Difficult Discussions About and With Aging Parents
By Brigitte Bell, Mediator1
Introduction
Families find that they too often don’t discuss all the issues related to aging parents until the difficulties of one sort or another have started. It is much more difficult to try to have these discussions then, and even though the discussions are inherently difficult, it is critical that we take on the challenge of having these conversations will everyone is able to participate fully.
What Difficult Discussions are we talking about?
• Finding out whether a parent has thought about making financial and/or medical and/or legal plans for their declining years
• Finding out if those plans were made and when and by and with whom
• Finding out enough about a parent’s resources to be able to be helpful in planning
• Finding out who knows the plans and who doesn’t
• Discussing the need for plans if there aren’t any
• Discussing the need for family members to know the plans if they’re made but not known
• Discussing with family members how the practical aspects of care, when needed, will happen
• Discussing with family members how money will be used and, if there isn’t enough, how expenses will be shared
• Dealing with particularly disenfranchised or disaffected family members
• Talking about dependency and care issues and the requisite forms that would need to be filled out to make it legally binding
• Discussing confidentiality concerns
Why are these discussions so difficult?
• our society tends to see conflict as negative and unseemly rather than as the source of change
• being in family discussions brings back the family patterns of our youth, no matter what age we are or what our professional status is
• these discussions happen on three levels at same time:
- what happened? (“just the facts, ma’am”)
- how does each participant/the speaker feel about what happened (and how do those feelings play into the conversations)
- what does that particular topic/conversation/wording mean about who I am (the core identity conversation)
What can we (you) do to make these discussions more effective?
• start early
• overcome reluctance about difficult conversations
• remember that not every conversation needs to end in resolution: it can be good to agree not to resolve anything, just to hear each other’s point of view on some issue
• understand the power of speaking in the calm about a coming difficulty as opposed to speaking from the center of the whirlwind (i.e., crisis management is the least effective way to resolve family problems)
• involve as many participants as necessary so that no family member or person with information feels omitted from the discussion
• decide beforehand what, if any decisions need to be made and, if so, how that will be done
• acknowledge and normalize the inherent difficulty of these discussions
• clarify the assumptions that each participant brings to the discussion
• don’t be afraid to air even the most difficult and sensitive topics (the one you leave out will be the one you deal with first)
• use professionals as neutral mediators and facilitators
- their neutrality helps keep the discussion on track
- they know how to help people hear each other
- they know how to “hear” what’s not being said and ask about it
- they will help record the necessary agreements in an impartial way
- they can help make sure that all issues get addressed
What substantive issues should be discussed?
• Long term care insurance
• long term care planning
• health care directives
• living will issues
• disposition of property, including the “stuff”
• funeral/burial wishes
Added Complications
• stepfamily issues
• family business involvement
• legal issues
1 500 Davis Street, Evanston, Illinois (847-733-0933) or 53 West Jackson Boulevard, Chicago, Illinois (312-360-1124); mediators@bsbpc.com; www.mediate.com\brigittebell.
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