregiver area seems to trigger chaos in another. Just when driving issues calm down, sibling conflict erupts over money. Just when housing accommodations get better, a parent falls and winds up in the hospital. In the face of this steady stream of dilemmas, the natural instinct is to work harder in search of the illusive mix that will stabilize this disruptive phenomenon. Ironically, upping the work ethic on dilemmas only seems to give birth to new ones, a sorcerer’s apprentice law of dilemma management that runs caregivers ragged. Now what?
The first rule of dilemma management is to reset expectations. There are no final, elegant solutions, just the dance with complexity. Unlike problems, win-win is not part of dilemma management, which is usually a messy process that requires patience and smaller bursts of sustainability. All of this argues for a different orientation, softer reins, and deeper acceptance. In the end, the predictable dilemmas of aging require a different skill set that is not intuitive but essential for everyone’s well being.
The other element is the deep-seated ambivalence older adults have to unwanted advice. This goes beyond the collision between developmental stages, though that is part of it. There are different psychological forces at work here, present at all ages, but markedly enhanced in the final phase of life. We are talking about ambivalence to change.
Choosing to engage ambivalence head, to tell older adults what and how to change, only intensifies and prolongs resistance. Like dilemmas, overcoming ambivalence to change requires a different set of skills. Instead of provoking resistance, we need to soften ambivalence and make room for the possibility of change. This is not an intuitive strategy or skill, but it can be learned with patience and practice.
Last Updated on Monday, 11 February 2013 12:30 Written by David Solie Friday, 18 January 2013 11:45
This is an interview I did for the Senior Real Estate Institute on January 17, 2013. The topic was communicating with senior housing clients, older adults and adult children. The focus was the two psychological hurdles that have to be considered in working with seniors: developmental tasks combined with ambivalence to change. The goal was to help professionals appreciate the role each of these hurdles and how to partner with them. The audio presentation is a good overview for all professionals in the senior services industry and equally useful for family members caught up in power struggles with aging parents.
Last Updated on Monday, 11 February 2013 12:37 Written by David Solie Sunday, 6 January 2013 06:28
A lead caregiver of aging parents was going to extraordinary lengths to keep everything together only to find herself drowning in transactional quicksand. As her parents drifted into the land of “more and more care,” her uninvolved siblings either refused to acknowledge the burden (it’s not that bad) or preferred to keep their distance from the fray (I’m not comfortable having them move in with me). Even when the lead caregiver’s own family faltered with a sick husband and dysfunctional teens, it drew essentially zero empathy from the siblings. As a last resort, the caregiver attempted to plead her case. It fell flat, and that’s when she asked me for advice. Here is what I said:
“It sounds like you have reached a tipping point in terms of what you can offer your aging parents. Despite heroic efforts, their needs exceed your capacity. It a simple fact of the complexity of aging. We do the best we can do until we are not enough. Hopefully we don’t self-destruct before we figure that out. But once we do, it becomes clear things need to change. This insight may not be shared by your parents who would like things to continue as they are or your siblings who would prefer a hands off position. Trying to convince them you are drowning under the weight of “keeping everything together” is pointless. This is your epiphany and your responsibility to act to protect your sanity and your family. The pleading phase is over. The informing phase has begun.
Inform your parents and your siblings you have gone as far you can go. Your home is no longer an option. Your parents need to find a living environment that is designed and staffed to address their health issues now and in the future. You are willing to help the family select a senior living location and with the transition. If your siblings feel this is excessive and your parents don’t need this level of care, they are free to offer their home as an alternative.
This is not to suggest that the informing will be easy or without pushback coming in ample doses of guilt and anger. Hold a firm reign, stay calm and rational and things will shift away from you carrying the entire load. Don’t expect anyone to thank you or be thrilled with the new configuration. But as your stress level recedes, you can take comfort in the fact your parents needed more and you had the courage to insist on it.”
Tags: aging parents, caregiver, caregiver stress, Caring for aging parents, communication conflicts with aging parents, conflict with siblings over aging parents, David Solie, eldercare, How To Say It To Seniors, sandwich generation, sibling conflict, sibling problems, the stress of caring for aging parents | Posted under Aging Parents, Siblings | No Comments
Last Updated on Monday, 11 February 2013 01:03 Written by David Solie Sunday, 1 April 2012 11:44
Last year I went to a conference on accepting the limits of being a caregiver. It was attended by mostly hospital-based healthcare professionals who have to deal with suffering and loss on a daily basis. The focus of the program was on finding and sustaining a balance between compassion and equanimity.
Compassion was defined as the tenderness of the heart that responded to suffering, the pain we feel when we see others, especially our loved ones, suffer. Equanimity was defined as a spacious stillness the accepted things as they are, the realization of what we can and cannot control. Finding a balance between the two allowed caregivers to care without being overwhelmed and all to often undone because of that caring.
The program presented a number of phrases that could be used in prayer or meditation to enhance the “art” of this delicate balance. This one caught my attention:
May I offer my care and presence unconditionally, knowing it may be met by gratitude, indifference, anger, or anguish
As caregivers will tell you, your best efforts to care and be there for aging parents can generate all of these responses from the same person, maybe on the same day. Because there are so many emotions swirling around the drama of aging, it’s easy to chase the negative ones to make things better. Despite noble intentions, this can prove to be an emotional sinkhole with very little to show for it. Better to focus on compassion tempered by equanimity in the midst of emotional storms. Better for the aging parent; better for the adult children.
I call this practice transformational kindness. It is not easy, and first attempts can fall apart repeatedly, but the effort work beyond the emotional responses is in itself transformative for all parties. It reduces the fear and panic of setbacks and constant bad news. It offers a higher level of stability. Most important, it signals that unconditionally means just that, unconditionally.
What encourages transformational kindness? Certainly a kind heart lies behind this love and compassion for others, but I also believe there is another important factor that makes this possible: gratitude.
Our suffering or the suffering of love ones can easy isolate us. But a closer look at the situation always reveals there are many helping hands, some we see, some we don’t see, who are offering their skills, resources, love, and support. When we feel the presence of this helping network, our capacity for unconditional care and presence is expanded and we immediately feel less isolated. To offset the isolated mind set of suffering, it is helpful to read “gratitude prompts” that recalibrate our perspective. One of my favorite is from Einstein:
How strange is the lot of us mortals! Each of us is here for a brief sojourn; for what purpose he knows not, though he sometimes thinks he senses it. But without deeper reflection one knows from daily life that one exists for other people – first of all for those upon whose smiles and well-being our own happiness is wholly dependent, and then for the many, unknown to us, to whose destinies we are bound by the ties of sympathy. A hundred times every day I remind myself that my inner and outer life are based on the labors of other men, living and dead, and that I must exert myself in order to give in the same measure as I have received and am still
I love the line “whose destines we are bound by the ties of sympathy.” As caregivers of our aging parents, we are bound to do the right thing. The healthier goal is to do the right thing in a way that offers compassion and equanimity for all parties in the drama.
Tags: adult children, aging parents, boundaries elderly difficult parent, caregiver stress, caregiver support, caregiving dilemma, Caregiving Websites, Closing the communication gap with aging parents, compassion, David Solie, David Solie's blog, eldercare, elderly communication, equanimity, gratitude, How To Say It To Seniors, loving kindness, suffering | Posted under Aging Parents | No Comments
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