Excerpt from "How to Say It to Seniors"Chapter 1
Different Missions, Different Agendas
How the Aging Process Affects Communication
The Driving Test
I was sitting next to an elderly couple and their 50-something son early one Sunday morning in a quiet café. From the moment they were seated it was clear the son was irritated with his parents. He tried to hurry their breakfast order, balked at his father's attempt to make small talk with the server, and brushed off his mother's suggestions to let his father "have some fun." His mood made it clear that this family gathering was not about fun. Once they placed their food order, he launched into a discussion of a "family problem" involving his father.
The father, who appeared to be in his eighties, was scheduled to take a written driving test in order to renew his license. The problem, from the son's perspective, was his father's inadequate preparation for the test. The father tried to explain what he was doing to prepare by offering his ideas on test-taking in general. He even wanted to discuss how much the "rules of the road" had changed since he was a boy. His son would have no part of that discussion. He hammered home the message that his dad "just didn't get it." He repeatedly interrupted his parents to point out the lameness of the content of their conversation. "Here is what you need to know," the son insisted, "to pass the test."
Sitting there and listening to this exchange I heard two distinct voices. From the son I heard a steady flow of anxiety, scolding, sarcasm, impatience, and lecturing, tinged with frustration and anger. From the parents I heard embarrassment, puzzlement, shame, guilt, and inadequacy, also fraught with frustration and anger. Their collective resentment soon filled the room. Their food got cold. The bill came none too soon.
Most people assume that getting old is just more of the same. Aging is seen as being an adult, just older. This is what the son saw when he looked at his parents: older versions of the people they had always been. Somehow in the aging process they had become less effective at organizing and managing their daily lives.
His job was to help them overcome these deficiencies so they could stay on task. He needed to keep them focused and help them get things done. It annoyed him that his parents seemed unaware of how far they had fallen off the pace. What about a simple written test did the old man not understand? Why did preparing for this test have to be so complicated an issue between them?
It was clear to me that the son's questions to his father were not getting him near his goal of facilitating the test-taking. So what if the son's assumption—that his father "just didn't get it"—was wrong? What if the aging process demands that older adults undertake a completely different tack in their lives that is totally foreign to anyone who is not yet old? What if the elderly are on a mission that is not only far more complicated than the son appreciates, but would also prove to be the most significant of their lives? If we assume these questions are worth asking, then a clear gap exists between the middle-aged son's assumptions about what's important to his aging father and what his father considers to be important—about test-taking as well as life's bigger issues. This gap in the son's knowledge about the real mission of aging is what may have been causing their communication difficulties. If the son wanted to achieve meaningful dialogue and change a chronic pattern of conflict with his parents, he would need to know more about their mission, and how it differs from his middle-age concerns.
The Geriatric Gap: The Secret Mission of Older Adults
On any day in any major city in this country, we can find dozens of courses on child development, but not a single course on geriatric development. In fact, the term "geriatric development" strikes many of us as an oxymoron, a contradiction in terms. What kind of "development" could possibly be taking place in elderly people, whom we observe to be in a state of general decline: slowing down, losing their faculties, turning inward, and becoming increasingly set in their ways and stuck in the past? Why do we have nearly infinite patience for a two-year-old's communication challenges—sometimes in the form of a tantrum—and almost no patience with a 79-year-old widow when she quietly changes her mind about a well-conceived plan to revise her financial statements, or our elderly relatives when they start repeating a story we've heard many times? Are we being age-ist? Are we engaging in a double standard—patient with our difficult children, impatient with "difficult" older adults? If the answer is yes, is something else at work? Do we lack key information about the aging process and how it affects our elders? If we had such information, would it help us appreciate what they're going through and enhance our ability to communicate with them?
