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Difficult conversations: How to start a conversation about care

How to start a conversation about care

We understand that starting to think and discuss the topic of care with your loved one can be a daunting process for both of you, especially if they are finding it hard to recognise that a little extra support may be needed.

Whether you’re a caregiver for your partner, parent or friend and you’re finding it difficult to support them on top of your other commitments, or your loved one is becoming increasingly frail and you’re worried for their safety at home on their own, it might be time to consider the different care options that are available. That way, you have the peace of mind that your loved one has the help they need so that you can continue to enjoy your time together as a family.

But where do you start? How do you begin the conversation? And what do you do if your opinions clash or your loved one doesn’t even want to consider care as an option?

This page aims to provide you with the information and support to guide you through these conversations with your loved one, highlighting common obstacles you may encounter when approaching the discussion of care and how to overcome them.

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Preparing for the conversation

Approaching the topic of care can be unnerving for all involved, but the most important thing to remember is to have open channels of communication. From the very beginning of the conversation, try to make it clear that it is a two-way discussion and you only have their best interests at heart. It’s important to make sure that your loved one knows that any support or care is completely their decision, and you are simply informing them of the options that are available because you care about their wellbeing and you only want the best for them.

  • What are the pros and cons of care?

In every decision we make in life there are positives and negatives, and if your loved one isn’t warming to the idea of care, you may find it challenging to help them focus on the benefits it can bring. That’s why it’s important to be informed about the different care options available so that you can identify these potential challenges and help your loved one to overcome them.

  • Choose the right time and place

It’s important to consider the timing of your conversation so your loved one is more likely to be receptive and cooperative. Try and find a time where you’ll be able to talk about their concerns without feeling rushed and when you’re both in the right frame of mind. Try to allow as much time as possible for you both to express your views and discuss the options available.

  • Reach out for advice

If you’re unsure about approaching the topic of care and you’re not quite sure where to start, don’t be afraid to reach out for advice. You might find comfort in confiding in another member of the family or a close friend who may have had a similar experience themselves. They may even be willing to talk through some possible scenarios with you to help you prepare for any eventuality of the conversation.

  • Plan your opening line

As one of the closest people to them, you will be one of the first people to notice if your loved one is starting to find difficulties in tasks that they have not had trouble with before; so you could start that conversation by gently asking how they are managing in that area. For example, if you have noticed that your loved one’s mobility is a little slower or

their house isn’t as clean as it usually is, you could start the conversation with: “How are you getting on with the housework? It’s a big space to manage on your own, are you finding it okay?” Try not to dive straight into the conversation with opinions or instant solutions such as “I think you need to do this”, as this could create a barrier in the conversation before it has even begun.

Raising the subject

When the time comes to approach the subject of additional help and support for your loved one, it can often be an upsetting and difficult time for both of you. Planning for the conversation in advance gives you the opportunity to have all the information and resources available to you should your loved one ask for them.

Perhaps the most important things to remember are to ensure that you remain calm throughout the conversation and involve your loved one as much as possible, but there are also a number of other things to consider throughout the discussion too. Try to remain impartial at this stage to reassure them that the decision is in their hands, and you are only here to help.

  • Tone of voice

When it comes to a sensitive discussion with your loved one, it’s not always about the words you choose – but it’s how you say them that can have the biggest emotional impact. Try to use a gentle and encouraging tone in your discussion and take the time to explain your reasons why you feel that having some extra support might be something worth looking into.

  • Listen to them

Communication is more than just talking; maintaining eye contact and keeping your body language open and relaxed will show your loved one that you’re listening to them too. If they are upset or finding the conversation difficult, allow them to speak for as long as they need to and pay close attention to what they’re saying. If you can identify what they’re concerned about, you can use your previous research to advise them of the options available to them and find a solution together.

  • Take the ‘care’ away

Finding the right words to say can be difficult, especially if your loved one is resistant to the idea of care. Instead of using the words ‘care’ and ‘carer’, try using words like ‘support’, ‘personal assistant’ and ‘companion’. You may find that your loved one is more open to the idea of additional help if they feel there are just having ‘some help around the house’ instead of being ‘cared for’.

  • Give them reassurance and time

Throughout the conversation, reassure your loved one that a carer will allow them to do more of the things that they love, so they can keep their independence without having to worry about the small things. But if your loved one becomes upset or is unsure of whether or not they feel ready to accept care, you may want to postpone the conversation to give them time to think things through.

