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#3-Tips for Having "the Conversation" about Needed
By Lawrence Rickards
Posted on 4/4/2017 5:15 PM

Blog #3:  Tips for Having “the Conversation” About Needed Assistance: Negotiating with the Elder


Once the family has gained clarity, and hopefully agreement, on the issues and concerns to be addressed with the older family member, thought should be given on how best to approach the conversation with them. There are a variety of approaches to successfully navigate the conversation about assistance. These include:


  • Being mentally prepared for the discussion; know what issues or points you want to raise, the tone you want to use, and how you want to steer the conversation. It can be helpful to rehearse the discussion head of the meeting.


  • Timing is important. Choose a time when there are no distractions or other obligations. Give the conversation your undivided attention.


  • Choose the setting carefully. Plan where you want the conversation to take place, again, free of distractions.


  • Speak calmly and clearly. Be sure you are being heard and avoid raising your voice or shouting during the conversation. Be respectful and don’t patronize; no one likes being talked down to or bullied. Confrontation and overstepping boundaries are usually counter-productive, increasing the elder’s resentfulness and resistance, and the likelihood that care suggestions will be rejected.


  • Share your observations, concerns and feelings. If you have noticed a problem, be clear about what you have observed. You may need to be persistent, empathic and strong as you talk with your loved one to find the right solutions to their care needs.


  • Put yourself in their shoes. Be aware of the elder’s need for freedom and independence, and that their initial response to those trying to help them may be hostile and rejecting of assistance. Expect and accept disagreement, especially when discussing difficult topics. Describe the benefits derived from the assistance. Try to come up with compromises that everyone can accept.


  • Practice patience. For an older adult, acknowledging that they are no longer capable of being completely autonomous can be emotionally charged; accepting help can feel like a loss of status and their parental role. Thus, acceptance of the need for help may not happen immediately. It is important to allow the older person the time and space they need to come to terms with how their situation is changing.


  • Listen to their concerns and wishes. To validate their concerns, and to be sure you are listening closely, make a list of their concerns and apprehensions. Asking the older person what they need help with gives them control and may increase their willingness to accept assistance. This is valuable in helping to find the most appropriate solution based on their preferences.


  • Emphasize your role as their partner and advocate. It helps to express your concern for their welfare and wellbeing. It also helps to be explicit about wanting to understand and fulfill their wishes and that they can depend on you.


  • Prioritize the elder’s needs and address them over a series of conversations.


  • Start early with small issues that aren’t of great concern. This is a way to slowly build trust and cooperation about areas of their life without pressure or crisis.


  • Understand that not all concerns can be addressed in only one conversation and that it may take time to reach to appropriate solutions.


  • Discuss who will provide the assistance – a family member, homecare agency, or other arrangement – and how this may alter daily routines.


Of course, every older adult is a unique individual, with their own wishes, viewpoints, and abilities. Thus, their engagement in the conversation and willingness to receive assistance will reflect their own personality and circumstance, as well as the particular history and dynamics of the family.


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 Guide to Having Tough Conversations Over the Holidays is also available at no cost from