Carol Cummings, RN, BSN, Expert on Aging Well

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11 April 2016

coaching tips for the conversation about senior living

In last week’s blog we talked about some coaching to tips to help you have the conversation about senior living with an aging loved one. Just to review, we said that there is always ambivalence around behavior change. We can argue both sides. If the adult child takes up the “good side” of the argument the natural tendency will be for the parent to take up the “bad side,” thereby reinforcing their reasons not to make a change.

Your assignment last week was to use open ended questions in your conversations. I hope you learned the power of this simple communication technique. It gets a person talking out loud-which is how most of us solve problems.
Specifically, we want the person talking about the change they need to make. Any move toward that is good and should be affirmed. Remember that there is ambivalence about making a change, so we want to bring that out and help the parent to resolve it.

The other skills that go along with asking open ended questions are affirmation, reflection, and summary.
These skills form the acronym OARS:

  • Open-ended questions — a question that does not have a yes or no answer
  • Affirmation — this requires empathy-affirm what is being said-especially when you hear someone saying what they need to do to change
  • Reflection — simply saying back what you heard so the person knows you heard them and understand
  • Summary — at the end of the conversation, summarize what has been discussed to be sure you are on the same page.

Let’s see how these are applied. Here is the conversation we started last week:

Adult child: “Mom/Dad, when you fell last week it really scared me. How are you feeling about what happened?” (Open-ended question)

Parent: “Well, I don’t know. I guess it was a little scary. It was a good thing Joey stopped by. But, I am fine now.”

Here it would be tempting to tell the parent that there needs to be a change for their own good. Resist that temptation! We can hear the ambivalence — on one hand the parent is fine, but the incident was scary. Affirm what you hear them saying and reflect the conflict.

Adult child: “I am so glad you are feeling fine now-and thank goodness for Joey! (Affirmation) But the fall was scary and could happen again. Joey is going back to college and I work full time so you could be hurt and alone. Where does that leave us?” (Reflection and open-ended question — putting the conflict out there for the person to resolve)

Parent: “Well, it is true that I could fall again. I am not sure what I would do if that happens. Joey is going back to college. My friend has one of those emergency pendants. I suppose I could try that. What do you think?” (Resolving the conflict-coming up with a solution)

Adult child: “An emergency pendant is such a great idea (Affirmation). How would you like to go about looking in to that? I am happy to help if you need me.” (Continuing to empower and keep the parent in charge)

Parent: “Let me talk to my friend and see what she has and how much it costs.”

Adult child: “Mom/Dad-the fall was scary, but it is a good thing you are doing fine now. I am so happy that you are going to look into a safety measure that will help you get help quickly if it happens again. I want you to stay independent, but it will help me to worry less if you have that in place. I am always here to help.” (Summary-Affirmation)

These techniques are simple but not easy. It takes mindful attention to resist taking control. Practice them in your daily life. They work well in many conversations. When you get the hang of it you will find it to be freeing as you are not the one who owns the problem.

Notice we did not even get near talking about senior living. But using this method of communication opens the door to future discussions. Helping an aging parent is a marathon, not a sprint. Keep up the good work and know that you are doing the best you can. We at Brookdale are here to help.

Be Well on Purpose!


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