Following up

It’s likely that your conversation about care will not just be a one-time discussion, but you will probably find that you have lots of little conversations over time. Talking about care is a very complex and emotional time for both of you, but if you involve your loved one in every step of the process, they may feel more in control of the situation and subsequently feel more comfortable and open to the idea of extra support.

  • Have patience

Patience is key, especially if your loved one is living with a progressive condition such as dementia. Time can be your greatest asset; making a decision around care can take weeks, months or even a year or two, but it allows you to take the time to guide your loved one and deal with every situation as it comes up, helping them to approach the topic of care at a pace they’re comfortable with.

  • Bring support in gradually

You may have noticed that there is an element of daily living that your loved one is finding more difficult or doesn’t enjoy doing as much, such as preparing their meals or sorting the laundry. In this instance, what is the least amount of help you can arrange? Short visits from a carer, PA or support worker once or twice a week are a really effective way to help your loved one get used to the idea of having some extra support, without becoming overwhelmed by a drastic change of lifestyle.

  • Offer temporary support

If your loved one is considering care, but they’re not sure how much help they want or need, introducing care on a short-term basis can be a good way to help them gauge the level of care that is right for them. Alternatively, if you’re due to go away and you’re concerned about your loved one being left alone, respite care on a live-in or visiting basis can be put in place just so that they can have a friendly face to either stay in their home with them or pop in every now and again for a cup of tea and a chat.

Overcoming common challenges

  • Refusing to talk

Possible reasons why:

If your loved one refuses to talk to you about their care needs, try not to take it to heart. It may be that they would feel more comfortable with talking to someone who is not as close to the situation – perhaps a friend or healthcare professional. If the care is for someone who once looked after you, such as a parent or grandparent, it could be difficult for them to get used to this change in relationship where you are now looking after them.

Possible solution:

If your loved one doesn’t want to talk to you about their care or if you feel that you’re not the right person to have this conversation with them – it’s okay, it doesn’t mean you can’t help them. Gently ask them if there’s someone you can help them reach out to or consider asking for professional advice from someone who deals with these situations on a regular basis, such as a GP.

  • Refusing to accept their condition

Possible reasons why:

Whether your loved one has recently been diagnosed with a progressive condition or they are simply becoming more frail as they grow older, it can be difficult for them to accept the changes that they are facing in their lives. Acceptance makes it real, so your loved one may find it easier to cope with these changes by overlooking them completely.

Possible solution:

First and foremost, have patience. Understanding the changes that they are going through can be difficult for your loved one to come to terms with. Empathise with them and reassure them that you are here to help them find the right support so that they can carry on as they were, just with a little help along the way.

  • Insisting they can manage on their own

Possible reasons why:

If your loved one is fiercely independent, accepting the need for additional support will, understandably, be very difficult for them. It may be that they don’t recognise how their health or mobility has deteriorated over time, or perhaps they don’t realise the extent or flexibility of the support that is available to them.

Possible solution:

Ask your loved one if there is anything they’re finding more difficult than usual, or use examples of situations that you’ve noticed where they may benefit from some additional support. For example, if you have noticed that their home isn’t as clean as it usually is, advise them that there are services available to help them around the house.

  • Reacting angrily or becoming confused

Possible reasons why:

If your loved one is reacting angrily to the conversation or they are becoming confused, they could be showing signs of the early stages of dementia. They may be having periods of ‘lucid moments’ where they are aware that something isn’t quite right, but they don’t understand what’s happening – which is causing them to feel frustrated.

Possible solution:

Patience is paramount. If your loved one is experiencing the early stages of dementia it will be a very difficult and confusing time for them. Reassure them that you are here for them and gently encourage them to see a GP – just to check that everything’s okay.

How we can help with difficult conversations

We understand that accepting the need for care is a big decision for all involved and it can often take time to come to an agreement that everybody is comfortable with. But it’s important to remember that, unless there is immediate risk, everybody has the right to live their life how they choose. No matter how much we love and care about someone, if they decide they’re not ready to accept care, it’s important to stand by them in that decision. We understand it’s not easy for you or your loved one to have these conversations, that’s why we’re here to help.

For over 30 years, we’ve been supporting thousands of families across England and Wales with having these conversations with their loved ones, offering expert guidance and support to help them come to a solution that both they and their family are happy with.

Built on a foundation of family values, we understand the importance of finding the right support for your loved one, which is why our services extend beyond just the practicalities of care; we’re here to help you every step of the way – starting with the conversation.

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Page reviewed by Sarika Dhillon, Regional Care Director on January 6, 2020

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