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You have reached a break with your mother and father, who are about to turn 80 years old. You think they need help at home, but they vehemently refuse. You are frustrated because you want to make their lives easier. They are angry because they think you are interfering in their affairs.
Can negotiation and dispute resolution methods used in the business world help eliminate these types of conflicts?
Yes, according to a group of researchers at Northwestern University. And they are onto something.
These experts have developed a training curriculum on negotiation and dispute resolution for social workers, care managers, and health care professionals who regularly work with refractory older adults. . Materials for family caregivers are also being developed.
Instead of avoiding difficult issues or simply telling people what to do (“You need home health aides several times a week for the foreseeable future”), professionals learn to capture what is most important to seniors and approach care planning as a collaboration, not a command from on high.
“People argue a lot when they get old. It’s something I see every day in my work,” said Lee Lindquist, chief of geriatrics at Northwestern University’s Feinberg School of Medicine, who led the project. Its purpose is to reduce conflicts and make it easier for the elderly to receive the necessary support, he said.
In May, Lindquist and his team plan to launch another part of the project: a trial of a computer-based training program for family caregivers of people with mild cognitive impairment or dementia in early stage. The program, called NegotiAge, features avatars of seniors and allows caregivers to practice negotiation techniques under various scenarios.
“You get different situations, different emotions, and you can 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 widespread.
In the meantime, there are many steps family caregivers can take to prevent or resolve conflicts with elderly parents.
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Preparation is essential for any type of negotiation, advises Jeanne Brett, professor emerita of dispute resolution and organizations at Northwestern’s Kellogg School of Management and a member of the NegotiAge team. “You want to think about the answers to several basic questions: What issues need to be addressed? Who are the parties invested in these issues? What are the parties’ positions on each of these issues? Why do you think they took those positions? And what happens if we don’t get along?”
It is helpful to write the answers to these questions in a planning document. Be sure to include yourself in parties and write down your goals for future conversations.
What would this look like in practice? Let’s say you want your father, who is in his early 90s, to stop driving, because he is starting to lose and his vision is not good. People who have a stake in the discussion include your father, your elderly mother, you, your two siblings, and your father’s doctor.
Your mother may be concerned about your father’s safety but is reluctant to raise the issue for fear of provoking an argument. One of your siblings might agree that it’s time to get the car keys, while the other might think that Dad is better off on the road. The doctor may recommend a driving test and then offer his professional opinion.
Find common interests
Your job is to find the areas where the parties’ interests intersect and work from there. Everyone wants your dad to stay active and see his friends regularly. Everyone wants to make sure he doesn’t hurt himself or anyone else on the road. Everyone wants to respect his desire for freedom. No one wants to call him incompetent.
Brett identifies positions, such as “I’m not going to stop driving,” and interests, or the reasons for having a position. In this situation, Dad may fear isolation, lose autonomy, or lose control of his activities. But he, too, may worry about hurting others unintentionally.
Negotiations have the best chance of success if they address the interests of all parties involved, Brett said. Don’t adopt an adversarial approach. Instead, emphasize that you are on the same team. The goal is not for one side to win; it is for people to work together to find a solution to the issue at hand.
questions
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, such as “Why?” or “Why not?”
If an older person says, “I don’t want to talk about it,” don’t back down. Acknowledge their discomfort by saying, “I understand that this is difficult,” while adding, “I care about you and want to know more.”
Lindquist favors starting difficult discussions with patients with open-ended questions: “What are some things you’re having trouble with? What are you doing that you wish you could have done differently? What would make it easier for you? life?”
Listening carefully and making the person you are dealing with feel heard and respected is important. If one of Lindquist’s patients told him, “I make my own choices, and this is what I want,” he might reply, “I agree that you are the boss, but we are here to make your life. that’s better, and I’m worried about you.”
Brainstorm strategies
Negotiations with family members are often charged with emotions that can easily get out of control. But don’t go back if someone is angry and flirting.
“When you buy a car, if you don’t agree with the dealer you talked to, you can go to another dealer. If you’re fighting with a family member, you don’t have this option. You’re more stubborn and more defensive about shortcomings,” says Brett, “and preserving relationships is even more important.”
Redirect your focus to brainstorming strategies that will help solve the problem at hand. Be creative and put more options on the table. Invite your parents to answer and ask “Why?” or “Why not?” again if necessary.
If you find yourself going in circles without making any progress, try saying something like, “We can argue about this all afternoon, but neither of us will agree. can go to events without your car,” Brett said.
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 check in with each other next week,'” suggested Lindquist, noting that many negotiations take time and not in a hurry..
Bring in a third party
If all else fails, appeal to a third party. This was Brett’s strategy when her husband, who has Parkinson’s disease and compromised vision, wanted to resume driving in 2021 after recovering from a serious fall. Brett and the couple’s daughter could not convince him that it would be dangerous, but the elderly man, who is 89 years old, agreed to get a driving evaluation at a facility associated with a hospital in Chicago. . When they recommended that he stop driving, he handed over the car keys.
Brett soon hired a neighbor in the small town in France where they now live to drive her husband to appointments several times a week. Twice a week, he takes her to a nearby village where she has coffee with friends. He went out into the world and he didn’t worry about safety—an outcome they could live with.
KFF Health Newsformerly known as Kaiser Health News (KHN), a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF—the independent source for health policy research, polling, and journalism.
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