Q&As about Communicating with Seniors

David Solie, MS, PA
April 15, 2005

These, our final extracts from "How to Say It to Seniors" by David Solie, contain a series of questions and answers designed to help readers in their efforts to communicate better with their elders. They are reproduced here with the author's permission.
Robert Griffith, Editor.

Q: How do I determine whether the older person is interested in addressing my concerns after I hear a non-answer?

A: The art of crafting questions takes time and testing. Not all of our attempts to salvage a conversation will be successful. Many times we will get perfunctory answers. Other times we will spark real discussions. In between these extremes is where we hone our skills. Our commitment to legacy coaching bids us to listen closely to senior adults to find topics that provide openings. There may be a subtle shift in mood, a return to some particular topic, or a new piece of information. These hints may be new legacy doors waiting to be opened by the right follow-up questions.

Q: Sometimes I ask a really good question but the older person goes off on a completely different topic. Now what do I do?

A: Sometimes secondary subjects that arise are not incidental to the discussion, but the whole deal! When the San Francisco matron stated so forcefully that "doctors don't know everything, mother's do," I waited and was astonished at where this statement led. She's well known in her community, yet no one knew how passionately she felt about the lack of services for special-needs children or how much she needed to talk about it. An innocuous comment about hot weather that prompts a childhood memory of a swimming hole and homemade ice cream begs us to help the senior adult glean legacy value from such a response. Nonlinear statements are among the most important we'll ever hear from our seniors. They beckon us to pick out patterns that indicate where their values may lie.

Q: I am concerned that some of my questions to senior adults may raise strong emotions, such as fear or anger or both. Should I avoid asking such questions?

A: Usually, the more intense the response, the more significant the question we've asked. Emotions are not something to avoid; we must learn to respond to them. Many times these outbursts are gut reactions to topics that have not been aired in the past. If the person appears uncomfortable, don't press for more details at that moment. Validate their feelings ("That sounds like a terrible time in your life") and move on. If our relationship with the person is solid, and we keep communication channels open, there's a good chance he or she will bring up the subject again in another attempt to understand its significance in the life review process.

Q: My mom and I have never seen eye to eye. My view is that she's a very controlling person, so the idea of reinforcing that behavior doesn't sit well with me. Would offering her control, using those action verbs, actually work with her personality type?

A: Yes, definitely. Even if your mom has no trouble leading the brigade, she's still looking for a sign that you recognize her right to do so. Part of our conflict with controlling people is that we tend to fight them for the very thing they won't surrender. Don't fight your mom anymore; rather, acknowledge she has all the control she wants. Offer her control language at every opportunity. When she realizes there's nothing to fight about, she's likely to relax and have more honest, open discussions on a variety of subjects.

Q: While I agree that my 80-year-old dad has a right to refuse medical treatment, I worry that his condition will deteriorate and I won't forgive myself for not trying harder to persuade him to seek help while I had the chance. What can I say to him about seeing the doctor if he refuses to go on his own?

A: Sometimes an elderly person's initial refusal to seek medical treatment is a warm-up answer. Wait a few days and mention the subject again by offering your dad complete control of the decision, the timing, and extent of further testing. If he refuses, assure him you accept his decision. If he asks more questions about the procedure, supply him with the answers without pressuring him to make an appointment. He's indicating he is willing to reconsider and needs to be facilitated, so raise the issue again a few days later using the same control language as before. Understand that your concern about your dad's deteriorating condition is not his problem. He's lived a long life and in reviewing it, he may have decided he's lived long enough. It's a subject seniors in compromised health review every day. It clashes with our age group's developmental drivers that compel us to take charge and resolve matters, but remember, we don't yet know what it's like to be old and need to respect our elders' decisions, even it we find them painful and don't agree with them.

Q: How many times in conversations with an elderly person should I use the word "control"?

A: Both nonprofessionals and professionals should use the word "control" and it's A-list of synonyms as often as possible. You will be amazed at the verbal and nonverbal responses you get. You'll observe elderly people relax and be more open to discussing any issue you want to raise.