To answer these questions, we need to address what I call a "geriatric gap" in our understanding of the way personality develops throughout our lives, and specifically how this lack of knowledge affects our interactions with senior adults. After World War II, when a lot of children were born, parents became more child-focused than their parents had been. In the post-war, baby-boom years, there was a need for these parents to understand their children and how they developed. The goal was to become better at nurturing this younger generation. Our parents took our developmental mission to heart. They bought millions of copies of Dr. Spock's Baby and Child Care. Beyond Dr. Spock, theories of personality development set forth by Piaget and Erikson, among others, once the province of academics, were popularized and consumed by this child-focused generation. Certain terms emerged as part of the vernacular. Our parents may have referred to the "terrible twos" and understood the reasons for temper tantrums. "Identity crisis," a popular term to describe the conflicts of adolescence, is one we may have used to describe ourselves when we started to mature.
This cultural understanding of childhood was not always so. Back when "children should be seen and not heard" was the generally accepted parenting model, there was less patience for childhood's unique developmental agendas, in part because earning a living during the Depression, when our parents were young, was so difficult. But when more children showed up in the baby boom years after WWII, that model was gradually replaced by a more child-friendly understanding of the underlying psychological conflicts every child works through on his or her way to maturity. The stages of development we see in children were proposed, tested, and re-tested, and found to be helpful tools in raising healthy, well adjusted kids.
While personality development models in children have been well described, we are still in the Dark Ages about how such models apply to middle-aged and older adults. We use some terms to describe aging beyond the early adult years; for example, the meanings of "midlife crisis" and "empty-nest syndrome" are generally understood in our culture. But we have no such terms or models to apply to the elderly. In fact, we wonder if such models exist for this age group, because what common experiences could older adults be dealing with? They've all led such different lives and strike us as a varied bunch. We think we know how to be successful in raising children, and we have a pretty good idea of what motivates our middle-age personalities, but we've never been old ourselves and don't know what that experience feels like. We have difficulties communicating with older adults, but each person seems to have different issues that are expressed in various ways.
Is there a set of common issues that motivate senior adults? If so, what are these issues and can we learn to appreciate them? If we appreciate them, would we be better able to communicate with and nurture our parents and others of their generation as they age? What are the developmental tasks associated with getting old and how can knowledge of them enhance our ability to communicate with this age group?
Personality Development: Growth through "Crisis"
To answer these questions, we need to understand the basics of personality development—how we acquire the tools needed to manage the journey from infancy to adulthood and into old age. If we understand this process, we can appreciate what motivates the elderly, and why we sometimes clash with them. Our newfound knowledge can help us close the geriatric gap in our understanding of older adults because we can begin to realize that the behavior we see as "diminished" in elderly parents, clients, and friends actually exists to do a very specific developmental job.
A word of caution: Describing anyone from a developmental perspective is interesting and useful, but this is only one aspect of personality—a tool that may help us improve our ability to communicate. Those who regularly interact with elderly parents or clients will find this information useful in understanding why the elderly tend to act and react as they do.
In each stage of life, so the theory of personality development goes, an individual must deal with a pair of tasks that conflict. This conflict motivates our behavior, even though we aren't aware of it. Erik Erikson, a towering figure in the field of psychoanalysis and human development, referred to these conflicting tasks as "crises" that we must resolve in order to move forward to the next stage of our development. If we don't resolve the key issues at each stage, we may get stuck and be considered immature by our peers.
In the case of the elderly, their attempts to resolve their developmental "crisis" propel them backward, not forward, to reflect on what their lives have meant—to themselves, their loved ones, and the world at large. When we observe the ways senior adults sometimes communicate—by repeating stories, or fretting about details, or forgetting things—we may think that they're becoming frail or losing their grip. Nothing is further from the truth. In fact, this communication style may indicate that seniors are responding to their developmental tasks (also called drivers, or motivators) in a compelling and urgent way. Why the urgency? If they are able to respond to their developmental mandate and resolve their conflict, they will be remembered for their time here on earth and cherished by succeeding generations. If not, they fear their lives will fade away and be forgotten.
The Two-Year-Old's Crisis
Let's look at the developmental crisis of a two-year-old, who needs mom but also needs to begin the long process of separating from her and developing an independent identity. These two needs are contradictory and produce a conflict that the child finds difficult to resolve. Note that children don't choose to deal with these conflicting needs; they are not even aware of them. Sometimes, while trying to resolve the tricky conflict—needing mom and needing to be separate from mom—children balk or throw a tantrum, which is a perfect expression of the difficulty of resolving the conflict. Only by having a tantrum (which expresses the need for independence) and also having mom there (to offer comfort and manage the crisis) can the child resolve it and toddle off to the next developmental stage, which has its own set of conflicts that drive the child's behavior.
