Before you start
Prepare your friend or relative for the conversation by letting them know you’ll be talking to them. This gently plants the seed and lets both of you think about the conversation beforehand. It’s helpful to consider the time, place and who will be involved, as well as what you might say.
When to talk
There will never be a perfect time for sensitive conversations. You should arrange to talk when you both have enough time. Don’t bring up the subject just before an appointment, or when their favourite programme is about to start. And try not to blurt it out when you or they are angry or frustrated.
Where to talk
Make sure you’re somewhere quiet and private where you won’t be disturbed, especially if the subject is likely to be emotional. If you’re talking about housing options, it might be a good idea to talk away from your friend or relative’s home. You could talk when you’re out walking, for example. Try to do it in person, not on the phone.
Who should be there
You may need to think about whether you are the right person to have the conversation with them. For example, it can be hard for a parent to hear advice from their children and emotions can cloud the advice. They might feel more comfortable talking with another family member or there may be some topics that are better dealt with by a professional, such as a GP or a social worker. But try not to involve too many people, so your friend or relative won’t feel that you are ganging up on them.
There could be many options to consider and you may come across some confusing jargon. You can:
- do some research so you can explain and discuss their choices
- be clear about what you want to say
- prepare what to say in advance – practise, if necessary – but be open to their response
- get advice – call the Independent Age Helpline and arrange to speak to an adviser
- be aware that these conversations can be challenging if the older person has specific communication needs – for example, if they are deaf or have hearing loss. RNID has tips for making these conversations less stressful for everyone.
I think you have to plan in your own head what you might say so that it’s fair and it’s not too much of a jumble. But the actual timing, your heart will tell you, intuition will tell you that it’s okay.
Starting the conversation
Make sure your friend or relative is comfortable and try to bring the subject up naturally. If you are relaxed, they are more likely to be too. Be clear that this is a two-way conversation and you want what is best for them.
- use triggers for the conversation – for example, talk about a leaflet on the subject, a TV plotline you’ve both watched, a newspaper article or an item on the news
- ask leading questions, such as: ‘My friend’s mum is thinking about moving into a care home - how would you feel about that?’
- link the conversation to direct experience, by talking about somebody you know or yourself. For example – ‘I’ve just updated my will. When did you last look at yours?’
It came up because we had a leaflet through the door. Plus we have been to a funeral before which was really nice, in a woodland setting… something came through the door about a funeral just like that and it brought it up.
How to manage the conversation
When you do talk to your friend or relative, try to put yourself in their shoes. These could be important decisions for an older person to make.
- Don’t start with your own thoughts - listen to their opinions.
- Ask what they want.
- Offer choices wherever possible – explain the options and discuss them to help them decide.
- If you’re worried, try not to criticise but instead express your concerns.
- Think about the language you use – not ‘you should…, you must…’ but ‘I will help you… it’s important…, we need to… let’s… ‘.
- Be aware of your body language – don’t stand if they are sitting, try to stay relaxed and calm, keep eye contact, nod and smile to show that you are listening.
- Don’t be afraid of silence – they may need time to reflect.
There’s no need to cover everything straightaway. You can do it in stages.
Keep in mind what you are trying to achieve, which should be their safety, well-being and quality of life.
Anticipate their reaction
Your friend or relative might welcome the conversation and be more open to the discussion than you expect. If they don’t react in a positive way, there may be valid reasons. Think about how they might react so you can offer them choices or time if they need it.
If they refuse to talk
You might not be the right person to be having the conversation with them. Ask if there is someone else they would prefer to talk to. This could be another friend or relative, their GP or someone in a similar situation.
If they deny there is a problem
They might not realise that they need help, or they might be finding it hard to accept that they have an illness or their condition is getting worse. Give examples of things you have noticed and reassure them that they can get help. You might want to leave the conversation and come back to it later when they’ve had time to reflect.
If they're angry
People can be angry because they are afraid, embarrassed or defensive. It may be that your friend or relative is upset about their situation, rather than by you bringing it up. Take your time. This is important to them, and they will need time and space to accept and process their changing circumstances.
If they find it hard to communicate
Physical issues can make it more difficult for some people to communicate – for example, if your relative has had a stroke or they are living with dementia. You can get advice or support on communicating in this kind of situation from organisations that deal with specific conditions, such as the Stroke Association, Alzheimer's Society or Parkinson's UK.
Prepare for the conversation by thinking about what you'll say, where and who else could be there.
Remember to be patient and give them time – these could be important decisions to make and they may need to think about them.