Why Family Communication Matters – An Introduction
Family communication matters as we age because we need more care. Our family members, including spouses, siblings, and children, often provide that care. Sometimes as the primary caregiver, and other times supplementing care provided by non-family caregivers. Care can come in many forms. For example, help with activities of daily living such as helping Agers eat and use the toilet or with instrumental activities of daily living like helping Agers clean their home or pay their bills. Regardless, the family is almost always a critical part of care.
To every thing there is a season,
and a time to every purpose under the heaven:
A time to be born, and a time to die;
And a time to get, and a time to lose; a time to keep, and a time to cast away
Family Involvement Creates Better Outcomes
In all aspects of the five master techniques: housing, health, finances, end-of-life chores, and family communication, the better the integration with family, the better the outcomes. There are sociological, anthropological and psychological reasons why this is true. We’ll share a few of these in this Section.
Super Agers Communicate Better & Do Better
Carmen and I share what we’ve learned from studying communication among Agers, their families, and their caregivers. For example, seniors navigating aging issues best, what we call Super Agers, all have great communication skills; or strategies and tactics that allow them to communicate effectively with family, caregivers, and Doctors. They know why good family communication matters. Non-Super Agers have problems communicating effectively with family, caregivers, and Doctors.
Super Agers were better prepared overall. They had mastered the five master techniques related to finances, housing, health, end-of-life chores and family communications. They knew what they wanted and didn’t want. This knowledge also allows them to be accountable to themselves and in turn to others. Because they knew what they wanted, they could communicate this to family, caregivers, and Doctors.
Most Of Us Are Poor Communicators
The rest of us, non-Super Agers, are poor communicators. We don’t know what we want, and when we think we do, we certainly don’t have a good plan on how to make it happen. Even when we have a plan, that plan is often based on unrealistic assumptions and cannot be implemented. Carmen and I found this to be especially true when we studied how Agers moved from one living environment to another: home transitions
Communicating During Housing Transitions
Our initial work focused on how families dealt with Agers transitioning from independent living to assisted living. This transition involves adding assistance to an Ager’s living environment. This might also involve adding caregivers to an Ager’s primary residence or moving to a place that provides the needed assistance.
When we asked Agers in this phase about what they were thinking or how they were contemplating a change, we heard things like:
When we had an opportunity to check back with the same seniors that had made a transition, we heard things like:
The transition usually revolved around a manifestation of a health condition like congestive heart failure, dementia, a broken hip, a broken leg, or complications from diabetes. Most health-related cases involve hospitalizations and time in rehabilitation facilities. The effect of this trauma or catastrophic medical event was the undeniable awareness that something significant had changed in the senior’s life. In other words, their very autonomy and independence were now at stake unless they made a change.
Super Agers Know Family Communication Is Important During Housing Transitions
Super Agers also had clear criteria they could use to assess their ability to remain independent. They developed these criteria early in their senior years. They viewed it as common sense. For example, it was often as simple as acknowledging that if they had trouble climbing steps or fell, it was time to leave their current home. However, sometimes it was more nuanced like if they and their spouse were unable to address all their ADLs and 3 of 5 IADLs (See Health Section). Regardless, this awareness of age-related issues allowed them to address age-related issues.
If they were having problems managing their medication, there was a remediation plan. If the Ager was walking poorly there was a remediation plan. These plans were usually very simple. Things like, if I cannot properly sort my medicines, I’ll bring in a nurse to do it. Once I’ve tripped or fallen, I’ll use a walker. As simple as they were, they tended to minimize catastrophic events and allow for smoother housing-related transitions.
The awareness, coupled with a remediation plan, gave them confidence and foreknowledge. They know that good family communication matters. It also dramatically affected their family, caregivers, and doctors. It wasn’t that everyone was on the same page all the time, but they were certainly reading the same book and usually on the same chapter. In other words, it was a kind of book club. To continue the metaphor, Carmen and I found that most Non Super Agers didn’t like to read.
