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#2 Tips for Having the Conversation: Preparation
By Lawrence Rickards
Posted on 1/31/2017 2:07 PM

Tips for Having “the Conversation” About Needed Assistance: (1) Preparation

By Lawrence Rickards


Many elders tend to avoid discussing their need for help for fear of burdening their family, concerns about relinquishing control over their lives, or fear that they may be forced to move out of their home. Adult children, too, may feel awkward or reluctant in raising care concerns with their parents. Unfortunately, these “talks” are often delayed until there is a crisis--the least optimal time for exploring options, rational planning and decision making. Leaders in the field of aging agree that taking the time to have the conversation early generally leads to better outcomes.


Preparation for the Conversation


Frequently there are several adult children in a family concerned about the wellbeing of their older family member, which offers both benefits and challenges.  Prior to raising care concerns with the older person, family members should discuss these issues among themselves:

  • Who will raise the care concerns with the older person?  Will it be one-on-one or a family meeting?


  • Accept that not everyone in the family wants to be involved in planning and executing the elder’s care strategy. It is important to respect anyone’s decision not to participate and try to avoid lingering resentment that can build up and cause family friction.


  • Pick a location for the conversation – either a physical place or by remote conference calls (such as Skype) – to ensure that everyone who wishes to participate in the discussion can do so.


  • Develop a set of talking points to be covered during the family discussion that addresses the important areas of care concern. This will help focus attention on key issues.


  • All family members should be allowed to voice their questions, opinions and emotions without fear of being censured or ridiculed.


  • Perfect harmony is unlikely. Despite best efforts to be civil and keep the peace, the challenges involved in planning, paying for and carrying out an elder’s care may still cause some friction and family division. Siblings may disagree on how an aged family member should be cared for, or family members who live far away may be in denial about an aging loved one’s declining functioning and health.


  • Identify and outline roles and responsibilities for participating family members. This may be based on how close one may live to the elder, time available to devote to helping out, or particular skills or talents related to the elder’s needs.


  • Summarize and recap the important decisions made, identify each person’s responsibilities and commitments, and develop a timeline for action. This will help assure that all family members are on the same page regarding the steps to be taken and how they fit into the older person’s care plan. Also, discuss how to keep family members regularly informed about progress and any changes in care needs.


  • If the family tends to be combative or avoid difficult topics, consider asking an objective third-party, such as a friend, social worker or clergy, to join the meeting and help with facilitation.


  • Finally, remember that you don’t have to shoulder this alone. We live in a city where there are resources to help us think about and plan care strategies. The Village partner Iona Senior Services employs social workers and care managers skilled in all aspects of aging, who are eager to help elders and family members with care planning.


The March blog post will offer tips about “Negotiating with the Elder.” 


Sources and additional information. The following guides are recommended for those involved in care planning for older persons:  Care Plan Assessment, Home is Where the Help Is, and The Caregiver’s Survival Guide are available at no cost from; and the Guide to Having Tough Conversations Over the Holidays is available at no cost from