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6 Tips for Difficult Family Caregiving Conversations
Before you jump in, do your homework
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Key takeaways
- Start difficult caregiving conversations early and revisit them often, as needs, wishes and circumstances change.
- Gather specific observations and research practical options before suggesting changes or raising concerns.
- Patience, empathy and ongoing dialogue can help families reach decisions about care, safety and support.
One of the most common topics in the AARP Family Caregivers Discussion Group is how to talk with those we care for about difficult topics. As a longtime caregiver, I have had many of these discussions with my grandparents, parents, sisters and other family members over the years. I’ve learned that these conversations do not have to be painful — and they can be successful with some preparation.
The topics may run the gamut. Perhaps you’ll discuss finances, legal issues, estate planning and living situations or take a deep dive into care and treatment plans, safety and driving. These are all sensitive subjects, and your perspective or opinion may differ from those of your loved ones. Here are my hard-earned tips; I hope they help make your conversations easier.
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1. Talk early and often.
The more you’ve discussed and planned for the future, the easier it will be when it is time to make decisions. Talk early because it’s easier to discuss matters when they are in the future or hypothetical rather than imminent. The last thing you want is to struggle to have critical conversations in the middle of a crisis.
Talk often because we never know when our loved ones’ wishes will change or the situation will shift because their health, finances or housing has changed, for example. We need to be aware of our loved ones’ current wishes and ensure that plans made years ago are still viable.
2. Observe and do your homework before you act.
If you are suggesting a change for your loved ones, spend time with them observing and gathering accurate, specific information about your concerns before you even begin a conversation. Talk with the people who see them regularly, and try to be objective.
Try not to think of it as “gathering ammunition” but instead as getting a realistic view of their abilities and needs. Most people will respond better if you are specific about a concern rather than making broad observations that may be perceived as threats. For example, “I’m concerned about you carrying your laundry down the stairs; I want to make the home safer for you” will be much easier to discuss than “You can’t stay in your home safely anymore.”
Never bring up a change unless you have realistic alternatives to offer. Research the options related to the change you are suggesting so they know you aren’t trying to blame, take things away or limit. Instead, show how you want to help them find safer solutions, improve their quality of life and lower their stress.
3. Approach with love, concern and support.
Remember, you are all on the same team and have a common goal: the best possible care and quality of life for your loved ones. You want them to be as independent as possible for as long as possible. Be sincere; they will see through a snow job right away. It’s about honest, caring, clear communication. Starting out with a confrontational, negative attitude will sabotage the discussion.
Our role as caregivers is always to support our loved ones — not to completely take over their lives, unless they are medically deemed incapable of making daily decisions independently due to cognitive impairments. If you are caregiving for your parents, I urge you not to adopt the viewpoint that you are now parenting them. You may be in a more supportive role now, but our parents will always be our parents, and they will respond better to a respectful, compassionate attitude.
4. Communicate effectively.
If you’re uncertain how to bring up a specific subject, try an indirect approach, such as discussing an article or a book you read, a friend’s situation or a television show. You’ll find many helpful articles and videos on AARP’s caregiving website and YouTube channel.
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Use “I” statements. Starting sentences with “You need to” or “You just have to” puts people on the defensive. Instead, try beginning with “I am concerned about,” “I want to help you with,” “I’m wondering about,” or “I’d like to support you in.”
Ask for their input. It’s not a one-way conversation, so ask how they think they are doing and what adjustments they’ve thought about. Specific questions can be helpful, such as:
“Do you have any worries or concerns?”
“Is taking care of the house and yard becoming challenging for you?”
“Would a bit of help with some things ease your stress?”
“When it’s time for you to hang up the car keys, have you thought about other changes you’ll want to make?”
Listen, reflect and validate. Focus on listening with an open mind, then rephrase and reflect back what they have said. Have compassion for their situation, and understand that the unknown can cause fear and discomfort for all of us at any age. It’s normal to want to avoid change, so tell them you understand their feelings of reluctance, fear, anger or hopelessness and that you want to help make change easier for them. Sometimes people just need acknowledgment that this is hard to deal with.
