Wondering how to start the conversation with an aging parent about a sensitive topic? Whether you need to talk about moving to a senior living community, giving up driving, or bringing in help, knowing which words to use and to avoid can improve the odds of moving towards a solution.

A good place to start is to first realize there are typically two fundamental personality types of parents:

  • those with whom you have a relationship in which you can be very straightforward and they welcome your ideas and feedback and,
  • those who tend to be more self-conscious or private and don’t welcome these kinds of discussions and may even find it somewhat insulting.

You should also be fully aware that even if in the past, your parent was sharing and receptive, this can change due to aging-related issues like depression, creeping dementia, lowered self-esteem, or other frustrations. On the other hand, a close-lipped parent may be relieved to talk because he or she is worried as well.

What to say about sensitive subjects can also be tricky because both parties typically have different goals. Adult children want to solve the problem and move on. Their parents, however, want foremost to maintain a sense of control and dignity in a time of their life that can be marked by many losses. Your goal in how to have “the talk”: Balance both sides’ needs by moving forward slowly and with care.

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Do Some Homework

Before you say a word, take some time to collect information and research possible solutions. Ultimately, the goal is to problem-solve together through a dialogue with your parent rather than trying to dictate the solution or attempt to convince through arguments. If you gather facts first, you’ll be able to help in a way that’s better informed and less stressful for everyone.

Health Issues

Observe what specific kinds of limitations you’re seeing. Trouble climbing stairs? Cooking? Managing finances? Grooming? Thinking in terms of specifics helps you to figure out the best solutions, as well as accurately describe any concerns to any outside resources and to your parent.

Driving

Make it a point to personally observe your parent drive while looking for potential signs of unsafe driving. Research alternate transportation services in your parent’s area or explore other ways he or she might get around without a personal auto.

In-Home Care

Closely observes what activities your parent are having trouble with. Look around the house for concrete signs that he or she may not be doing well living independently. Start to research sources of in-home care help and associated costs.

Moving/Senior Living Communities

Check out a few places on your own so you have concrete examples to talk about. If you live a long distance away, read reviews about various options and if possible, make an appointment to tour them when you’re there. Don’t think of it as being “sneaky,” as it can actually be less anxiety-provoking for your parent if you present them with options you’ve already checked out. And…you can also make them feel empowered by going through the whole list of choices together if he or she prefers.

Test the Waters

Before you start the conversation, take time to get a sense of whether your parent is open to it. You can do this by first introducing an unthreatening related topic. This can be done by phone before a visit, or if you see your parent often, in a separate visit. This isn’t yet the time for hot-button topics, criticism, or anything contentious. Keep things positive and generalized. Does he or she respond openly? Defensively? Evasively? This will give you the important insight into how to proceed.

Say something like:

  • “How’s the house? It must be hard to keep this place in good shape.”
  • “How’s your health? What’s the doctor saying these days?”
  • “How’s the car? Still driving to where you need to go?”

If your parent sounds interested, say something like:

  • “Is there some way I can be helpful?”
  • “Yes, I can see why that would bother you. Let’s talk about it more when I see you.”

Even if in a “test-the-waters” chat, your parent sounds receptive to discussing a tough issue, it’s usually best not to plunge in yet. In this first talk, you should be looking to simply float the issue, not problem-solve. You want to show in a respectful way that you can be a helpful, non-judgmental resource.

If he or she asks you, “What should I do?” say something like:

  • “I’ll be there soon. Let’s work on it together then.”
  • “What are your thoughts? Give me some time to think about that too.”

What not to say:

  • “Yep, that’s a problem. I’m going to do X and Y to take care of that for you.”
  • “Sounds to me like it’s finally time to move to an assisted living place.”
  • “You sound confused. I’m going to call your doctor.”

