With mom and dad in their late 80s, you’ve hit a snag. You think they need help at home, but they adamantly refuse it. You are disappointed because you want to make their life easier. They are angry because they think you are meddling in their affairs.
Can negotiation and conflict resolution techniques used in the business world help mitigate these types of conflicts?
Yes, says a team of researchers at Northwestern University. And they’re on to something.
These experts developed a negotiation and conflict resolution curriculum for social workers, caregivers, and health professionals who regularly work with resilient older adults. Materials for family caregivers are also being developed.
Rather than avoiding difficult questions or simply telling people what to do (“You’ll need home aides several times a week for the foreseeable future”), professionals learn to tease out what’s most important to older adults and approach caregiving as a collaboration , not an order from above.
“People fight so much as they get older. It’s something I see every day in my work,” said Lee Lindquist, chief of geriatrics at Northwestern University Feinberg School of Medicine, who is leading the project. Its goal is to defuse conflicts and make it easier for seniors to receive the support they need, she said.
In May, Lindquist and her team planned to begin the second part of the project: a trial of a computer-based training program for family caregivers of people with mild cognitive impairment or early dementia. The program, called NegotiAge, features avatars of older adults and allows caregivers to practice negotiation techniques in a variety of scenarios.
“You get thrown different situations, different emotions, and you play the negotiation game as often as you want,” Lindquist said. Nearly $4 million in funding for the project comes from the National Institutes of Health. After evaluating the effectiveness of the program, Lindquist hopes to make NegotiAge widely available.
In the meantime, family caregivers can take several steps to prevent or resolve conflict with elderly parents.
Preparation is essential for any type of negotiation, advised Jeanne Brett, professor emeritus of conflict resolution and organization at Northwestern Kellogg School of Management and a member of the NegotiAge team. “You want to think about answering several fundamental questions: What issues need to be addressed? Who are the parties involved in these issues? What are the parties’ views on each of these issues? Why do you think they take these positions? And what will happen if we can’t agree?’
It is useful to write down the answers to these questions in a planning document. Be sure to engage with customers and state your goals for future conversations.
What might this look like in practice? Let’s say you want your father, who is in his early 90s, to stop driving because he has started to lose his vision and his vision is not good. The people who are interested in the discussion are your father, your elderly mother, you, your siblings, and your father’s doctor.
Your mother may be concerned about your father’s safety, but hesitates to raise the issue for fear of provoking an argument. One of your siblings may agree that it’s time to get the car keys, while another may think that dad is still fine on the road. A doctor may recommend a driving assessment and then give their professional opinion.
Find common interests
Your job is to find areas where these clients’ interests intersect and operate from there. Everyone wants your dad to stay active and see his friends regularly. Everyone wants to make sure they don’t hurt themselves or anyone else on the road. Everyone wants to respect his desire for independence. No one wants to call him incompetent.
Brett distinguishes between positions such as “I won’t stop driving” and interests or reasons why someone takes a position. In this case, the father may fear being isolated, losing autonomy, or relinquishing control over his affairs. But he too may worry about unintentionally hurting someone else.
Negotiations have the best chance of success when they address the interests of all parties involved, Brett noted. Do not use an adversarial approach. Rather emphasize that you are on the same team. The goal is not for one side to win; people must work together to find a solution to the matter.
Don’t assume you know why your parent takes a certain position (“I don’t want to go to the doctor”). Instead, ask follow-up questions like “Why?” or “Why not?”
If the older person blurts out, “I don’t want to talk about it,” don’t back down. Acknowledge their discomfort by saying, “I understand that this is difficult,” and adding, “I care about you and want to know more.”
Lindquist favors starting difficult conversations with patients with open-ended questions: “What things are you struggling with? What do you do that you wish you could do differently? What would make your life easier?”
It is important to listen carefully and make the person you are negotiating with feel heard and respected. If one of Lindquist’s patients says to her, “I make my own decisions and this is what I want,” she might reply, “I agree that you’re the boss, but we’re both here to make your life better, and I’m taking care of you.”
Think about strategies
Negotiations with family members are often charged with emotions that can easily get out of hand. But don’t give back if someone gets angry and upset.
“If you can’t agree on a car purchase with the dealer you’re talking to, you can contact another dealer. When you’re in conflict with a family member, you don’t have that option. You’re more stubborn and more defensive about your disability,” Brett said, “and maintaining relationships is even more important.”
Shift your attention to thinking strategies that can help you solve the problem you have. Be creative and put a lot of options on the table. Invite your parent to respond and ask “Why?” or “Why not?” again as needed.
If you find yourself going around in circles without making any progress, try saying something like, “We could argue about this all afternoon, but neither of us will budge. Let’s put our arguments aside and think of five ways you can get to activities without your car,” said Brett.
Don’t expect to agree on a strategy right away. “You can say, ‘Let’s bring mom and talk about it later,’ or ‘Let’s think about it and get back to you next week,'” suggested Lindquist, noting that many negotiations take time and shouldn’t be rushed. .
Bring in a third party
If all else fails, appeal to a third party. That was Brett’s strategy when her husband, who has Parkinson’s disease and impaired vision, wanted to drive again in 2021 after recovering from a bad fall. Brett and the couple’s daughter couldn’t convince him it could be risky, but the elderly man, then 89, agreed to a driving evaluation at a facility affiliated with a Chicago hospital. When he was advised to stop driving, he handed over the car keys.
Brett later hired a neighbor in the small town in France where they now live to drive her husband to meetings several times a week. Twice a week, she takes him to a nearby village, where he has coffee with his friends. He goes out into the world and she doesn’t worry about security – an outcome they can both live with.
We want to hear from readers about questions you want answered, problems you’ve had with treatment, and tips you need to navigate the health care system. Visit kffhealthnews.org/columnists to submit your requests or tips.
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