Super Agers Had Clear Criteria For Transitions
The criteria used by Super Agers allowed for a kind of forecast of what was coming. Moreover, agers’ families, doctors, and caregivers were aware of these. They were able to use these criteria to help with ongoing assessment. There was also a kind of collective assessment taking place. Family members were kept aware of how the Agers were doing. Consequently, they could increase their visits if warranted and start to intervene and help where needed. People and institutions involved in the ecosystem of senior living were seen as resources. They were also not demonized as a harbinger of the grim reaper to be avoided at all costs. This allowed longer stays in preferred housing environments and smoother transitions into new ones.
Non Super Agers Hid Deterioration
But for most Agers, the opposite was true. Everyday Agers hid diminishing cognitive and physical issues from their family, caregivers, and doctors. This meant the effects of this decline were not shared.
Declining health issues like shortness of breath or weakness when doing household chores were not discovered until family members noticed these when spending time with Agers. Poor driving habits and accidents were not discovered until family members noticed dents in cars or increases in auto insurance premiums. The inability to manage finances was not discovered until family members found unpaid bills or frequent late fee charges applied to paid bills.
The worst problems occurred around the inability to manage, or mismanagement, of medical protocols. These included medication management, diabetes, and heart treatment compliance, proper use of pain medication, and simple hydration goals.
Blowing these protocols would frequently result in an Ager’s hospitalization. Families and doctors would discover what happened only after the Ager was hospitalized. More often than not, the Ager disagreed with the Doctor’s assessment. We heard countless stories where the Ager said, “I was taking my medicine, I was drinking water all the time, I didn’t overuse my pain medication.” In short, the average Ager was hiding their declination from family and Doctors. The sad part was, it was often easier for the Family and Doctors to go along with the lies than it was to try and intervene.
Most Families Say They Communicate Well
Carmen and I heard positive things from most of the families we talked to about the effectiveness of their family communication. Agers generally talked positively about getting family members together for Thanksgiving, Christmas, funerals, and weddings.
Many families bragged about getting over a hundred members to an important event or how they had hosted a holiday event for twenty years or more. But as soon as Carmen and I broached a sensitive topic like how family addressed issues like addiction, mental illness or broken marriages, things changed. “We don’t do that well in those areas,” was the common reply.
When it came to aging issues, Carmen and I found that as long as Agers were healthy, made their own decisions, lived on their own, and in their own home, communication among family members generally worked. It worked in large part because communication was focusing on positive life milestones, not painful and complicated issues.
But When The Going Gets Tuff, The Communication Fails
But in difficult areas, communication was not necessarily taking place. We also heard many stories about people working around the hard issues. For example, stories concerning addiction, mental illness and broken marriages.
Carmen and I believe most families were avoiding or minimizing conflict. This was the norm. When we had opportunities to talk to multiple family members, we discovered something worse. They said things like, “ever since we found out about [pick a family member with a serious problem] we’ve been dancing around the issue. We’ve had five family events, and not once have we addressed them.” Carmen and I believe this was reinforcing avoidance. This seemed to us to maintain old habits and reinforce them as people grew older.
The Communication Monsters
Regardless of the origins of the monster, psychologists are unanimous about why children of this age are susceptible to this type of fear. Firstly, all young children are anxious about being left alone, separated from their parents or getting hurt. Secondly, around the age of four or five, children begin to understand abstract concepts like monsters. At the same time, their ability to imagine things is growing. Anxiety about being alone is easily transferred to imaginary things like monsters under the bed. At four of five, children don’t have the experience to distinguish fantasy from fact. For example, that’s why a creaking bed, can be a monster noise.
As We Age, We Find New Monster
Do people over the age of seventy have monsters under their beds? In the Section Why We Created The Framework, Carmen and I tell the story of how seniors were completely unable to tell us their responsibilities as seniors. In other words, we heard things like “Stay alive, love our kids and grandkids, and have fun.” How could seniors be so unable to articulate their responsibilities? They had fifty years or more to think about these issues. Why were their answers so strange?
