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How to talk to your aging parents about falls

As a caregiver to a parent who is getting older, it’s hard to know when to step in or how to bring up tricky but necessary conversations.

Sensitive topics like aging-related changes and fall prevention can feel hard to navigate. Perhaps you’ve danced around the conversation of home safety in the past, and maybe your conversations haven’t gone well. Whether it’s denial, refusal, or resentment — the dynamics of these conversations feel complex and frustrating — for both you and your parent.

Lots of families just like yours are struggling to make changes. And far too often, ineffective conversations lead to things staying the same. And as a result, preventable falls keep happening.1

Here’s the truth: Conversations with aging parents can be productive while still being sensitive to their feelings and beliefs.2 Far too many resources around fall prevention don’t go deep enough to navigate all the tricky aspects of these conversations.

That’s changing now. Keep reading to understand actionable and research-supported ideas for how to join forces with your parent around the goal of fall prevention.

 

Communication Basics to Transform ALL Your Conversations

Want a conversation to feel good and generate change? Start with these 3 things: invite honesty, create shared goals, and agree on the next steps.

 

Invite honesty (which goes both ways)

In many conversations, we are so concerned about sharing our own perspectives that it is hard to hear what the other person is saying. This can create gridlock as each person digs in to defend their position.

FRUSTRATION ALERT: Emotional gridlock is real and can become even more challenging as we age. As we grow older, we rely heavily on our emotions and perceptions in conversations and decisions.3 Instead of becoming frustrated by conversations, try meeting your parent in the space of how their feeling rather than what they need to fix.

You’ll notice a huge shift simply by beginning a conversation with genuine curiosity about your parent’s feelings, ideas, and motivations. In fact, the solutions for what you want to accomplish are often found in your parent’s responses.

 

Focus on shared goals

It makes a difference to rally around a shared goal. For instance, maybe you figure out that your parent’s primary goal is to stay in their home. That’s information you can highlight when discussing fall prevention.

 

Agree on action steps

It’s so frustrating to have a conversation over and over again without it going anywhere. And no one feels good about forcing your loved one to do something they don’t want to. To replace conversation circles with a mutually agreeable plan, give the conversation a goal at the beginning.

Even saying, “By the end of this conversation, my goal is to have 1 to 2 ideas to change your bathroom to make it safer. But first, help me to understand what you are thinking in terms of your bathroom.”

This helps them feel included and empowered in the conversation, rather than pushed into changes they don’t want.

 

Now that you have some communication basics, let’s apply these concepts to the common fall prevention hurdles.

There are 3 main barriers to consider:

  • Injured pride shuts down conversations.
  • Stigma and false beliefs about aging.
  • Change feels difficult so people don’t like it.

We’ll take the time to understand what’s behind each barrier and provide some conversation tips to help you have a productive chat with your mom and dad.

 


Image courtesy of Pexels – Madison Inouye

Hurdle #1: Fall Conversations = Injured Pride or Self-Concept

As soon as you start talking about falls, does your mom or dad shut down? They don’t want to admit challenges to themselves, much less experience a change of perception by others.

So they hide challenges, hastily reject all ideas, and even pretend nothing is the matter. This can be very frustrating for concerned family members who can clearly see the signs of a potential fall.

 

Understanding Their Experience

No one wants to feel old. That’s a big part of why many aging adults struggle to acknowledge a body that’s weakening or a mind that isn’t as sharp.1

FRUSTRATION ALERT: Consider also the huge identity shift that’s required to go from the role of caretaker to care receiver. For many older adults, it feels intrusive or embarrassing to have family or outside professionals point out physical or environmental shortcomings.1,4 You can begin to see how resistance can build with all the feelings of loss happening at once.

 

Ideas & Conversation Tips

In general, your goal is to validate your parent’s experience, whether that’s feelings of intrusion or grief from the loss of independence. Keep looking to include your parent in the decision-making process to respect their self-image.4

 


Conversation starter: I know it feels uncomfortable for you to have me and home health coming here and proposing changes. Remember, we’re all here with a shared goal to make daily life easier for you. How are you feeling about it?