How do parents respond to two-year-olds having tantrums? We manage this task as best we can—giving them space, love, guidance, and understanding. One thing we learn not to do is to punish children for this behavior, because experts tell us that doing so could actually delay achievement of the independence children are struggling to attain.
The Teenager's Crisis
Teenagers have similar developmental drivers: needing independence from parents ("Get out of my face!") while preserving parental protection ("May I borrow $20?"). Though more verbal than two-year-olds, teens find resolving the conflict between their developmental drivers just as difficult and do so with equally disruptive behavior. Instead of throwing tantrums, however, they might totally withdraw from their parents, or lecture them, or engage in risky behavior that causes us to doubt their sanity.
How do parents help teenagers resolve their developmental crisis? Much the same way we respond to two-year-olds, giving them patience, guidance, and space to take the risks that allow them to learn and mature from those experiences.
The Adult's Crisis
What are the developmental tasks of adulthood? In early adulthood, we experience a crisis between our newly found independence and a need to develop intimacy with others, or a significant other. Ironically, just as we achieve our lifelong dream to be independent, we begin to look for a partner with whom we will give up some of that independence. Many young adults use the aforementioned term "identity crisis" to describe the conflict they feel, but most of us work through this crisis, come to terms with our independence and our urge to merge, and move into the next developmental stage, that of middle adulthood.
In middle adulthood, having resolved the conflict between achieving independence and giving some of it up, we begin to feel we're at the peak of our game. Because we have acquired all the confidence-building experience we think we need, we feel powerful, independent, and in control of our lives. Yet at this stage, we are also pulled in different directions: still raising children and—because people are living longer than they did in previous generations—sometimes taking care of elderly parents. Just as we arrive at our performance peak, ready to go all out for our careers or other personal interests, we begin to feel the conflicting need to give something back to other generations. Erikson calls middle adulthood the time of life when we are "generational," that is, we want to express our strengths solely for personal gain, yet also feel a conflicting need to use our power to nurture others and contribute to society.
How do we resolve this conflict? Some of us never do. Artists, the proverbial mad scientists, and workaholics of every stripe focus their energies and creativity exclusively on themselves and ignore the conflicting driver that tells them to nurture other generations. But most of us in this middle-adult stage realize that despite our ability to soar to new heights, we must also be rooted in society. Therefore we focus some of our energy in ways that contribute to something beyond ourselves: raising our children, volunteering for community organizations, and the like. If we do not address this conflict—find balance in our lives—we fear we'll arrive at the end of life alone, with our energies spent, and be unable to cope with the demands of a long and difficult old age.
The resolution of early adulthood's developmental drivers is usually a marriage, a surrender of two independent lives to create one solid union. The resolution of the middle adulthood drivers—the conflict between ego gratification and civic duty—is an investment in the future, a marriage to something bigger than ourselves. Yet, these two developmental pushes of adulthood have one thing in common: a sense of control over our lives and destinies that we take for granted. Sure, some things will happen we can't control: fate intervenes or we have a run of bad luck. The person we want to marry marries someone else. A couple of career breaks don't go our way. But we are confident of our abilities and generally get to select where we want to go: We marry someone else, embark on another career path, decide when to become parents, and choose what civic duties will engage us.
Imagine our discomfort when we begin to realize that these powerful feelings don't last. Although we haven't personally experienced old age, we observe that our elders no longer seem focused on the future; they want to dwell primarily on the past. This powerful feeling of middle adulthood has waned in them, and we conclude it might not exist in later years. We see that older people are no longer at the top of their game—don't even seem concerned about it—so we assume they are in decline.
But could something else be replacing these feelings of peak power in the psyches of our elders? If so, what is driving the developmental agendas of people at this stage of life?
