Sandwich generation

How to have high stakes conversations…starting with elder care…

So I’ve been thinking a lot about crucial conversations – those high stakes conversations we all have to have from time-to-time. Whether it’s in your working life with your boss, a team member who is struggling, with your partner, your child, or your own parent in your extended family life. How we show up in these conversations really matters. Not only in our relationships, but also to our own health and wellbeing.

I do a lot of training for schools and for parents in family life, around having difficult conversations. It’s something very close to my heart when I consider the successes I have had with navigating really difficult conflicts in school life as a school leader…but also when I consider the several difficult conversations I never had, but should have.

Since my father’s sudden death, I have been my mother’s carer for nearly 3 years now. Not because she is physically frail, intellectually incapable, but because of her mental health needs. Looking back, over the past 15 years, I can now see more clearly the subtle, but inexorable tells of anxiety and depression growing and occupying more, and more territory in her mind.



There were many points at which greater courage, more conflict, might have led to interventions that could have slowed or challenged and even reversed the now myriad prohibitions that inhibit her independence, exaggerate the real restrictions of the pandemic, prevent her having balance and holding on to the good things in her life… The ‘mind-forged manacles’ that lock her in spirals of obsessive and intrusive rumination of problems, past slights, minor frustrations that become all-consuming, mean her real and meaningful presence in our relationship – and all her relationships – is elusive.

There is no doubt in my mind, that we needed to talk about the ‘Kevin’ -of mental illness. But we failed to do so meaningfully or courageously, out of sensitivity, love, not wanting to rock the boat, to attack her or my father’s dignity, a wish that this was not really as bad as all that… meaning the problems grew, and all of our chances – especially hers – shrank.

Meaningful, authentic, and appreciative relationships of mutual understanding and respect are one of the most important pillars of our psychological wellbeing. The greater our perception of good social supplies, the more able we are to weather the storms in our lives. And the nature of the pandemic, and how we are adapting to cope with its threat is an attack on the rich array of important means we have to connect.

Behind the mask or perspex screen, interruptions to connection take place even more. Worries are internalised and ruminate without adequate opportunity for meaningful and appropriate expression. Many crucial conversations get delayed even at the best of times. Whether in family life, at work, or at school, our ability to express our concerns when the stakes are high, and get our needs met – or at least feel we can be seen, and heard – is crucial to maintaining meaningful relationships and reducing stress.


 
The majority of us, the majority of the time, will be avoidant of these conversations. We’ll swerve away at the last minute, afraid of rocking the boat, and we can end up living a grudging compromise, or developing narratives of helplessness or even the ill intent of the other person, who, sadly…or happily…is not a mind-reader.
 
Even the boldest, most passionate, driven, go-getting and committed leader, will have some patches of the garden they failed to weed in time. And those areas become increasingly dangerous and no-go, the longer they are left, as the breaches repeat, the patterns deepen, and the inner disappointment, frustration, anger, foments.
 
At the next level, some of us will go for it. We’ll jump in and have a go at the difficult conversation. But we might be doing it badly because it’s too emotionally charged. We take the plunge in reactive mode. Driven by our feelings bursting out from being suppressed over time, we’ll tend to throw out some squid ink of rage, toss in some seasoning of sarcasm, blame and shame. Fire will meet fire, the emotional dimensions will cloud the issue that’s really at stake. Blame will spark aggression or defensiveness rather than engagement, responsibility, and accountability. And the prickly weeds of the unaddressed issue in the garden of the relationship will spring back again and be even tougher to tackle the next time round.
 
I’m going to think about a really meaty difficult topic in family life, as my ‘lived case study’. Although it’s not based in school life, it’s a situation that is ‘live’ for many of us right now. For parents and teachers alike – the negotiations we need to have with our parents as they age.

Who knows what 2020 has brought up in your lives, and the lives of those you love. Fingers crossed, we will be allowed to come together – albeit in still-limited ways. This article is designed to help you think about what topics may be brewing in your lives, what worries you need to be addressing…and how you can increase your chances of success when you raise the issues that really matter.

For those of you who are reading this as teachers and school leaders, this is the perfect topic to centre on to explore high stakes conversations. Something that is a source of real stress and struggle at the sharp end of school life.

It’s the type of conversation that comes up where emotions run high, opinions very, and the topic is really important. 
 

Every day recently, the issue of care for the elderly has been headline news. The impact of the restrictions and separations due to the pandemic. The terrible difficulties in providing adequate care for our elderly relatives. The recently revised equation of independence with isolation. Whilst we have all been busy wearing masks, what has been unmasked, is the strain there is for families and our society at large where elder care is concerned.

The topic of elder care is so resonant and relevant on so many levels. Firstly with many couples now delaying having children until later in life, we have the phenomenon of the ‘sandwich’ generation. Where elder care becomes a pressing concern to people who are still very much in the midst of their careers and family life – with young children or teens who actively need their parents. (Even if they go to great lengths not to show it!).