Choose the Best Messenger

What if your parent resists any talk about his or her future? Pause to consider whether this conversation is best had by another person. A neutral third-party such as a doctor, family friend, clergy can perhaps be better suited to bring up tricky topics like driving or whether to continue living independently. These people can lay the same groundwork, explaining what seems to be wrong and suggesting options for fixing it, without risking a strained relationship in the way an adult child does when a parent is especially resistant or feels manipulated.

Set the Right Tone So you’ve done some homework and have a sense of how ready (or indifferent) your parent is. How do you take the plunge? Plan to start the conversation on a different day from your test-the-waters chat. This conversation should be done in person if at all possible as it feels less threatening or overbearing, and more natural. Make sure you are not critical the minute you walk in the door. Focus on connecting and having fun while also using some time to observe. While you may be on a mission to resolve the problem, you’ll have a more ready audience if you first take the time to enjoy one another’s company before diving in.

Try opening with compliments by saying something like:

  • “I like how you’ve…”
  • “Wow, looks like…”

Look for an Opening The best time to segue into a serious conversation is when your parent brings it up first and asks for your help. If that fails to occur, look for an opportunity when everyone is relaxed. Then take the plunge and describe what you’re seeing.

If a direct approach feels welcome, say something like:

  • “I see the steps are a problem for you and you almost fell this morning. Is that happening a lot?”
  • “It looks like you’re having trouble getting off the couch, and you seem a little lonely and mixed up when you’re tired. You know they say that people do a lot better where there’s a lot of activity going on, and things to enjoy.”
  • “Mom said you got another ticket, and I noticed the rear fender of the car is dented again. What do you think is going on?”

If an indirect approach seems like a better strategy, say something like:

  • “I read about this man in the paper who lost control of his car and killed some kids on the sidewalk. He was about your age. It made me think we should consider what’s in your best interests with the car now.”
  • “Lauren’s parents just sold their house on Elm Street and moved to a retirement community. You should have heard her mom rave about not having to do any more yard work.”
  • “Remember Jack, my friend who became a doctor? He told me that his whole family has living wills and I’m thinking we should all do that too.”

What not to say:

  • “The house was a mess last time I was there. You need a housekeeper!”
  • “Mom…dad looks awful! We need to go to the doctor when I get there, because you obviously are having trouble looking after him.”
  • “When are you going to give up driving? I heard you had another accident.”

Listen and Follow Your Parent’s Cues

Use reflexive listening an effective communication technique for difficult conversations. Rephrase what your parent says, as a way of playing back that you understand making your parent feel supported and then move the conversation forward.

Say something like:

  • “I hear you saying… but it’s also worth thinking about this…”
  • “Yes, I agree that… on the other hand…”
  • “I know you’re really worried about… Me, too but if X doesn’t happen…”
  • “That sounds upsetting for you… Have you thought about…?”

Realize that some older adults can’t articulate the real issue. They may shy from change, perhaps because they fear what it would be like or they lack the energy to deal with it. Often they avoid making a change not because of their own preferences but because they worry about upsetting someone else.

If she’s anxious, say something like:

  • “You’re right that moving is big hassle. But we’ll help you sort and pack and you won’t have to do much. We’ll set up your new bedroom to look just like this one.”
  • “I know we’ve always spent the holidays in this house, but we’d love to have Thanksgiving at our house this year. You can make your special pies there without having to worry about all the getting ready or cleaning up.”
  • “You may call them ugly old grab bars, and that’s what they used to be. But I was reading how universal design is really trendy, attractive home design right now.”

Find ways to be reassuring. Talk up the positives or stress how the solution is good for everyone.

If she’s resistant, say something like:

  • “Bob says he’ll pick you up for Breakfast Club every morning so you won’t have to miss it, and I’ll get your groceries.”
  • “Let’s make a list of pros and cons.”

To help with resistance, focus on the solution. Or, look for the underlying cause. Some people push back for a specific unmentioned reason, which may be emotional, physical, or cognitive. Maybe Dad doesn’t want to talk about moving because he thinks he can’t afford it. Maybe Mom lacks the cognitive ability to realize she can’t live alone. If the person is very resistant, the most successful person to have the conversation is not usually the adult child. A family friend or physician may have better luck.