The "Secret Mission" of Older Adults
What we as a culture have failed to recognize in the theories about personality development is, simply, that it is a lifelong event: These crises continue well into old age. We have become quite good at understanding the personality drivers of children and younger adults, however we often fail to appreciate what happens when we get old. Why? We've all been two years old, and most of us have raised children who are traveling through various stages on the road to adulthood. But no middle-aged person knows how it feels to be 70. Without first-hand experience, how can we effectively nurture the elderly? We can't possibly provide them with support for their end-of-life tasks if we don't know what those tasks are.
As a culture, we've been suckered into thinking that the deterioration we see in senior adults is the common experience of this age group. So what could possibly be driving them forward developmentally? We look at older adults, interact with them regularly, do our best to communicate with them, and all we sense from them is a desire to reflect backward, not forward, in their thinking. We notice they can sometimes be as tempermental as two-year-olds or teenagers, with behavior that can be just as irritating. What is going on that makes them so difficult?
If personality development is a lifelong process, then at the end of life, the elderly face a developmental conflict they have trouble expressing but must resolve. Seniors' developmental tasks compel them to maintain control over their lives in the face of almost daily losses, and simultaneously to discover their legacy, or that which will live on after them. I describe this conflict as needing to hang on tight while also needing to let go and discover the meaning of their lives. These tasks are so important, and have such an impact on our daily interactions with older adults, that we examine them in detail in the next two chapters.
Trying to resolve this conflict sometimes produces a "difficult" communication style. The elderly sometimes wander from subject to subject, repeat stories we've heard dozens of times, postpone decisions, go off on tangents, or describe something in endless detail. We look in depth at these unique communication styles—and how to respond to them—in Chapter 5.
Such verbal behavior can be frustrating to us, because we haven't learned to appreciate the tasks on their agendas. After all, we're at the top of our game. We need to load up the fax machine, whip out that Palm Pilot, make endless lists, and cross off as many items as possible every single day. That process makes the middle aged feel powerful and in control, as indeed we are. When we encounter these older adults, who move at a snail's pace, we get frustrated and blame them for their supposed infirmities.
That frustration is the crux of our difficulties with senior adults. I call it the clash of two different age-based agendas. We need to slay those dragons and achieve as much as we can, but elderly people have very different motivators. Control, as we'll discuss in the next chapter, is slipping from their grasp daily, as their health fails and their peer group fades away. Control isn't an issue for the middle aged—we have it, we know it, and we use it—but for a 70-year-old in failing health, it's a huge issue, because when it begins to slip away, many elderly people feel the need to hang on to everything they can. Rather than see old people as diminished, we need to understand that their drivers do a different job: resolve the conflict between the need for control and the need for reflection in order to discover their legacy.
This conflict between hanging on and letting go produces a communication style that we see as diminished or difficult, but the way our elders communicate contains clues to the urgency they feel in trying to resolve these items on their agendas. Only by understanding these behaviors can we begin to improve our relationships with this generation and help them complete their compelling end-of-life tasks.
Facilitating the Crisis
Now that we understand the dynamics of aging in a totally different way, let's again consider the breakfast meeting that opened this chapter. The son, with his middle age developmental agenda, was feeling powerful and in control. His experience behind the wheel and in renewing his driver license several times helped him focus the discussion with his father about how to approach the exam. Yet he wasn't connecting with the older man's concerns.
Why? Because his parents were responding to their own developmental drivers that were steering them in a different direction. They wanted to approach the matter their way, with the test itself taking a back seat to their memories of what driving has meant to them throughout the years. The result: a complete communication breakdown.
How different would the discussion have been had their son realized that passing the written test was not the issue for these 80-something parents. What was important to them was remaining in control of the process, pass or fail. Had the son known about these developmental tasks, he might have responded this way:
"Tell me, Dad, how have the ‘rules of the road' changed since you first got your license?"
I guarantee he would have had a more meaningful and productive conversation with his father if he had.
As we'll see in later chapters, in almost every conversation with an older adult, control and legacy issues rise to the surface. By listening for and responding to those verbal cues, we can bridge this geriatric gap and facilitate their end-of-life tasks. Once we understand this gap and begin to appreciate it, the clash fades away. How? Because we stop fighting our elders for the one thing they will not surrender: the control they need to manage their lives and shape their legacies.