Most of us will have to wait a long time before we reach pensionable age. The phenomenon of early retirement – so much more possible and present in the ’80s and ’90s has now receded, and receded…and how far beyond the horizon it will be after this financial crisis, no one knows…What will old age look like for us after pension schemes becoming more and more untenable for employers?

Old age is a very elastic concept – it can span decades and be a very unpredictable thing. Some 65 year olds have the needs of an 80 year old. There are plenty of redoubtable 90 year olds still rocking their independence. 

It is interesting to note that often we spend a great deal of time thinking, planning, researching around the beginnings of life. Placing unborn babies on nursery wait lists…Endless agonizing over schools, moving to catchment areas, tutoring for 11+ tests or scholarships – quite literally moving heaven and earth to get the best for our children. 

In contrast, the transitions the older generation go through are rarely undergone proactively, by design. Quite often it is by default because of the taboos of facing the inevitability and actuality of the decline as the years pass post-retirement. It can feel cruel and crass to bring the subject up.

There’s a lot of baggage around what in essence are very simple questions that can move us on from a stand-off of silence to a more open sense of wants, needs, possibilities. For a start, old age is expensive – and talking about money is something we’re not so good at in family life. And – to be blunt- part of the inflationary economy of family life that has existed so far has centred around the next generation having a massive leg-up the property ladder via inheritance.
 

This is why the topic of elder care is so suitable for thinking about having the sorts of crucial conversations we are having to have in schools and family life right now. And the pandemic has made us much more aware of the logistical difficulties when random periods of self-isolation, lockdown, illness strike. How can we have equilibrium in our working lives, our family lives, when we just don’t know when situations in our extended family might so easily go nuclear. 

In particular, teachers are running on empty right now. They are teaching lessons in school – and are deeply committed to doing so despite the risks. They are also teaching increasing numbers of children self-isolating, having to involve them digitally, or provide resources one way or another. They are having to teach remotely from home when having to self-isolate.  This alone means SEVERAL strands of planning. For it all to be banjaxed at the last minute when the email comes saying more pupils are having to isolate, or lessons have to be cancelled / rearranged, or they have to cover more classes (and being exposed to larger numbers of children from different bubbles. They are teaching in an educational equivalent of an Agatha Christie… ‘And then there were none.’ AND – here’s the kicker…they are doing this with masks on, in rooms that are ventilated i.e. freezing cold. 

Teachers have always worked hard in a high stress job. And they cope. But the wheels start to come off when there is disruption, difficulty, sudden danger and threat on the family front. This is why so many teachers with young children yo-yoing in and out of school are waking in the night with anxiety. This is why when the call comes from a social worker or hospital, that your elderly parent has had a fall or a stroke, or has coronavirus, that all the plates being frantically spun come crashing to the ground. 

 


The stakes could hardly be higher. And many resonate with the conversations had between school leaders and parents where mental health, wellbeing and a failure to thrive is at stake with children in school. 

The key issues in a high stakes conversation with the older generation:

  1. Emotions run high
  2. Opinions are likely to vary
  3. The impact of poor communication, poor planning could be really serious – affecting health, quality of life, and life itself. 
  4. There are massive sensitivities around the sense of dignity of the elderly parent, the sense of responsibility and obligation of the child / future care-giver.
  5. There are serious financial implications.
    In a way, it’s all made worse, because from birth we are told stories that work towards happy endings. And there is no happy ending to aging. But here’s the truth. Happiness is not a destination. It’s a mood, an emotion that comes and goes.

We’re going to limit the chances for happiness in our relationships as we transition from having been dependent on our parents as children to being independent as adults, to them being dependent on us in age, if we put off and avoid authentic, difficult and painful conversations that will lead to greater understanding and more real support. It’s like a bottle of milk that’s gone sour. You know it’s there, lurking in the fridge. But if you don’t pull up your big-boy / big-girl pants and get it down the sink ASAP, it’s never, ever going to improve by being left. 

How can we help our parents and relatives access as much happiness as possible in age? By opening up choice, giving them the chance to proactively design their future beyond the fear of loss so that they are able to exercise as much agency as possible around the next stages of their future. So that what could be a whole series of changes to meet their changing needs can be fully supported. Before life imposes change on them, on you, and limits the choice and chance you both have to flourish.

Powerful Questions to consider…to open up exploration, reflection, communication…

Look at appreciative enquiry as a model…
DISCOVER – open questions and explorations. Allowing each person to speak and reflect. Maintaining non-judgmental listening in this phase – it is all about finding out what’s good, what the peak experiences are. You are in curiosity, ‘yes’ brain mode…
DREAM – extending this exploration and discovery. What are the aspirations for the future, building on the discovery of what’s going on now that is going so well.
DESIGN – working together – collaborating on what practicalities will be needed to get as close to that vision as possible.

