Tough Conversations

Solutions Through Compassionate Communication.

Trading Places

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Changing roles is an inescapable byproduct of time. From your baby’s first step, to his first day at school — from the day she gets her driver’s license until her college dorm is in your rear view mirror — your role is changing. And your relationship evolves from all-knowing protector and teacher to “out to lunch” parent of a teen, to bankroller with a good idea once in a while, surprising your nearly grown college freshman.

Then, for several decades, the parent-child relationship becomes adult-adult. This period can be very pleasant. Like good friends, you help each other in a pinch, but live your own lives and make your own decisions.

Role reversal begins when the child assumes control of some aspect of a parent’s life. It may begin at the parent’s request and be relatively minor, such as taking care of Dad’s car maintenance, or driving Mom to medical appointments, doing income taxes or balancing checkbooks. This control shift is limited and non-intrusive. Inconvenience to the child is minimal and the parent is grateful. [Read more…]

The Portland Paradox

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In May 2017 my wife and I visited Portland, Oregon, for a week. We had a wonderful time. There’s plenty to do. The weather was awesome. Our hotel was top-notch. Everything clicked.

Our first evening there we saw a play. The theater is in a building that houses several art galleries. One is called “The Geezer Gallery.” After years of writing about ageism and the need for us older Americans to face life squarely and with self-respect, I was honestly appalled that an organization could call itself that. (My online dictionary defines geezer as an odd or eccentric man, usually an elderly person). [Read more…]

When Is It Time?

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Tough Conversations is pleased to feature an article by Guest Blogger Susy Murphy who is a respected Aging Life Care Manager and Owner of Debra Levy Eldercare Associates in Maryland.

Making The Difficult Decision to Move a Family Member to Assisted Living or Memory Care
(reprinted with permission)

When is it timeOne of the most difficult decisions that any family faces is making the decision about when, or if, moving a family member to assisted living is the right thing to do. As Aging Life Care™ Managers, this is often when we are called on, whether to schedule an office consult with concerned adult children to discuss options or to meet with a spouse in their home and assess whether or not their husband or wife can still be safely cared for there. It is nearly always an emotionally fraught decision. Sometimes adult children promised their parents that they would “never put them in a home,” whatever that may mean in today’s world where some skilled nursing facilities actually more closely resemble a Hilton Garden Inn with nurses, and long before being faced with the realities of a difficult diagnosis, such as Lewy Body Dementia. [Read more…]

Changing Places

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Roseanne Cash describes sitting at the grave of her father Johnny Cash, and writing a song, “God is in the Roses.”

She wrote “I love you like a brother, a father and a son. . .” These words describe the changing roles we all will play in relationships as we and those we love age. We become our parent’s parent. We become our children’s child. This can be painful for everyone, another layer of necessary loss.

As roles change, our way of speaking may change too.

If a parent (or spouse or friend) loses memory, we may be tempted to speak to him/her as to a child. What effect does that have on the person? Does he react negatively? It’s important to appreciate that as older adults depend more on others, they may become more accepting of the treatment they receive, even though inside, they may be offended, or even outraged.

Once we begin providing care to others, we may act the parent. More often than not role reversal takes place: the child becomes the parent and vice versa. Whatever the transition, it’s important to remember that we’re speaking to an adult. It’s important to respect his dignity – and guard our own.

These are challenging situations. We want to do the right thing. But we often confront a different way of thinking and doing. While a younger person may prefer to pursue matters linearly, an older adult may want to take a more roundabout (and time-consuming) approach. Here, we recommend listening more than talking. Remember, listening is not the same as agreeing. And listening can have a healing effect on the older adult.

Some do’s and don’t’s:

If the loved one were fully competent – how would you speak to her? If not competent, how would your speech change? Be aware of the difference. Keep your speech as respectful as possible while maintaining her safety.

Make requests, don’t issue commands. “Would you like to sit here?” not “Sit here.”
Let him do as much as possible for himself – don’t rush to “help” him do what he can still do. (If you’re the one needing care, don’t slip into expecting others to wait on you. Do as much as you can for yourself.)

Offer choices: “Would you rather have fish or chicken for dinner? What vegetable would you like? We have string beans, tomatoes, and broccoli.”

Think of ways the person can still be useful – and ask her to help you. Then say, “Thank you.”

Respect and choices are crucial to maintaining compassionate communication – and healthy, loving relationships — in the face of changing roles.

We welcome your creative suggestions – how have you handled this?

Carolyn Parr

“Am I too old to…….[fill in the blank]?”

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“Am I too old to…….[fill in the blank]?”

Don’t tell me that this question hasn’t crept into your psyche. It has mine. Too often. And I lead an active and (I’d like to think) productive life. But this demon thought has a way of infecting my self-esteem and diminishing my self-worth.

If I see a flyer for a hiking trip, or a job announcement, or news about some vacation that I would have jumped at 20 years ago, the thought creeps up on me: “Aren’t you too old for that?”

Where does this thinking come from? I attribute it to two sources: one external, the other interior.

The external sources include attitudes many elders confront daily: One is Ageism, a form of discrimination — sometimes subtle in nature — against older people in the workplace, in sports, in the media, almost everywhere. The other is Elderspeak: the verbal expression of ageism where we’re treated condescendingly and sometime addressed as “dearie,” or “sweetie,” or some other irritatingly infantile-sounding term.

The interior source is our own situation: Aging does take a toll. Inevitably an array of limitations – from cataracts to cancer – are going to impact our physical and mental well-being.

But aging has its benefits: while I may not be able to run a four or even eight-minute mile, I see a change in my emotional strength; improved people skills, more willing to compromise on my likes and dislikes, and greater openness to listen to both sides of an issue.

Conclusion: I may have become too old for some things. But if I take a longer view, I conclude that elder-ing (not aging) has advantages that I need to recognize and relish.

Sig Cohen

Are We Infantilizers?

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What is more humiliating to an older adult than to be addressed as ‘sweetie’ or ‘dear’ or some other condescending term? It’s not enough that older adults experience one loss after another. For example, loss of hearing, loss of a loved one, or loss of independence. In the process they also suffer the loss of dignity and self-worth.

Too often we treat older adults like children because they may be incapable of carrying out some of their activities of daily living (ADL’s). We mistake their diminished ADL capacity for mental or psychological regression. What we forget is that addressing them condescendingly may only reinforce their despair and hopelessness. Just because we believe these so-called terms of endearment may instill a bond of friendship, doesn’t mean that it’s OK to use them with older adults.

Imagine how belittling it must be to an older adult resident of an assisted living or nursing home when a staff member young enough to be their grandchild calls them by their first name without asking permission.

Many older adults were used to being addressed as ‘Mr.’ or ‘Mrs.’ before moving to a nursing home or assisted living residence. Too often, however, when they enter such a ‘facility’, the staff customarily addresses them either by their first name or something worse like ‘hon’ or ‘dearie’ or ‘love.’ When registering a prospective resident of an independent or assisted living home, why not take a moment to ask him or her how they would like to be addressed. (Ditto for doctors: Why don’t doctors inquire of prospective patients how they’d like to be addressed after they introduce themselves as “Doctor so-and so’?)

Rather than create an emotional connection with the resident, research shows that these expressions often accentuate his or her negative self-perception. Persons in their eighties and nineties need all the respect as they can get.

Let’s keep in mind both the tone and language we use when conversing with older adults. Are we remembering to talk with them as elders who deserve our esteem and respect, or as someone who because they depend on our assistance has lost her or his claim to a positive self-image?

Sig Cohen