Carmen and I share being confused at this lack of knowledge. To the point where we asked nine-year-old kids to answer our responsibility question. They all told us similar things like “We have to go to school, do our homework, listen to our parents, be nice to our family.” We asked seventeen-year-olds about their responsibilities. They all expressed similar things like “I need to do well in school, I need to look for a job, I need to go to college or a vocational program.” And again when we asked young parents, they expressed similar things like, “I need to care for my child, I need to keep a roof over their head and find a career so I can provide opportunities for my children.”
We Turn Our Fears Into Our Monsters
Why the difference? Why were experienced, wise, and caring seniors unable to tell us what the Super Agers all knew? Ultimately, Carmen and I changed the question we asked to, “What are your greatest fears as a senior?”
Seniors told us similar things like, “We’re afraid we’ll run out of money, we’re afraid we’ll lose our health, we’re afraid we won’t be able to stay in our home, we’re afraid we’ll be a burden to our children.” In other words, the five areas Super Agers actively managed. These are the monsters under a senior’s bed.
Culturally Americans are driven toward independence and freedom. In other words, autonomy for Americans is sacrosanct. For example, how many times have you heard, or even uttered yourself, “If I ever reach a place where I can’t take care of myself, shoot me.” Carmen and I have heard this hundreds of times.
There’s a reason parents and grandparents are comfortable telling their loved ones to commit a felony with a life sentence as a solution to their inevitable aging. It’s their monster under the bed.
Most seniors also have no experience with permanent debilitation requiring others to care for them. In other words, no experience requiring others to make their decisions. No experience abdicating their role as an autonomous person. They are the equivalent of a four or five-year-old afraid of the monster under their bed in these areas.
Know The Answer To The Riddle Of The Sphinx
There is an interesting mythological connection to these monsters that a Jungian psychologist would be eager to explore. It involves the connection between these monsters and the Riddle of the Sphinx. The Sphinx is a mythical creature that had the face and breasts of a woman, the haunches of a lion, the wings of a bird, and the tail of a dragon. It guarded the ancient Greek town of Thebes, where many of the Greek hero myths emerged.
The Sphinx would devour any traveler attempting to enter Thebes unless they correctly answered a riddle. “What goes on four legs in the morning, two legs at noon, and three legs in the evening?” The answer is man, who crawls as a baby, walks like a man, and uses a cane in old age. It would be interesting to investigate if the path to enlightenment or heroism requires self-knowledge of one’s mortality and associated implications.
However, one group of adults are better at dealing with disabilities and how they affect a family. Those are parents of special needs children. Many parents in these situations become Super Parents, who know what our Super Agers know. In other words, parents of special needs children learn the five techniques, because their children are like dependent seniors.
CarePlanIt’s Take On Why Family Communication Matters
Our Family Communication program helps you address difficult family issues. These include where we live, how we save and spend money, how illnesses impact our daily life, and how to manage things if we become incapacitated.
Carmen and I will also help you navigate some of the more sensitive family issues like addiction, mental illness, estrangement and uncooperativeness. The information and techniques in this Section are also designed to get you through the most difficult end-of-life issues when Agers are dealing with hospitalizations, chronic illnesses, dementia, and the inability to live independently. Remember, good family communication matters.
Super Agers also communicate well with their family and their family members with them. The issues can be easy or difficult, but Super Agres have mastered some basic communication skills. That mastery requires a conscious or intuitive understanding of basic communication concepts and what motivates people. Our Super Agers also understand their family, their personalities and how to best communicate with these different personality types.
The knowledge and techniques shared in this Section can make you a Super Ager too.
Other Resources On Why Family Communication Matters
Make sure to see our other sections, especially, Getting Things Done here, and Best Practices: Tips and Techniques, here.
A great resource on family communication here.
Also a good resource here.