|
March 11, 2005
These extracts from "How to
Say It to Seniors" by David
Solie give good advice on
the best approaches to
achieving successful
conversations with older
people. They are reproduced
here with the author's
permission.
Hidden Communication
Challenges in Everyday
Living
There are as many nonverbal
as there are verbal
indicators that predict the
success of our conversations
with senior adults. While
communication between any
two people contains seen and
unseen, spoken and unspoken
challenges, communication
between the generations is
particularly sensitive to
such factors as timing,
pauses, tone of voice - even
the way we phrase our
questions - because we may
bump up against
developmental issues that
trigger strong responses and
create distance rather than
connection.
Strategies are designed to
create a dialogue that
immediately offers control
to seniors, which is a key
to connecting with this age
group. With control no
longer an issue, we create
the space for legacy issues
to surface.
The Dangling
Conversation: The Importance
of Settling Rituals
"I was never the same after
Myrtle died, you know . . ."
In the conversation at
Starbucks, my mom took about
20 minutes to settle in and
gauge my demeanor (relaxed,
focused on her instead of my
electronic gadgets or
departure schedule), before
she began a vividly detailed
story about an incident in
her life that profoundly
affected her: the death of
her beloved older sister
when she was a child. I knew
about this family tragedy,
but had never heard her
describe it with the
intensity and focus she did
that afternoon. I've often
thought about what I did and
did not do that allowed
these memories to surface.
Settling In
What was it about our
interaction at Starbucks
that caused my mother to
reveal such vivid details? I
had three hours to spend
with her before my departure
for the airport, so instead
of the harried, hurried,
preoccupied middle-aged
executive who usually
greeted her, she saw across
the table a relaxed,
attentive son who focused
only on her. Even so, she
took 20 minutes to begin her
story. During that time I
purposely hadn't said much -
I wanted to let her talk
that day. But I realize I
opened a communications door
by giving her ample time to
express what I now call her
"settling rituals."
[Senior's] settling rituals
involve getting physically
comfortable in their chairs
(a longer process for them
than for us), engaging in
nonlinear discussions before
revealing more heartfelt
material, and gauging how
receptive we are to them.
One of my colleagues, who
saw an elderly woman a
couple of times a week in
his medical rounds at a
nursing home, noted that she
loved to knit. When he began
bringing her small balls of
yarn, she began looking
forward to their interviews,
rather than resisting his
intrusion into her day. By
adapting to her settling
rituals, he noted she was
able to focus more quickly,
which made the time he spent
with her more productive.
After 20 minutes of
nonlinear conversation with
my mother that day in
Starbuck's, I felt that
"click" and attempted to
refocus the discussion.
"Mom," I asked, "have you
heard from anyone in the
family lately?" Then I
remained silent. This gentle
probe unleashed a flood of
memories.
Timing Rules
Start with the right
attitude. The potential for
meaningful dialogue is
lurking beneath the surface
of every conversation with a
senior adult. Assume this
potential exists, but don't
force it.
Read the start-up code by
learning to decipher an
older person's settling
rituals. Identify the
components of the ritual,
which include conversation
topics and the amount of
time devoted to settling
into the discussion. Resist
the urge to shorten the
ritual.
Learn to accept the topics.
Determine what topics are
comfortable for the person
we are seeing or
interviewing.
Don't try to predict when
the developmental alarm bell
is going to ring. Meaningful
moments are not always based
on cause and effect. They
can appear in an otherwise
mundane discussion. Be
prepared to shift gears
quickly.
Watch for a change in
subject. Don't be surprised
by quick transitions out of
and into substantive
discussion.
Wait for the conversation to
end naturally. In
conversation with parents or
older clients, how many of
us have been guilty of
answering a question before
it's been asked? Of solving
a problem before the older
person mentions it?
Leave with the right
attitude. Departure rituals
are settling rituals in
reverse and require equal
attention. As with most
conversations, ours with
senior adults are effective
when we take the time to sum
up and determine a plan of
future action. With seniors
we need to clarify and
reinforce mutual values,
then decide when to talk
again.
How to Say It:
"I've enjoyed our talk, Mrs.
Jones. I agree there's no
need to rush this procedure.
You let me know when we need
to meet again."
A Word about Setting
The setting in which we
attempt to converse is
crucial because not all
environments are conducive
to meaningful discussion.
Some settings can signal
thoughtfulness; some can
signal a timed event (can we
relax and settle in, or do
we need to get back in an
hour?). Forgetting to
disconnect our electronic
leashes can undermine an
effective setting, as can
obsessing about the food,
service, lighting, or noise.
The most ineffective
settings include doctors'
offices and noisy
restaurants. Avoid them for
important conversations.
Doctors' offices usually
have a sterile smell and
harsh lighting, and a sense
that we lack control over
our lives. Noisy restaurants
are distracting and
impersonal places where it's
hard to focus and hear
clearly.
