Changing the Conversation

A couple of weeks ago I had posted on my Sonya Barsness Consulting Facebook page the proposed title of a recent presentation:

Let me tell you how I got to this title. When I am out and about and tell people I am a gerontologist, the first question I get is “Where is your practice?” This is because gerontologists have an identity crisis and people frequently think I am a physician. I have more to say on this, but that is for another post. When I explain more about gerontologists and what we do, the next question I get is something along the lines of “Oh, I need to talk to you about my mother. How do I get her to [insert scenario here]?” The scenarios are: How do I get her to move into assisted living, stop living by herself, stop driving, stop wearing heels, accept help, etc. And people are often not too happy with my response, which is “What does your mom want? What is important to her?” This often leaves me awkwardly drinking my glass of wine alone at a party.

Now, I am not diminishing the challenges of these scenarios. These are incredibly hard conversations and decisions. It is emotionally, financially, and socially difficult to actually make these transitions, for all involved. And there are certainly cases in which we might find ourselves making decisions for an elder in our lives on his or her behalf. For example, perhaps this person has dementia, is having difficulty with these decisions, and we are concerned for his or her welfare. These questions I am asked come from a good place.

Yes, and….

Underneath this question of “How do I get my mom to…” is a paradigm about growing older that concerns me, and is one we need to address and perhaps, rethink. This paradigm of growing older seems to make the following assumptions:

• Older people do not know what is best for them. “We”, the not-yet-elders, are in a better position to evaluate this.
• Older people relinquish the right to have opinions about how their lives need to be, typically when they make decisions that we, the not-yet-elders or caregivers, do not agree with.
• The most important thing as we grow older is to be safe.
• “Experts” know better about growing older than elders themselves.
  • I say this because sometimes I get the feeling people think that, because I am a gerontologist, I have “the answer”. Sometimes I think people expect I will have a magic phrase that I can give them that will result in all the elders in their lives doing exactly what the not-yet-elders want. If I did have this magic phrase that made people do what you want them to, I would certainly have used it for good.
• Older people do not have a vision for the future.

These are not good assumptions. They are more than not good. They are largely untrue. And if this is what makes up the paradigm we have of growing older, then we need to change the paradigm.

So one way we can start is by changing the conversation. And I’m not just referring to the conversation with a parent or family member about assisted living. I mean all conversations with the elders in our lives regarding what they want and need and how they want to live. By asking what is important to them. By truly listening to their perspectives.

You might be wondering, “What about people with dementia? How do we know what they want?” Maybe you can’t have the same type of conversation with a person with dementia (or maybe you can), but you can still try to see things from their perspective. If you know them as they want to be known, and try to understand what is important to them, you will be taking a step to honoring who they are.

When we approach these difficult conversations and transitions by asking the question, “How do I get my mom to…..” we are at risk for not really seeing the perspective of Mom. We might be denying ourselves and elders the opportunity to work through something together, to really try to understand each other, and to both learn from it. And we also might be contributing to a paradigm of growing older that none of us want to have, as we all grow older and want to have honored what is important to us.