Q: My parents don't realize they need more help doing simple tasks around the house, such as cleaning, cooking, and maintenance. Whenever I bring up the subject, they refuse to discuss it and dismiss my concerns. They mutter something about privacy and do not want "strangers" with them "constantly." How do I bring up the subject again so they'll hear me out?

A: Offer the language of control. For example, you might say, "Dad, it's completely your decision, but you know I've mentioned that it's getting more difficult for you and mom to maintain the house. What kind of assistance do you think you both can manage? Can I help you create a schedule for a helper that won't interfere with your activities? If you had to create a resume of the ideal person to assist you, what kind of experience would you envision for the person you hire?" This kind of language - using active verbs that place seniors at the helm - will offer your parents control of the situation. They'll relax and be able to think things through in a more focused, less defensive way.

[These Q&As have covered] communication strategies that allow seniors to feel in control of their lives at a time when they're dealing with mounting losses. If we master the art of allowing our elders to push the control buttons, we find them responding in new ways that facilitate both of our age-based agendas. With less conflict, they relax and their conversations become somewhat easier. We begin to feel like heroes in their eyes. Why? Because we've freed them to focus on their other equally compelling developmental task: the search for the way they wish to be remembered.

Q: I know my dad misses my mom, his weekend golf outings with his buddies, and the freedom he had when he could still drive, but he never talks about it. In fact, all he seems to do is sit around and mope. What can I say to him that will spark his interest in life again?

A: Facilitate an unstructured conversation with your dad. Ask open-ended questions that give him the opportunity to bring up issues that matter to him, such as the losses he's recently endured. From his answers, try to discern what needs to become part of his legacy and help him find the connections that will fill the void he's feeling.

Q: I understand why I need to listen for the values, but I'm not clear about how to interpret what I hear. Any pointers?

A: Think of the different ways you would answer a factual question on a questionnaire or an open-ended question posed by someone you trust: To a fact-finding question you might give a two- or three-word answer. To an open-ended question you might never finish to your satisfaction. That difference in response illuminates our values. When talking with our elders, we have to listen carefully with our legacy coach ears to what is repeated, what is emphasized, which details surface again and again, and how these details shift. If we think about their answer to a fact-finding question and compare it with their answer to the same question asked in a slightly different and open-ended way, we begin to see what they value. Those values can be used in forming their legacies.

Q: I've tried these open-ended questions, but they don't seem to work with my grandmother. Whenever I bring up a subject that I'm most curious about, she shoos me away like she would a pesky fly. How can I break through and get the information I want?

A: First, make sure all her control issues are resolved. Is there something about which she feels a sense of loss and hasn't expressed? If so, she may be focused on loss and regaining her balance and not have energy left over to probe more deeply into her past. Ask her directly what she needs. Next, consider that you might not be asking her the right open-ended questions. She may not be interested in talking about her father, but a question about her boyfriend at age 18 might evoke memories that lead you to subjects you want her to explore.

Q: This legacy coaching stuff seems time-consuming and laborious. Is it really worth the effort? What's the real value to the older person - and to us?

A: In medicine the dictum is: Cure when possible; comfort always. We can't cure aging, but we can offer comfort. We can't make old people better, faster, or quicker, but we can try to assist them on a developmental level. In doing so, we help them stitch together the legacy quilt they are compelled to create. It's their gift to us, one that we can later embellish and hand down to our children. How can we question the value of this legacy coaching process that offers such huge emotional rewards?

This is the final set of extracts from David Solie's book that we are posting on HealthandAge.com. If you've found them useful, you will find the book many times more useful - we've only scratched the surface. You can buy the book at Amazon, click here

Source

• David Solie, MS, PA. How to Say It to Seniors: Closing the Communications Gap with our Elders. (2004) Prentice Hall Press, New York.

Related Links
How to Talk With Your Elders
Anxiety: The Most Misunderstood Element in End-of-Life Care
'Beating the Senior Blues'

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