5. Include key people in the conversation.
Sometimes, the right people at the table can make all the difference. It may be important to include a family member they listen to or a respected adviser, such as a lawyer, doctor, faith or community leader, or friend. You might even consider an objective third party, such as a geriatric care manager, counselor, or family or eldercare mediator, to facilitate the conversation.
6. Approach with patience, empathy and realistic expectations.
Be realistic about how conversations may unfold, given the personalities involved, as well as varied skills, viewpoints, strengths and goals. You may not always get what you ideally want, and sometimes you may have to let go of preconceived ideas. Compromise is paramount.
One conversation isn’t going to resolve everything. You will likely have many conversations before you come to a mutual agreement and make decisions.
For example, when we wanted Dad to stop driving, we met with his trusted doctor, who brought up the subject; it was easier for Dad to absorb. Then, Dad insisted he and Mom would move to a senior community because they didn’t want to be isolated in their home. We had numerous conversations about the big move. I visited about a dozen locations (my sister joined me for several of them), then narrowed it down to three, which we took my parents to visit. We were OK with any of the three choices, so they made the final decision.
Bottom line: Try to reframe these conversations as a compassionate process, not a one-and-done deal. Always remember that you can make another decision in the future if this one doesn’t work out. And give yourself some grace — you are likely stressed out and overwhelmed too, so take it slowly.
Quick Start: 5 Common Caregiving Conversations
Not sure how to start? Here are five discussion topics caregivers often find are the hardest. Adapt the wording to fit your own relationship and situation.
If you want to talk with your loved one about driving:
“I love that you’re still so independent, and I want to help keep it that way. I’ve noticed a few things on the road lately that worry me — can we talk about how we’ll know when it’s time to make a change and what the backup plan would look like? How are you feeling about driving? I want to make sure you can always get where you need to go when you need to go there, and I don’t ever want you to be isolated.”
Be sure to ride along first so you can make valid observations. Then share specific alternative transportation options that you’ve researched, so they will feel reassured if they consider cutting back on or stopping driving. Check out AARP’s free virtual seminar for family caregivers, “We Need to Talk,” for more practical tips on conversations about driving.
If you’re concerned that they aren’t taking care of themselves or following the doctor’s orders:
“I know it’s a lot to keep track of — it is so hard keeping up with everything! And I can imagine that, if you don’t feel great, it’s hard to get motivated. I want to help you stay as healthy and independent as possible. Can we go through your medications and the doctor’s instructions together so I understand where things stand? I’ve noticed you aren’t getting much exercise. I can do it with you, and we can listen to music!”
Observe their daily routine before you talk to them about it, and identify your specific concerns. Then present viable supportive options that can help them with their daily living and any additional tasks doctors and therapists have ordered. They may be more open to professional assistance than family help with certain things.
If you want to discuss your loved one’s future wishes for the end of their life:
“My friend told me she had a conversation with her parents about their end-of-life wishes. Can we set aside some time just the two of us, or with your doctor, or whomever you wish to talk through what matters most to you and what you’d like me to do?”
Be prepared with specific questions about end-of-life planning. You might also approach this as a paperwork task, working out advance directives and estate planning.
If you’re worried about their safety in their home:
“I love that you’re comfortable here, and I want you to be able to stay that way. Have you noticed any safety issues we need to address? AARP has a free HomeFit Guide with suggestions for every room in the house — would you be open to reviewing it together and walking through the house to spot easy changes to make it more comfortable going forward? Then we can decide what to tackle first.”
Stay with them for a few days to get a real sense of the situation. If you believe they need more support or care at home, be ready to explain who could help and how the costs could be covered. If you believe they should move, investigate housing options, costs and locations, as well as activities, meals and transportation offered there.
If you need to talk with siblings about helping with caregiving tasks and costs for your parents:
“I want to make sure Mom and Dad get what they need and have the best possible care. Their budget won’t cover it all. I know we all have financial limitations; none of us can carry it alone. Can we sit down as a family and figure out how we’ll share the costs and the caregiving tasks?”
If possible, come to the conversation with clear information about your parents’ budget and other resources, a list of current needs (and anticipated future ones) and the type of support they will require. Gather examples of the cost of various types of care in your area. Avoid accusations or putting anyone on the defensive. If needed, ask an eldercare mediator or geriatric care manager/aging life care expert to facilitate the conversation.
The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.
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