How this works: Validate their feelings and then remind them of the shared goal. Offer a chance for them to talk through their feelings.


Conversation starter: I know it feels uncomfortable for you to have me and home health coming here and proposing changes. Remember, we’re all here with a shared goal to make daily life easier for you. How are you feeling about it?

How this works: Validate their feelings and then remind them of the shared goal. Offer a chance for them to talk through their feelings.


Conversation starter: We want to respect your wishes as we make these changes to reduce the risk of falls. Assuming we are going to make some changes to reduce falls, where would you like to start? Is there anything that feels especially important to leave alone for now?

How this works: This one makes it clear that changes will happen but gives your parent the chance to express what they prefer. Use this information to pick your battles and when possible, get some easy wins through changes that you mutually agree on.


Conversation starter: You are the strong and capable person that I’ve always known you to be. However, your body just doesn’t have the same strength it used to have. Let’s make some changes around the house so that you can keep doing as much as possible for yourself without us bothering you so much.

How this works: Reassure them that their physical or environmental situation doesn’t change how you feel about or view them. Then in a non-threatening way, bring up the safety risk that you want to talk about. End by proposing a solution with a bigger benefit that will matter specifically to them.


 

While sometimes pride, stubbornness, or self-deception can be frustrating because these conversations won’t always be logical. But resist the urge to dig into a battle. Rather, be thoughtful about your approach and the feelings that are involved.

After all, with health on the line, it is more important to build rapport and safety than to stick to the rules of logical sense.

 


Courtesy of Pexels – Leeloo The First

Hurdle #2: Stigma & False Perceptions Hijack Fall Prevention Conversations

It can be hard to convince a loved one to make changes around fall prevention because there is a stigma around aging and so many false beliefs connected to aging and falls.3

  • Aging adults associate adaptive equipment like walkers or grab bars with stigmas attached to aging.1
  • Older adults feel like falls “just happen” and can’t be prevented.4
  • Many older adults associate a fall or fall risk with removal from the home.1

FRUSTRATION ALERT: These beliefs won’t always make logical sense to you. Just know, left unaddressed, you’re going to have a frustrating, uphill battle to make even simple changes. And each day of inaction leaves the door open for an unfortunate incident with big consequences.

 

Ideas & Conversation Tips

Your main goal is to identify any false beliefs that are getting in the way of your parent making a change around fall prevention. Then, talk them through so you understand their perspective and can help them to see the belief in a different light.

 


Conversation starter: I noticed you didn’t really like the idea of adding a grab bar in the bathroom. Can you tell me more about why that is?

How this works: When you understand the core barrier to action, you can be sure to address that issue specifically. Maybe using a walker or grab bar makes them feel old. Now that you have that information, you can think about how to address their specific concern.


Conversation starter: I’ve been thinking about the other day when you said, “Whatever is going to happen is going to happen.” I know there is more you and I can do to prevent falls around here. I’ve got some ideas that can fit your needs without being too much of a bother. Would you be willing to talk about them with me?

How this works: Discuss a statement they have made that’s getting in the way of taking action around fall prevention. Then, find a non-threatening way to bring that false belief out into the open so you can talk about it. In this example, the false belief is that falls “just happen” and can’t be prevented. Having a conversation about that belief can help your parent re-evaluate that belief and see alternatives.


 

The good news is there are many resources available to help you change these perceptions. That includes aging-in-place experts like occupational therapists and home remodeling specialists. You and your parent will be both amazing options that take into account both design and safety.

 


Image Courtesy of Pexels – Alexas Fotos

Hurdle #3: People Resist Change

Reducing falls starts by deciding to make a change. Which isn’t always easy.

