Moyan Brenn/Flickr
Source: Moyan Brenn/Flickr

This post kicks off a series on how to have difficult conversations with aging parents.

                  Over the many years of talking with older adults and their middle aged children (and as supported by current research), I have learned that there are a number of predictable areas which often come up as challenges: driving, financial autonomy, “new” relationships for older single parents, independent living, serious health problems, and dealing with end of life.  In writing about these issues, I will focus on why these conversations are so difficult, how and when to initiate them, and ways to talk about them while respecting the rights of all parties. 

Driving can be a touchy subject for older adults. It represents so many things: freedom, spontaneity, and independence, and as one patient said, “the right to do whatever the hell we’d like, and with nobody’s damn permission.” For many older adults, driving means they can still do the things they’d like to do without depending on others. For these reasons, it is understandable why the children of older adults would want to avoid the subject. Beginning a dialogue before there is an actual safety threat to them or to others, such as a major accident, is the right thing to do. While driving may be less of an issue for those who live in large cities that offer outstanding public transportation, driving is something that is considered a right by older parents and can be a highly contentious subject.

All that being said, you might not realize there is a problem until things occur. The most usual problematic behaviors include traffic tickets, a few fender-benders, or Mom or Dad driving too fast or too slow. Your parent might also have health issues that make driving a concern. For example: uncontrolled diabetes, the use of pain or other medications that compromise reflexes, and night vision difficulties. Signs of memory loss or early Alzheimer’s may also be a worry. It is one thing when older adults lose their keys, but it’s a serious problem when they can’t remember how to put the keys into the ignition and start the car. Try to get a sense of what the issues are and how serious they are before beginning the conversation.  

There are a number of ways to approach Mom or Dad when beginning a discussion. Let me start by giving examples of what probably won’t work.

NOTHING BUT THE FACTS:

So Dad, Rose and I have noticed that you’ve gotten into a few minor accidents lately and of course, there was the ticket for going too slow and slowing traffic. We’ve decided that it’s time for you to stop driving. We’ll take you to your medical appointments. You can have food delivered. Most of your friends are within walking distance, and the subways, trolley, and buses are great.

How do you think that will go over? Not very well, I suspect.  What’s wrong with that approach? Almost everything. Even though the factoids might be correct, I suspect that Dad (or Mom) would bristle at the notion that you have “decided” what’s best for them, and will push back—no chance for a dialogue here.

Another approach not likely to lead to any effective resolution might be labeled,

BEATING AROUND THE BUSH:

“Hi, Dad.”

“Hi, Son.”

“So how’s the old car running?”

“Just fine. How’s that new sports car of yours? When can I take it for a drive?”

“Well, actually, that’s what I wanted to talk with you about.”

“About when I can take your car out for a drive?”

“Not exactly.”

“Well, any time is fine for me.”

The hope here is that Mom or Dad will take the hint and begin the conversation about driving competence. It won’t work. They either haven’t a clue about what you really want to talk about or won’t take the hint.

A more effective way to begin this conversation comes from the research on Motivational Interviewing and the books such as Humble Inquiry and Appreciative Inquiry. The starting points of these approaches is creating the framework for a dialogue by inviting but not demanding that a conversation occur,

“You know, Mom, I’ve been a little worried about something. Would it be all right if we were to have a talk about your driving?...We know there are a lot of upsides for you to continue driving.”

“You bet there are. I’m my own boss.”  

“What else?”

“Well, it keeps me from having to depend upon you and Gene to take us around.”

“Are there any downsides about your continuing to drive?”

“Well, I almost did run over the dog, and _______, and ___________, and __________.”

By first acknowledging the payoffs for driving, it makes it easier for your Mom or Dad to admit to some problems. While not a guarantee, it has been well documented that this type of approach sets the stage for a conversation as opposed to a confrontation.

If changes are going to be initiated, they need to be tailored to the individual needs of the older adult, and what makes the most sense. For example, Mom and Dad agree to drive within a restricted perimeter from their home, that they drive only during daylight hours, or that driving on freeways is off limits. It doesn’t have to be all or nothing, and solutions will depend on your parent’s needs, circumstances, and abilities.

Another way to explore creative solutions is to bring up options that promote continued independence if the older adult agrees to not drive. Recently, I met a friend who is now in her 90’s. When the subject of what she was doing came up she rattled off a series of activities she was engaged in, and then proudly announced, “I had to stop driving, but that doesn’t stop me from going to my meetings and classes. Now, I take Uber everywhere.” Companies like Uber, Lyft, and ride services for seniors make it possible for older adults to not be stuck or have to wait for friends and family in order to get around. Knowing that these options are out there may help to lessen the apprehension about starting the conversation with Mom or Dad. One recommendation is that this initial conversation be private and have a limited number of participants. Having all of the children there might make your parents feel they’re being ganged up on, and make this discussion more difficult.

Conversations with older parents about driving can be taxing, frustrating, and anxiety-producing because driving can represent critical parts of our parent’s lives: their connections with friends, their community, their independence, their livelihood, their purpose, and even the ability to care for themselves without help. Keep in mind, that the issue of driving is not likely to be resolved in one meeting. A series of conversation might be needed. It will take courage, openness, and some vulnerability from every single person involved in order to engage this topic in a frank and honest way.

When are you ready to begin? 

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