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Three Difficult Caregiver Conversations

Being a caregiver to an older adult or someone else with special needs requires a lot of care and attention to details.  It also requires a lot of courage, because some of the conversations a caregiver has with their loved one delves into topics that we all may find difficult.  Such a conversation confronts some of the casualties of aging like the loss of certain privileges and some subjects would be awkward to address with just about anybody.  Let me start with the easiest of three: giving up the car keys.

       Driving. Talking with an older adult about whether they should still be driving can be most challenging if addressed head on.  It becomes easier, however, if you try to take the role of the older adult and simply ask yourself how you would want to be approached.  If you already accompany them to their physicians’ office visits, you may discreetly ask the provider if there are any physical issues that detract from their capacity to drive.  When you do address the issue directly, bear the physician’s feedback in mind and ask about how traffic is on the days when mom or dad is out.  Chances are that they may initially see it as all those other crazy drivers.  Work into it by asking about how safe they feel on the road and be prepared with other transportation options that might be more comfortable and “safer” alternatives to driving themselves.  This may take some time.  Check out some of my other tips in one of my earlier postings.

       Funerals. What are your loved one’s plans for their funeral?  This conversation may surprise you. Your loved one may have gone so far as to have prepaid for their funeral already and all those decisions might now be a thing of the past.  But as with the car keys, it can be helpful to think about how you would wish to be approached on this subject before talking it over with your loved one.  You may even introduce the subject about how you have recently given it some thought owing to someone whom you both know from the community who has died.  And remember, it is not about you.  It is about respecting the wishes of your loved one that you are asking, and if they do not wish to speak about it, that may just have to do.

       Intimacy. Finally, if this is your mother or father for whom you are a caregiver, you may remember how awkward that first conversation about the birds and the bees was when they broached the subject with teenage you.  Now, if your older loved one is still living independently at home or in a senior residential community, you should not even broach the subject.  If one of both require some level of assisted living, then you may ask the facility about their policies and be prepared to advocate on your loved one’s behalf.  No matter what age, individuals who are capable of making their own independent decisions ought be encouraged to decide about intimacy as well.  It may even surprise you to learn that their desire for intimacy may be as basic as holding hands and sharing a quiet moment.  All that said, the odds of an older adult being diagnosed with stress, anxiety or depression are lower if they are sexually active.  This is one of those behind the scenes conversations where there may be a need for more education and a bit of advocacy.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  Please email your questions to


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