What do our parents really want from their old age – what would their vision be?
• What is most important to them and why?
• What aspects of their lives really nurture their sense of who they are?
• Whose old age would they most want to emulate? Who are their role models for a good old age? What was it about what they had, and how they nurtured that approach to life that resonates so much?
• What social connections are most important?
• What would they find most difficult to be without?
• What are their dreams and expectations in terms of family? What are your dreams and expectations in terms of your own potential involvement in care-giving? 
• How are they really getting on with independent living? 
• NB if you navigate explorations successfully around this, it is the gateway to other questions down the line becoming easier?
• What do you respect and value about their approach and attitude to life? 
• What are you noticing? What factual observations? What is it that you are seeing, hearing, sensing when you see them in their home? 
• What is it that really matters to you about what you see?
• How can you nutshell the values at stake for you in a relationship that is going to have a momentum of change with age and changes in agency?
• What might the impact be if you DO speak up? If you DON’T name it?
• How can you share that perspective with them in a way that seeks collaboration?
• How can you create and maintain psychological safety around this conversation? How can you focus on their agency, their choice, their ability to have control?
• How can you use your listening skills to get beyond pride, dignity, red mist, to what’s really at stake for both of you in your relationship?
• If a sudden change in health, or accident affected one or other of them, what is the plan?
• What are their resources?
• What are their social supplies? Friends, neighbours? How do they stay connected and check in on each other? How are they able to build reciprocal and meaningful connections in age?
• How can they feel that they make a contribution? What do they do, what can they do for others?
• What practical resources do they have – if they want to maintain independence in the home, what savings and funds to they have? If they might want to move home, downsize, or look at shared or single sheltered accommodation options, what financial planning have they done, what might they need to do in order to make that happen?
• How will they know when it’s time to get help? What to them might be the thresholds?
• Looking ahead to a time when their needs increase – and may accelerate. Where would they like to live?
• What do they really know about the options available to them? What do you really know about the options?
• This is where it is a good idea to look ahead. Like all the best schools and nurseries, good care homes are rare and wonderful places – but they do exist. They are really hard to find when you’re in a position where you suddenly really need them. Then you’re scrabbling and ending up with something by default. They have waiting lists. The other added bonus of looking ahead and shopping around, is that you can tune into word of mouth, the best sorts of recommendation. Especially in these times when visiting facilities is so restricted. 
• Looking for and understanding the pros and cons of sheltered accommodation, sheltered accommodation +, residential care, nursing care, dementia homes.

Crucial convo hacks:


  1. We can only change and control ourselves. We can’t control their reaction. We can’t change or force them to engage. But we can do our best to give them the chance and the choice.

    1. Self-awareness and self-management IS THE KEY. You know your parents from birth. You know how they are likely to show up when the emotional chips are down. BRACE, BRACE, BRACE…prepare for difficulty, deflection, distress, disappointment, frustration.

      1. Eyes on the prize. it’s not about what you want to happen. Really spend time focusing on the values and importance of the conversation. Anchor your sense of purpose. You need to prepare on this by making sure you can nutshell the essence of why this matters so much in a simple, clear sentence. If you can’t do that, the likelihood of losing the focus, getting deflected will be higher. You don’t want to be heading for the wrong target, or cloud the picture by having too many targets. Neither do you want to be wasting time nitpicking on the ‘what happened’ narrative. It’s more important to really get to the why to get engagement and understanding and move into the how we’re going to move forward.

        1. If you’re going to have clean communication about this difficult topic, you need to do your own emotional housekeeping first…and dust out the corners of the negative attributions you might be making, where you create a narrative around hopelessness or obstructiveness – or even mal-intent on the part of the other person you need to have the difficult conversation with.

          1. Notice the patterns – is it groundhog day with these discussions? Chances are you’re dealing with the wrong problem – you’re missing some key aspect that hasn’t surfaced properly because you’re revved up, they’re revved up, and tension has built a no-go-zone. 

            1. Track the history of the problem where there is a pattern of repetition and build up accountability around the situation that’s recurring. The first time is the first time. The second time, the plan they had hasn’t held…The third time, we’re on the road to relational consequences – erosion of trust, building negative feelings, perceptions of reliability, doubts of competency or commitment. 

              1. Before the conversation, ask yourself what you really want. What do you really want for yourself, for the other person, and for the relationship.

                1. Choose your time and place wisely – no public ambushes – AND GO FOR IT!

I think you can tell, that this one has come very much from the heart. Apologies for the length – it’s been a couple of weeks in the brewing. I do hope, however, that this has had some helpful resonances for you to think about.  Do let me know if it has. Please also encourage anyone else who you know could benefit from this sort of thinking and support to sign up to the newsletter via my website home page – or get in touch.What conversations are you not having?What do you want to do about it?What difference will it make?What will you take away from this piece?What will you do next?How can you begin?Good luck.With love and gratitude,Emma.

More to explore

Working with worry

Pubs or schools for September? Living with uncertainty – and working with worry as the impact of the lockdown release measures unfold…

Working with fear

Lockdown 2 challenges. The reality of fear, worry, death, and how to work towards acceptance and self-care What does this second lockdown mean to you? 

A

Time for an inner MOT

Time for an Inner MOT?
Debriefing ourselves in the aftermath of tough times…
And it doesn’t get much tougher than the last 12 months!