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March 24, 2005
These extracts from "How to
Say It to Seniors" by David
Solie concern the sort of
answers you sometimes get
when talking with elders,
and how best to handle them.
The extracts are reproduced
here with the author's
permission.
Interpreting the Answers
Now that we're more savvy
about striking the right
tone when we ask questions
of senior adults, how do we
evaluate the answers we
hear? Here are some things
to listen for as we measure
and note responses.
The Warm-up Answer
Many times our first
attempts to bring up
sensitive topics only
produce what I call warm-up
answers. These are responses
that don't invite further
conversation. Our best
strategy is to drop the
subject, because the older
person has a clear
resistance to it at that
particular moment. But
remember that the person is
processing other possible
answers constantly. Bring
the subject up again at a
later time and see if the
person's answer is
different. Don't fight the
warm-up; if we do, we'll
leave the person no room to
change his or her mind later
on. He'll have no choice but
to defend the warm-up answer
to the grave, even if his
thinking changes. When the
person arrives at other
answers, and we pick up on
and give the right verbal
and nonverbal signals that
say we are available to
listen without judging, the
elderly person will provide
clues to more meaningful
answers.
Warm-up answers are
frequently heard after
treatment is indicated for a
serious medical condition. A
friend of mine told me the
story of her elderly father
who had survived a quadruple
bypass several years ago.
After a recent check-up, his
internist reported that his
PSA level was high and
suggested a biopsy of his
prostate. The father
refused, and when my friend
and her sister tried to
persuade him to "follow
doctor's orders," he became
adamant about not wanting
any treatment whatsoever.
It's natural for a daughter,
who loves her father, to
want to get the most
aggressive treatment
available, but consider this
situation from his
perspective: The father's
initial refusal of treatment
could be a warm-up answer
until he can process the
fact that, at age 81, he
might have cancer as well as
heart disease. He may change
his mind and be open to
another discussion at a
later time. Or, his warm-up
answer might be his final
thought on the matter: his
astute judgment call about
how he'd like to spend his
remaining years.
How to Say It:
"Dad, making this kind of
decision is not easy. The
most important thing is:
What would give you the best
quality of life for the
greatest number of years? We
will go along and support
what you feel is right for
you."
"Treatment options are
improving all the time.
Shall we look at some
information on one of those
Internet medical sites?"
"If that is what you want to
do for now, that's what
we'll do for now. Just
remember that, as you used
to tell me, nothing is cut
in stone. If you change your
mind tomorrow, then we will
help you make that change.
We're here for you."
The Non-answer
We ask a question and get
some sort of response, but
achieve no real meeting of
the minds or resolution to
the matter. We may wonder
whether the older person
heard us or understood what
we were asking. After
seeking assurance that we
were understood, we need to
interpret such a response as
a signal that the person
does not wish to discuss the
matter further.
How to Say It:
"Mrs. Jones, let me clarify
my question. Are you
comfortable with this
upcoming procedure?"
"Aunt Em, just reassure me
that you are set for the
weekend."
If we still hear
noncommittal responses, we
might assume that something
of significance is being
processed underneath the
surface and we must use our
legacy coaching skills to
find out what it is.
The Angry Answer
We think we've asked a
benign question ("Mom, did
you take your medications
today?" "Dad, when do you
want to schedule that
follow-up appointment?") and
we get an explosive
response. While we might
expect this type of reaction
from a hormone-driven
adolescent, it's quite a
shock to hear it from a
mature person. Is the person
just having a bad day? Being
difficult? Or have we
brushed up against some
sensitive developmental
nerves?
An unexpectedly explosive
reaction to a routine
question signals that the
matter is under intense
scrutiny in the person's
life review. The person may
not be reacting to the
content of the question we
asked. We may have intruded
on what the person considers
to be a private matter. What
we need to do is back off,
at least for the time being,
and let the person bring the
subject up again later.
How to Say It:
"Sorry, Mom. I'll leave
those details up to your
good judgment."
"Dad, I'm surprised by your
reaction, but I accept it. I
know you'll make the call
when you feel the time is
right."
Allowing senior adults to
have some breathing room to
calm down and collect their
thoughts, to figure out for
themselves why the question
triggered such emotion, is
probably our best strategy.
When they figure it out,
they'll either dismiss such
questions as trivial and not
worthy of more discussion,
or bring up the subject in
another context. By backing
off, we place control with
them - where it belongs!
Source
David Solie, MS, PA. How to
Say It to Seniors: Closing
the Communications Gap with
our Elders. (2004) Prentice
Hall Press, New York. This
article was published with
permission from
www.healthandage.com
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