Changes to prevent falls could mean modifications to the home, addressing lifestyle, or physical health. These are not quick and easy changes. All too quickly, fall prevention plans are derailed by the planning, investment, and energy required to make them happen.1,4

In a nutshell, it feels easier to fight the change than to go through the discomfort and unknowns associated with something new.

 

Understanding the Older Adult Perspective

If change is hard for everyone, change can be especially hard for aging adults who have decades of habits and preferences.1

Additionally, older adults don’t always have the cognitive capacity or energy to set up appointments or look for adaptive equipment.4 If they feel overwhelmed by the process, the easy response is to keep things the same to avoid the effort or hassle.

Ideas & Conversation Tips

To overcome this fear of change response, take care of what feels difficult or overwhelming. This could be narrowing down options, setting up appointments, or coordinating installation. Just keep in mind the importance of keeping your aging parent in the loop so they don’t feel excluded in the process.


Conversation Starter: I get it. Change is hard. Especially when you’ve been doing something for so many years. That’s part of the reason we should be making some changes now. That way you can get used to them before you really need them. I’ve got some extra time in the next few weeks. How about we get this house working better for you and knock out some of these appointments? What are your thoughts?

How this works: Bring their hesitation out into the open and then redirect the conversation to the benefit of making changes earlier. Try to offer help in a way that doesn’t feel threatening or inconvenient. After hearing their thoughts, it’s important to agree on 2-3 concrete steps.


Conversation starter: I know exercising is not your favorite activity, but I think it will make a big difference in how steady you are on your feet. Truth is, I could be working on the same thing. How about I come to your physical therapy sessions and learn the exercise routine with you so we can do it together?

How this works: Start by recognizing their hesitation but then paint a picture of the benefit of moving through the discomfort. It’s even more effective when you can share the change and help them navigate the steps to success.


 

A Different Approach for a Different Outcome

Even if conversations haven’t gone well before, try again with a new approach. Honesty and perspective-taking can make some surprising differences in the effectiveness of your conversations around safety and fall prevention.

As humans, it’s easy to start with our own fears, beliefs, and wishes. You’ll be tempted to talk about your reasons for wanting your loved one to stay safe. Lean into understanding the unique barrier or motivators of your mom or dad. When you can meet those, you become partners around shared goals for your parent’s safety at home.

And it might take time and caring persistence to achieve the goal of home safety. So keep at it. Even one prevented fall is worth the discomfort of a difficult conversation and the effort of change.

 

At HealthCraft, we’re changing the conversations around fall safety through education and innovative product design. Browse our product line for ideas and order the right product for your loved one.

 


Additional Resources

National Council on Aging: Fall Prevention Conversation Guide for Caregivers
How to Initiate Difficult Conversations with your Aging Parents

 

References

  1. Dickinson, A., Barnett-page, E., Mcnnies, E., Horton, K. Bunn, F., (2008). A systematic review of older people’s perceptions of facilitators and barriers to participation in falls-prevention interventions. Ageing and Society, 28(4), 449-472. https://www.cambridge.org/core/journals/ageing-and-society/article/abs/systematic-review-of-older-peoples-perceptions-of-facilitators-and-barriers-to-participation-in-fallsprevention-interventions/1D7E4BF3061874634A69D68A9CBB1190
  2. Williams, K., Kemper, S., & Hummert, M. L. (2004). Enhancing communication with older adults: overcoming elderspeak. Journal of gerontological nursing, 30(10), 17–25. https://doi.org/10.3928/0098-9134-20041001-08
  3. Melissa L. Finucane (2008) Emotion, affect, and risk communication with older adults: challenges and opportunities, Journal of Risk Research, 11:8, 983-997. https://doi.org/10.1080/13669870802261595
  4. Simpson, J. M., Darwin, C., & Marsh, N. (2003). What are older people prepared to do to avoid falling? A qualitative study in London. British journal of community nursing, 8(4), 152–159. https://doi.org/10.12968/bjcn.2003.8.4.11190