If she’s interested or agreeable, say something like:

  • “What would it mean to you if you stopped driving/had someone to cook meals/moved?”
  • “What would be the most difficult thing about….?”
  • “Let’s make a list of what you can do about this.”
  • “Let’s think through the pros and cons of each situation.”
  • “Why don’t you try doing X for a couple of months and see how it works for you?”

The goal is to encourage more input and to keep the discussion positive and collaborative. If you want a parent to consider an assisted living option, one methodology is to casually drive by the best place you’ve identified through prior research and suggest dropping in together to have a look. Better yet, if you have a logical excuse, such as visiting a friend’s parent, stopping to see a “friend” who works there, or…participating in an activity or meal you’ve prearranged. Make sure it’s a place you’ve prescreened so that you’re fairly certain your parent will find things to like. Even if there is not much choice, lay out the options along with their pros and cons, strategize solutions to the biggest problems, and let your parent draw his or her own conclusion (assuming dementia is not an issue).

Let It Percolate Awhile

Whatever you do, don’t launch an aggressive “sell” on your favorite option the minute you get back home or the next time you talk. And don’t push for making a decision right away. Try not to even hint or nag at first.

What Not To Say:

  • “I hope you’ve been thinking about our idea of bringing in some help.”
  • “So…about selling your car have you done anything about that yet?”
  • “Wasn’t that place we saw nice? We need to get you out of here!”

Be Ready to Continue the Conversation at Any Time If your parent mentions the conversation at all, use this as a wedge to revisit the matter in a supportive way.

If he or she offers something positive, say something like:

  • “Yes, I could see you being happy there. What do you think it would be like to live there? Let’s think about what we’d have to do to make that happen I can help.”

If he or she expresses a concern:

Take this as a positive sign that he or she is at least aware of the issue and thinking about it. Go over the facts as well as the solutions again in a nonthreatening way.

If he or she says something negative: Don’t fall into the trap of an argument. Be patient and try to get at the underlying concern. Is it fear of running out of money? Is it a feeling that admitting help is necessary is also admitting failure of some kind? Look for ways to address and support the concern. As an example, maybe you give a weekly cleaning service as a Mother’s Day gift, “because I don’t know what else to get you and you deserve to be treated like a queen.”

Test the Waters (Again)

After some time passes, if your loved one doesn’t give you an opening, you can try bringing up the issue again in a test-the-waters way.

Say something like:

  • “How’s the car?”
  • “What did the doctor say?”

Know When to Bring In Help

Total resistance means it’s time for a third party (not the adult child) to try. This conversation may need to be more direct. It may have include a discussion of the risks and the possibility that if they don’t voluntarily give something up, for instance, their driver’s license or residence, there is a risk that others will take over because of the dangers involved and that they may have less say in what comes next. They can be told it’s better to work on it voluntarily with someone who loves them and only wants to help them get what they need. If the issue is critical and the person still won’t make a safe choice, it may be time to get a family doctor and lawyer involved to evaluate competency and, if appropriate, activate a Power of Attorney (POA) or appoint a guardian who can make safe choices on the person’s behalf.

Make It Clear You’re Comfortable With Any Decision

If your parent is of sound mind but just making decisions that you disagree with (not endangering ones), all you can do is continue the conversation in a positive way. Any choices are ultimately his or hers. You may not like the choice, or you may end up needing to revisit the matter at a later date. What you can do is remain upbeat and supportive, even if you’re frustrated or worried. This keeps a welcome sounding board as your parent moves, however slowly, toward resolution. Remember that transitions involve an ongoing dialogue. Difficult as that first conversation about a sensitive topic is, it’s only the first of many you’re like to have as you strategize your way towards a solution that everyone can feel better about.