Help is on the way!

The Difficult Conversations:
8 Strategies

1. Get Going! It is never too early to start having the difficult conversations. Contrary to popular belief, you are doing yourself and your loved ones a disservice by putting them off. Death, dying and end of life discussions can be a normal and regular part of family discourse. It’s only as uncomfortable as you make it.

2. Don’t Delay. If you recognize a problem, don’t even try to fool yourself. The problems are not going to fix themselves. Alternately… unaddressed, the problems will grow exponentially and will become a greater problem for all involved. If you’ve already cocked your eye in disbelief or asked others if they’ve seen the signs too… the time is NOW to address the issues.

3. Check it out. Share the concerns you have with your parents and describe what you’ve observed (Ideally in a non-judgmental/non-alarming way). Ask your parents what they believe is happening. If your parents acknowledge the issues, ask them if they are concerned and what they see as possible solutions. If your parents are steeped in denial and/or become defensive, use concrete examples to explore the issues. Don’t push too hard.

4. Straight Talk. Your parents are adults and do not need baby talk or patronizing speeches. Speak directly to them. Look in their eyes. Try to avoid becoming agitated or angry. Listen to them. Emphasize the importance of safety. Be respectful. Convey your love when you speak.

5. Person-Centered ‘Strategery.’ You know your parent. Work to find solutions that will play to their strengths and compensate for their challenges. Be strategic in determining solutions. Help them to ‘buy-in’ to a solution that will work for them… and you. If your loved one buys into a do-able solution…Home Run friends! Take a bow!

6. Think outside the box. Reality dictates: There is not only one solution and the best solution will still have pros and cons. Try to be creative when considering possibilities. Ask your loved one, “What is the goal?” When the goal is understood, the path can be created.

7. Help please! There are people who actually do this ‘aging’ thing for a living! Help abounds for caretakers and their family members. Bringing in a professional is often the best way to go. At least that way, you can tell everybody to blame someone else! Resources such as Blue Moon Senior Counseling can help provide invaluable support for you and your family.

8. Be Optimistic. Understand that some solutions will never work for your family. With a little education, forethought and strategy… you will find the solutions that work for you. Solutions are a process. Manage expectations. Expect positive results. We’re on your side.

3 Institute of Medicine. (2012). The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? Washington, DC: National Academies Press. 4 Wang PS, Lane M, Olfson M, Pincus H, Wells KB, Kessler RC (2005). Twelve-Month Use of Mental Health Services in the United States: Results from the National Comorbidity Survey Replication. Archives of General Psychiatry. 62: 629-640. 5 U.S. Department of Health and Human Services, Mental Health: A Report of the Surgeon General (Rockville, MD:1999). 6 Husaini, B,A, et. Al (2000). Prevalence and cost of treating mental disorders among elderly recipients of Medicareservices. PsychiatricServices, 51, 1245-1247. 7 Katon,W., Ciechanowski, P. (2002). Impact of major depression on chronic medical illness. Journal of Psychosomatic Research, 53, 859-863. 8 Warner, J. P.(1998) Quality of life and social issues in older depressed patients. International Clinical Psychopharmacology, 13, Supplement 5, S19–24. 9 Mortality Reports. National Center for Injury Prevention and Control. Centers for Disease Control and Prevention.http://www.cdc.gov/ 10 Blazer, D. (2009). Depression in late life: Review and commentary. FOCUS, 7, 118-136. 11 Luoma, J., Martin, C., & Pearson J. (2002). Contact with mental health and primary care providers before suicide:A review of the evidence. Am J Psychiatry. 159 (6), 909-916. 12 Grabowski, D.C., Aschbrenner, K.A., Feng, Z., & Mor, V. (2009). Mental illness in nursing homes: Variations acrossstates. Health Affairs, 28 (3), 689-700. 13 Dorenlot P, Harboun M, Bige V, Henrard JC, Ankri J. (2005). Major depression as a risk factor for early institutionalization of dementia patients living in the community. Int J Geriatric Psychiatry, 5, 471-8. 14 Buhr, G., Kuchighatla, M., & Clipp, E. (2006). Caregivers’ reasons for nursing home placement: Clues for improving discussions with families prior to the transition. The Gerontologist, 46, 52-61.

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