10 Tips for Having Difficult Conversations on Care

It can be a challenging time when we start to notice that our loved ones are experiencing some of the physical or cognitive effects of aging. We may start to notice as they struggle with performing their usual activities, experience physical decline, or have trouble with processing thoughts or retaining memories. This is only made more difficult if the person in question is in denial about their reduced capacity, and refusing or denying that they need assistance or care.

These tips can help you start to understand the situation from your loved one’s perspective, and have a conversation about their needs in a way that is supportive and compassionate. This is the best way to reach your loved one, and arrive at an agreeable solution for care that keeps them safe whilst also upholding as much independence, autonomy and dignity as possible. 

Why Do Older People Often Require Increased Support or Care?

Growing older is a unique and individual experience for everyone. Whilst some of us may remain relatively strong and agile well into our golden years, others may need a little extra help earlier on. A range of lifestyle, genetic, environmental and other factors all influence how much help we need and when we start to need it. There is no ‘normal’ timeline for aging, or for when we start to notice a decline in our physical or other abilities. It is not anybody’s fault when a beloved older person suddenly or gradually starts to become less capable of certain tasks or activities, and in most cases it is inevitable that we will need some help at some stage or another. 

Physical ailments or health conditions that become more common in later life can sometimes lead to having less energy or strength for things like housekeeping, shopping, or attending appointments. Sensory changes such as reduced vision or hearing can start to create communication barriers and potentially isolation, especially if this makes it difficult to drive or safely use transportation. Cognitive or memory challenges such as dementia can mean older people struggle to maintain adequate nutrition, hygiene, or other important aspects of health and wellbeing. The conditions that affect your loved one will determine the types and level of support they may need in order to age safely, healthily, and happily.

Common Objections for Receiving Aged Care Support

Even if it seems obvious to yourself and those around you that your older loved one needs help, sometimes they may initially reject or dislike the idea of receiving care. Suggestions that they need help to do things they once did independently can sometimes cause the person to feel judged or condescended, or they may feel like you are telling them they are ‘too old’ to live without support. Common responses to the idea of care in later life include:

• Refusal or reluctance to live in a home
• Insistence that they are able to look after themselves
• Frustration at the implication that they are no longer capable of independence
• Denial that they need help
• Dismissing the advice of someone younger than them
• Denying or trying to hide the impacts of age on their health and ability
• Blaming you or expecting you to provide care instead of a trained professional

You may feel upset, confused or frustrated at times by your loved ones’ resistance to receiving assistance from a care professional. This is normal, as we all want the best for those near and dear to us. However, we should also try to put ourselves in our loved one’s position, and think about how we might feel if we suddenly had to change the way we live and start accepting help from people we haven’t met before. This can be especially confronting when assistance is needed for personal care tasks like bathing or dressing. Try to avoid showing your frustration to your loved one, or making forceful demands about their need for care. This may only lead them to double down on their refusal or become more defensive about their ability to live alone and take care of themselves. Instead, try to have an open, respectful dialogue that acknowledges and validates the person’s fears or reservations about care, whilst highlighting the positive aspects of having more support. This conversation should emphasise that seeking help is not just about filling gaps in their abilities, but about reserving their energy and focus to do the things that matter most to them to enable a fulfilling, safe and happy life.

Consider the following tips when having a conversation about care with a beloved older person, to help keep the peace and protect your relationship, whilst achieving the best possible outcomes for your loved one.

1. Ask Questions

Even if you are concerned about your loved one’s ability to live independently, it’s important to treat them with dignity and respect. They are the experts in their own lives, and we should always take care to ask them lots of questions to help us understand how they feel about receiving care and why. They may have very valid concerns about receiving care, or they may have misconceptions about what it means to have assistance with daily living. Listening carefully to their thoughts and feelings will help them to feel heard and understood, and is an important starting point for a discussion about significant lifestyle changes. Try to avoid sounding judgemental, forceful, or ‘preachy’ about the person’s declining abilities, and reinforce the person’s strengths so that they feel dignified and positive about themselves throughout the conversation and transition into care. 

2. Reassure Them That They Will Still Have Meaningful Contributions to Make

One of the most common reasons for refusing or resisting care in later life is the feeling of losing one’s independence. Explaining that everybody relies on others in some way regardless of age may help to remove some of the shame or stigma the person may feel about needing support. You can also reassure them that they will still be making a positive impact on many people’s lives, perhaps by being more present and able to spend quality time with loved ones without the stress of trying to manage their home, health and responsibilities alone. Finding ways to keep your loved one engaged in community and social activities can reassure them that they will continue to live a meaningful and dignified life with the support of a professional caregiver. 