Some of the most effective
and productive settings for
conversations are out of
doors:
The Garden
Outside settings can be
effective for promoting
conversation with older
adults because for many of
us our happiest memories are
of events that have taken
place outdoors. It doesn't
matter how we get outside
and it doesn't matter how
long we stay. What matters
is that we experience fresh
air and allow it to evoke
memories. The outside world
brings to the forefront a
different part of our
essence, particularly in
senior adults with limited
mobility.
The Walk
Face-to-face is not always
the best way to spark
conversation. Some
discussions are best
approached from the side,
not head on. Some topics
don't arise unless they are
approached obliquely. A walk
provides a kind of safety
shield, another focus in an
interesting venue,
especially when the topics
are difficult. Don't
discount the warm-up or
settling in phase of the
discussion during your walk.
Be open to any subject that
arises.
I spent a few days with a
client when she was
undergoing treatment at a
clinic to learn how to
manage her diabetes. We had
several interactions having
to do with her health but
the best conversations we
had were on our walks
between her residence hall
and the building where she
ate her meals. She was a
very bright 78-year-old
woman and at the end of her
stay understood the reasons
why she needed to change her
lifestyle and eating habits.
About 20 minutes into one of
our walks, our focus shifted
from the business at hand to
more personal matters, and
we've been friends ever
since.
The Drive
A drive is like a walk on
wheels. When we are having
trouble resolving an
important issue, getting in
the car and going somewhere
or nowhere at all can take
the conversation in a new
direction. As with a walk,
this exchange does not have
to be face to face and might
make the older person more
comfortable testing out an
idea or a theory about
something personal or
revelatory. We want to
expose the older person to
new external stimuli and see
what bubbles to the surface.
Sometimes the open air and
skies inspire insights and
ideas, and relax
inhibitions. For example, an
old tree coming into view
might inspire a boyhood tale
and take life review in a
different direction.
The Visit
Particularly if the elderly
person has limited mobility,
going to visit someone
provides a focus outside
their usual venue for new
ideas to arise in the
conversation. Seeing a
newborn member of the family
can bring up associations
with other family members.
("I don't believe it. This
baby looks exactly like your
Uncle George when he was
born!" "Isn't it amazing
that this tiny thing has my
mother's eyes?") Follow up
with good questions. ("What
else can you remember that
was distinctive about
grandma?") Listening with
our legacy coach ears shows
genuine interest in the
answers.
Pauses
Silence is not toxic. Pauses
in any conversation serve a
purpose, but with senior
adults they allow the
unconscious to reconfigure
itself and catch up with the
conscious. When that
happens, those all-important
nonlinear thoughts start to
emerge.
Don't predict the path. Once
we begin to hear nonlinear
thoughts, we can assist the
pathfinder but not determine
the path. If we remain
silent but interested and
focused, nonlinear thoughts
will organize themselves and
perhaps emerge as an
epiphany that can lead to
legacy.
Be prepared for the
unexpected surfacing of a
major life theme. "Doctors
don't know everything." "My
life was never the same
after Myrtle died." "I
haven't thought about this
in 30 years." These are
examples of nonlinear
comments that emerged after
pauses in conversations I
had with older individuals
and foreshadowed something
greater than the words they
uttered. Once the insight or
incident emerges, senior
adults can then begin to
decipher meaning and assign
a legacy weight to it.
Silence is sometimes the
best response to emerging
life themes. When these
nonlinear statements start
to emerge, sometimes the
best approach is to pause
and say nothing, but
indicate with our body
language that we're "all
ears" and eager to hear
more. Let the person breathe
and don't try to anticipate
what he or she will say
next.
Various Forms of
Questions
How we ask questions can do
one of two things:
-
Positive Outcome Negative
Outcome
-
Shore up a person's
abilities
-
Demonstrate our superior
problem-solving abilities
Point out deficits
-
Strike fear in an older
person's heart
-
Partner for solutions
Bull-doze the person into
submission
-
Suggest ways to allow the
person to keep control and
dignity while indicating
the most opportune
direction to take Document
inadequacies and poor
preparation for life
Ramping-on Questions
In any conversation, look
for an opening in which to
share a personal experience
about whatever subject the
person is referring to, and
"ramp-on" by following-up
with questions that show
sincere interest in the
content.
How to Say It:
"You've referred to your
sister quite a bit. Are you
concerned about her in some
way?"
"I have heard you mention
Agnes a lot. How did you two
become friends in the first
place? Did you ever think
you would be friends all
these years?"
Parallel Circumstances
Questions
This style of questioning is
particularly helpful when
connection with the elderly
person has been extremely
challenging. A colleague,
John, told me of
difficulties he'd had
communicating with his mom.
One day, he went to see her
at a time he was extremely
harried. Dropping his usual
defensiveness at her
intrusions into his life, he
asked, "Mom," he said, "I
have two children whom I
love, but I feel as if I'm
on a treadmill in caring for
them and never have any time
to myself. How did you raise
four children?" Flattered
that he was seeking her
advice, she in turn dropped
her need to control the
conversation and responded
in loving, kind, and
insightful ways.
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
|
