an online resource for baby boomers

Communicating About Sensitive Subjects
A Guide for Family Conversations

Seniors, are there questions and topics you wish you could raise with your adult children, and other subjects you'd rather not discuss with them?

Boomers, are there conversations you'd like to have with your parents as they age, but just don't know how to start?

If you are finding it difficult to communicate with your relatives about sensitive subjects, you are not alone. As parents age, many families are hesitant to bring up important topics such as independent living, health, medications, driving, money, end-of-life wishes and legacies, and relationships. Research by the international caregiving company Home Instead Senior Care showed that "nearly one-third of adults in the U.S. say they have a major communication obstacle with their parents that stems from continuation of the parent-child role … rather than a peer-to-peer model…"

Other barriers to communication between seniors and their adult children include a fear of losing one's independence, a desire to protect one's own privacy or to respect another's privacy, a reluctance or inability to acknowledge some of the changes that aging brings, and a lack of clear guidelines for having such conversations.

Each family has its own patterns and ways of relating, but one thing that families have in common is love. Seniors and their adult children care about each other. As they age, their roles evolve, and often they are also trying to take care of each other. Consider the following examples:

• A daughter worries when she notices that Mom has mixed up her pills, gone out and left the stove on, or forgotten to pay her bills.
• Dad, who is having trouble seeing at night, gets into a car accident. His children are concerned for his and others'safety.
• Mom has recently been diagnosed with a potentially serious illness. How is she going to tell the children? Up to now, she has not written down her end-of-life wishes; her children are uncomfortable when she tries to raise the subject.
• Dad has recently died. Both Mom and the family are worrying about whether Mom has enough income and how she will manage living on her own. The parents have never had a frank conversation with their adult children about their financial resources.
• Mom is starting to feel pressured by her family to move to a senior apartment building or assisted living facility, but she really wants to remain in her own home.

If you're a "boomer" age 40 or older, or if you're a senior age 70 or older, this is the time to start discussing important topics with each other and to make decisions that will affect your lives in the future. Instead of waiting for a crisis, take the time now to open conversations, gather information, reflect, discuss again, make appropriate changes now and plan for the future. Honesty and mutually respectful communication are the keys to overcoming the barriers; the reward is everyone's peace of mind.

Suggestions for adult children to enhance communication with their aging parents:
These are offered by Home Instead Senior Care and communication expert Jake Harwood, Ph.D., of the University of Arizona.

• Don't draw a conclusion or make a decision based on a single incident. Take time to observe and talk with your parents. You may want to consult your parents' physician or a geriatric specialist, who can assess and address some of the changes you are noticing.
• If you observe a problem, mention to your parents what you've noticed and ask what they think is going on. If they acknowledge the situation, ask them to suggest some solutions and come up with a plan together. If they do not recognize the problem, give them specific factual examples. You may need to plant a seed, wait a while, and return to the topic after everyone has had time to reflect.
• An informal or light tone, rather than an accusatory approach, can be a good conversation opener. Some examples: "Goodness, Mom, how do you keep all these pills straight?" "The fridge looks pretty empty. What are you eating these days?" "Dad and Mom, I recently updated my will. Have you looked over yours recently?"
• Limit family meetings to immediate adult family members. It may be helpful to have a trusted relative or friend, who has your parent's "ear," lay the groundwork or begin the conversation.
• Address and try to resolve one issue at a time. 
• Treat your parents like adults and with respect, just as you would like to be addressed.
• Look for solutions, resources and supports that maximize your parents' strengths and that promote independence.
• Be aware. Stay tuned in to your parents' situation and any changes.
• Ask for help. Many resources are available through your community's family services (which may offer Eldercare Family Consultations), agencies on aging, senior centers, places of worship, and in-home care providers. 

Tips to help seniors communicate with their adult children:
These are offered by Dr. Jake Harwood.

• Be assertive. Say clearly and firmly what you need and want. Treat your family members with respect, and insist that they respect your dignity.
• Focus on the issues that are most important to you. It may be easier to let less important points go.
• Choose the times and places that work best for you to have serious conversations.
• Compensate for weaknesses. Have your vision and hearing checked. Keep notes or lists to help you remember important items.
• Foster your own independence. Look for mental and physical challenges, and do as much as you can safely do for yourself.
• Raise important issues that are on your mind with your adult child.
• Look for points of agreement; avoid defensiveness, anger, and accusations.
• Listen and try to understand each other's point of view. Express appreciation and love. Keep specific issues in perspective. What's most important is your relationship with your family.

Act Now and Relax: Guidelines for Older Adults and their Families
In order to ensure that your wishes are known and respected, prepare or update these vital documents now:

• Will
• Power of attorney
• Durable power of attorney for health care (medical power of attorney)
• Living will - The Five Wishes document gives you a format to express how you want to be treated if you are seriously ill and unable to communicate your wishes.
• Carry and post at home a list of your current medications and dosages.
• Home Instead Senior Care and Jo Myers, author of Good to Go, advise drawing up a pre-planning checklist that includes contact names, including your Personal Representative and physicians, to be notified in case of serious illness or death; where important documents are kept; contact names and account numbers for salary, pensions, insurance policies, investments, bank accounts, safe deposit boxes, properties; contact information for your accountant, attorney and financial consultant; and funeral arrangements.

Article by Jewish Community Services, Baltimore, Maryland.

Boomers Resource Guide is a special supplement to the Senior Citizen's Guide