3. Listen Respectfully to Their Objections or Concerns About Receiving Care

It can be tempting to focus solely on the positives of receiving care, such as increased safety, less worry for the person’s wellbeing, and increased time and energy to focus on the things they love rather than struggling to keep up with household or personal care tasks. However, ignoring or dismissing the potential downsides to receiving care may lead to your loved one feeling dismissed or disregarded. Resist the urge to counter the person’s objections or reasons for being apprehensive about care, and instead listen openly and respectfully. Be willing to consider a range of care options, and to compromise or make adjustments to your expectations. Try to keep in mind how you might feel if you were in their position, and remain calm and understanding to avoid any unnecessary conflict or tension. 

4. Try a Combination of Direct or Indirect Approaches

Everybody feels differently about the idea of receiving support in later life. The same approach to raising this issue may not work the same for everyone. If you have already tried a more direct conversation, consider an alternative strategy. This might be talking about other people in your life who have started receiving help at home or moved into an Aged Care Facility, or about how you would like to receive care when you reach that stage of your own life. This may get the person to see an alternative perspective, or feel like the conversation is less of a personal affront.

You could even seek out films, television shows or YouTube videos about living assistance, so that they can start getting more used to the idea before diving into it themselves. On the other hand, if you have been dropping hints or subtly suggesting that they may need help and you feel the message is not being received, you may need to be more direct in expressing your thoughts and concerns.

5. Be Compassionate and Understanding

Considering a change to how one lives their life is intimidating, so it’s important to maintain compassion and empathy with your loved one. Remember that they were not always an older person experiencing a decline in their capacity, but once a young, thriving, busy adult just like you. Transitioning into a stage of life in which regular care is needed can trigger feelings of fear, guilt, depression or grief for their former lives.

It may also increase the person’s thoughts and worries about their own mortality, which can be distressing and anxiety-inducing. Remain patient and calm with your loved one, and validate any emotions they may feel about the idea of receiving care. It is also important to practice compassion for yourself. Having challenging conversations with loved ones is never easy, so make sure you are taking adequate time to care for yourself in the process of caring for someone else. 

6. Involve the Older Person in Important Decisions Surrounding Care

Some people may fear that starting to receive living assistance or aged care will mean they no longer have a say in how they live their lives. One way to ease this anxiety is to show them that they do in fact have a choice in important decisions affecting them. Taking time to go through the range of different aged care options, from in-home support to residential care facilities, can demonstrate that they are still being listened to and taking an active role in their future. Making sure the preferences and needs of your individual loved one will also ensure a smoother transition, better quality of life, and more constructive and healthy relationships well into the person’s later life. 

7. Explain the Benefit of Care for the Person’s Family and Friends

Sometimes it is easier to accept help when we think about how it will improve the lives of those close to us. Expressing how much calmer and happier you will feel knowing your loved one is safe and supported may help shift their perspective, and realise that accepting care will not only improve their own life, but the lives of everyone around them. You can also highlight how having someone help with aspects of daily living will free up time for your loved one, and their friends and family, to spend quality time enjoying each other’s company and engaging in beloved hobbies or activities. 

8. Choose the Time and Place for Your Conversation

You may feel that your loved one is in urgent need of care or support, however it is not necessarily a good idea to rush the decision. It’s important to allow them to process their thoughts and feelings about receiving care, and to understand exactly what this transition will entail. You may find you need to have the same conversation with your loved one several times, or reassure them about their concerns on multiple occasions before they start to make peace with the idea. Be patient, and trust that they will start to accept the idea as long as it is discussed from a place of love, care and respect. Have the conversation in a setting where your loved one feels safe and comfortable, so that it feels less confronting for all involved. 

9. Do Your Research and Stay Focused

It is not possible to have all of the answers regarding aged care, but it can be helpful to do some research before raising the issue. The way care is provided for older people may have changed since you last looked into it, and your loved one may have false or outdated information about what it means to receive aged care. Having some information on hand to show that you have thought it out carefully and are well informed can help reassure your loved one that you have their best interests at heart. You should also take time to reflect on your own feelings and thoughts about care, and do your best to provide advice and information without being distracted by your own emotions.

10. Seek Support to Have the Conversation if Needed

If you feel you have tried everything you can to support your loved one with the idea of receiving care, it’s okay to find support to continue the conversation. Carer Gateway is the Australian Government’s central point of support, resources and information for people who provide care to a loved one who is older, lives with a mental or physical health condition or disability. They can assist you by providing help and advice with discussing aged care with your loved one, or connect you with other useful support services. They also operate an online forum for carers to connect, share stories and support, and ask for help with the challenges of caring.

Speaking to others who have successfully navigated discussing aged care with a loved one can reassure you that you are on the right track. It can also be helpful to share these lessons and stories with your loved one, especially those that end with the older person happy, dignified and satisfied with the care they receive. Support in the form of mediation can also be useful in providing a balanced perspective from a neutral third party to help settle any disagreements or tension. 

Key Takeaways

Raising the issue of aged care can be uncomfortable and challenging for a variety of reasons. However, if done with love, respect and compassion, it can actually be an opportunity to better understand your loved one and build an even closer relationship than you had beforehand.

Overcoming these challenges will help you and your loved one be assured that they will be well supported into their later life, with more time and energy to spend doing what they love.