An estimated 65.7 million Americans have served as unpaid family caregivers. A typical caregiver loses $303,880 in salary, Social Security and pension due to taking time off for caregiving. As social, economic and practical resources are stretched, the burden of care falls on the families.

When a crisis hits, such as a fall, acute infection, or stroke, or when a chronic situation slowly dips below a functional level, panic sets in and difficult choices are often forced upon us by health care professionals. More often than not, families and patients alike feel lost and unprepared. So why are families not talking about this?

As a social worker, I have seen families, time and time again, fall into a pit of despair as aging crises hit. Rapid and difficult decisions must be made, and families bear the financial and emotional weight of these choices.

There are, however, simple guidelines that you and your family can follow now, proactively, that can help to ease the role transition from adult child to caregiver, from parent to dependent, from partner to provider.

10 Tips for Successful Family Conversations

  1. Hold your breath and jump! Take a chance and start a conversation with your parents or your adult children about health, illness and aging. Use a story in the media, a book, or a television/movie that you recently saw as an introduction. Let your family read/watch the material and talk to them about it a few days later. This will give you a pulse on how open everyone is to these discussions.
  2. Personal = meaningful. If you have a friend or another family member that experienced an acute health crisis recently, share this story with your parent/adult child. Discuss the ways in which this friend's preparation, or lack of preparation, impacted the family's coping and overall functioning. Wait and see if your parent/adult child offers to discuss your own family situation.
  3. Ask sincere questions. Create discussions that enable your parent/adult child to look at their life and the meaning that it has to them. This life review cultivates the relationships within the family, which can help to increase trust and open the doors for communication. Ask questions like, "What has been your most meaningful experience? What are you most proud of? Tell me about the day I was born? What is it like to watch me be a parent? The more you know somebody, the more confident you will be to assist, support and help them make decisions.
  4. Hear their story. Silence is an undervalued communication tool. Do not forget to really listen to your parent/adult child's story. If you interrupt or try to immediately interpret what your parent/adult child is saying, it can create communication barriers. Make sure to listen and then ask follow up questions to be sure you understand fully what was said.
  5. Be conscious of terminology. The words we use to communicate give us insight into how somebody processes information. Do they use the word death? Die? Deceased? Passed on? Met their maker? Respect that terminology and the distance it may or may not create for that person and that topic. Allow your parent/adult child to protect him or herself with language.
  6. Take your time. If your family is not used to discussing difficult topics openly and directly, things cannot change overnight. Use the aforementioned tips and bite off small bits. Give the challenging topics time to marinate with each member of the family. Follow up every few months until you are satisfied with the depth of conversation.
  7. Remember your history. Each family has their own set of unique communication styles, personal history, cultural influences, generational influences, gender influences, role expectations, etc. Work with what you have. A square peg will not fit in a round hole.
  8. Be honest. Being dishonest will not get your family to a "non-crisis" mode. In fact, if we are not clear about our choices, more confusion and family dysfunction will ensue.
  9. Legal, legal, legal. Discussions are fantastic, and absolutely help with facilitating and following through on your wishes. However, it is necessary to complete the legal paperwork to ensure that everyone's wishes are met. You can always, at the minimum, just inform your parent/adult child that the paperwork is complete, and to contact the notary or attorney who assisted you in the case of an emergency.
  10. Edit, copy, cut and paste. Conversations about future plans with aging family members may not work the first time or the tenth time. Hang in there. Do some editing and try again.

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