Essential Conversations with Dr. Amy: Recognizing changes with your parents over the holidays

The holidays can result in more time spent together as a family than typical at other times of the year. During these family gatherings, it’s not uncommon for adult children to notice changes with their parents. A daughter may notice that her mom isn’t attending to her grooming or appearance as she once did, or notice that the house isn’t as clean, or perhaps that her dad is showing signs of confusion and forgetfulness. Or a son home from out of town may become aware of fluctuations in mood, noticing his dad is agitated or anxious in ways that are uncommon for him, and realizing that he isn’t participating in conversation like he usually does. Other differences that may be noteworthy can include a decline in driving ability, difficulty maintaining the household, or vision or hearing changes.

As upsetting as it can be to note these changes, they provide important information that may point to the need for essential conversations with your parents and other family members about maintaining—or improving—their quality of life. The purpose of these conversations is to do planning that allows your parent to continue to have the lifestyle they want and deserve, as well as to prevent a crisis situation from occurring. In fact, when planning is postponed until there’s a crisis, it can sometimes result in decisions that were not the older adult’s choice. Having essential conversations early and often helps to ensure that an aging parent continues to live the life they choose.

If you recognize it is time for an essential conversation with your parents, you may be wondering how to approach the discussion. Following are some suggestions to make these talks easier and more productive:

1)   It may be best to have a one-on-one conversation with your parent, versus having all family members present. Depending on your family dynamics, a group conversation may make an aging parent feel like family members are ganging up on them. The exception to having this conversation directly with your parent is if you notice significant cognitive changes. In that case, your aging parent may not be able to understand or process what you are discussing. You may need to talk with other family members and arrange a thorough assessment.

2)   Start the conversation by assuring your parent that your desire is to support their independence and to help them have the best quality of life possible. This can help a parent feel that you are on their team, rather than trying to interfere with their right to make their own choices.

3)   Once you’ve established you are there to support their independence and quality of life, you can share you have noticed some changes and you’d like to talk about them so that you can make sure they always have what they want and need. And that you realize that it might take some planning to ensure that happens.

4)   Then discuss what you have noticed without accusation and without a lot of emotion. You don’t have to mention every change. Respecting your parent’s dignity in this conversation is very important.

5)   If there are safety issues, these definitely need to be addressed as quickly as possible; safety is always the first priority.

6)   Offer to explore options with them, and create a “to-do” list with time frames.

At the end of the conversation, reiterate your intention is to support their choices, not to impose your own, and set a time to have a follow-up talk. This is important because having these types of conversations can bring up a lot of difficult emotions, and people often avoid them—which is harder to do if the next talk is already scheduled.

Dr AmyAbout Dr. Amy D’Aprix

Dr. Amy is a certified senior advisor, Vice President of the International Federation on Aging, and Co-Founder of the Essential Conversations Project. As a gerontological social worker, she has over thirty years of experience working with older adults and their families.