Broaching Sensitive Subjects with Aging Parents
Written by Nancy Sokoler Steiner
Did your parents have “the talk” with you when you were young?
As an adult child of aging parents, now may be time for you to have a
talk with them. And while it won’t involve where babies come from,
the conversation may be equally awkward to initiate.
Ujjwala Dheeriya, MD, Medical Director and Outpatient Physician for Torrance
Memorial Medical Center’s Palliative Care Program, has suggestions
about subjects you may need to broach and how to help make the conversation
less uncomfortable and more productive for all concerned.
Advance Health Care Directives & Future Health Care Planning
One of the most important topics is the advance health care directive,
says Dr. Dheeriya. “Often people do them with their wills and trusts
when they’re younger. Reviewing their health care directives with
your parents should be a routine occurrence, not just when someone gets
An Advance Health Care Directive specifies what kind of medical care you
would want if you developed a serious illness or were near the end of
life and can’t speak for yourself. Specifying your choices in advance
provides instructions to health care professionals, family and friends
and avoids questions that might otherwise arise.
Dr. Dheeriya suggests visiting the website prepareforyourcare.org to facilitate
this process. The website provides free printed materials and videos that
guide users in articulating their choices as they fill out the legal forms.
Older parents should also make plans for long-term care. “Ask, ‘What
is our plan, mom, for when you need help to care for yourself? What can’t
you imagine living with or without if you got sicker?’ It’s
not your plan or my plan but what are WE going to do just in case,”
says Dr. Dheeriya.
Driving can be another sensitive topic. “If you’re having open
and frank discussions with your parents, include driving. Try asking,
‘How do you think you’re doing with driving? Are you feeling
comfortable with it?’ And then follow it up with, ‘Have you
talked about it with your doctor? Do they agree?’ If you have concerns,
ask, ‘Is it okay if I share my concerns with you?’”
For any sensitive topic, Dr. Dheeriya says, “It’s all about
conversational tools. Ask people where they are at for that particular
issue. And then ask if it’s okay to give your opinion. If given
an opinion without asking first, people are more likely to be defensive.
This way, they’re much more likely to hear what you have to say.”
Dr. Dheeriya gives suggestions for initiating the discussion for additional
issues that may arise.
Issue: Depression, Anxiety or Dementia
Conversational strategy: “I’m concerned about you feeling sad.
Is there somebody we can talk to together about that?”
If the parent isn’t aware of a problem, it’s helpful to discuss
the issue in the presence of a medical professional. “I’d
really like to be part of your next primary doctor visit. May I come with
Issue: Isolation or Loneliness
Conversational strategy: “I’d like to help make sure you have
company. How can we do that?”
Offer options such as phone calls, in-person visits, use of technology
or participation in community programs.
Conversational Strategy: “I’ve noticed you have a bruise on
your arm. Did you fall? If you hurt yourself, I’d really like to
This may be another occasion to accompany your parent to his or her medical
Conversational Strategy: “I’ve heard as you get older, you
may have problems getting to the bathroom on time. Is that an issue for
If you’ve seen evidence of a problem, follow up with, “I’ve
Issue: Cutting Back on Food or Medication
Conversational Strategies: “I’m worried you’re not eating
enough. Is there a reason why?” “Do you need any help figuring
out your budget?” “Is there anything you’re not doing
because you think it costs too much?” “Is there anything I
can do to help?”
Issue: Vision or Hearing Loss
Conversational Strategy: “Are you having any trouble with your vision
or hearing? Have they been checked?”
Dr. Dheeriya notes hearing can be overlooked as an underlying cause of
depression and isolation.
She urges adult children to think about their own situations. “If
you’re over age 50, it’s not too soon to start planning for
your 80s,” says Dr. Dheeriya. “You don’t want to burden
your children so make a plan and write it all down now.”