What if “The Talk” Isn’t So Easy?

adrouin April 16th, 2011, 11:35 PM
Amy Dixon, BSN, RN
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A recent comment on my last blog got me thinking a little further about “The Talk“. It’s true. The discussion with my mom about advanced directives went quite smoothly. I’ll be seeing her again in a few weeks with copies of forms for to fill out with her, but had been my father been on the other end of that conversation, I’m not sure if ”the talk” would have gone quite so well.

I know this because throughout our relationship, I frequently tried encouraging my father to initiate some healthy behaviors that he didn’t think were necessary in that moment. Anyone else have a stubborn parent?

“Dad, you should really quit smoking!” I never liked when he smoked in the car when my mom was a passenger.

I said something like that to him when my mom had a bout of bronchitis one year. I was the quintessential nurse/daughter to my father.

Our pattern of healthy suggestions and stubborn responses started long before I became a nurse. I remember sitting at his favorite spot on the couch when I was 11 years old. He left a pack of cigarettes on the end table. I defiantly broke each cigarette in half, then placed them back in the pack before he came back in the room. I stayed close by playing with my dolls, expecting a big reaction. It never happened. When he discovered them broken up, he never conveyed how annoyed he was with me. He calmly threw the broken pack away and bought another one. It frustrated me that he never got the point. And he didn’t yell at me for doing it because he knew his actions were unhealthy.

To engage me in a talk about his smoking would have given me a chance to share with him all the things I learned about smoking in health class as an 11-year-old (as well as the additional information I acquired as an adult in nursing school).” No,” he must have thought. “It’s better not to discuss it all.” He eventually quit smoking after he retired. I was so proud of him for kicking his long-term nicotine habit.

Our discussion about advanced directives would probably have had a similar tone. He would have been watching one of his sports channels. I would casually have mentioned something during one the of the commercials. He’d have nodded his head. Then the game would have returned and I’d have lost him again for the next ten minutes, while the Cavs scored another three- pointer. At the next break, I would have planned to have the living will papers out of my purse into his hands. A-ha! He didn’t think he could weasel his way out of it that quickly, did he? I didn’t expect a refusal to take the papers from my hand.

He’d tell me to place them on the kitchen table, “I’ll look at them later, honey,” he’d say. Then, I’d have found them in the same place I left them on my next visit. How very frustrating! Sound familiar to anyone?

Unfortunately, I never had the chance to have that discussion with my dad. He passed away over a year ago.

I share this imagined story because time and again, I hear from caregivers who express their frustration with loved ones who aren’t necessarily engaging themselves in the most  healthy behavoirs. I’ve also heard reluctance from family members who dread talking about end-of-life issues with their elderly parents. I sense the worry in those caregivers’ voices.

Initiating discussions about health issues may not be easy with some family members. It may not even seem that those discussions are helpful, but it’s an opportunity. It’s an opportunity let someone you care about know that you’re concerned for their well-being, their health, their future and that you will support him or her during those times when their health may be declining. I think that’s all we can expect as caregivers.

My father would have eventually gotten around to reading the living will documents had I brought it up again … and again. That was his pattern. It would have taken him even more time to actually sign them, but I would have done what I thought was helpful, to the best of my ability. That is my pattern.

We’re all just trying to help.


  • I can identify with issues that adult children face when talking with aging relatives about getting frail and not able to care for oneself. It is difficult to have the conversation with them (from experience, I know). Thank you for the reminders in this post.

    Care for Self, Care for Your Senior

  • I would suggest a discussion about advanced directives should happen before someone is unable to care for himself or herself. Of course, that’s not always the reality. Repetition is key…and the ability to explain terms in laypersons language that is easily understandable. The actual forms are not very friendly in terms of language. One step at a time. Hopefully future generations will be comfortable with this information as they age.

  • We learned from my dad–one of the strong silent ones–not to put off broaching to subject of aging and end of life care. We had the first talk about having The Talk at the dinner following Dad’s memorial service. Months later we were able to schedule everyone involved to meet together in what we plan to be a year series of meetings. You can read more at http://www.desperatecaregivers.com/caregivers-consider-who-will-care-for-us

    I think you are so right about repetition being the key. We have to get used to talking about these issues before it becomes an emergency. Thanks for sharing your experience.

    Inside Aging Parent Care

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