A married couple should always talk. But in times of illness or disability, good communication will keep your marriage from going bad.
The first step you need to take is talking to your spouse. Find out what he or she wants. In some cases, however, your spouse may be unwilling or unable to talk about the future.
This can happen for a number of reasons, including incapacity, fear of becoming dependent, resentment toward you for interfering, or reluctance to burden you with their problems.
Whether your spouse wants to talk about the situation or not, the bottom line is that you need to have a plan. Start with a list of topics that you need to discuss. That way, you'll be less likely to forget anything.
Here are some things that you may need to talk about:
- Long-term care insurance: Do you have it? If not, should you buy it?
- Living arrangements: Can your spouse still live with you, or is it time to explore other options?
- Medical care decisions: What are his or her wishes, and who will carry them out?
- Financial planning: How can you protect your assets?
- Estate planning: Do you have all of the necessary documents (e.g., wills, trusts)?
- Expectations: What expectations do you and your spouse have?
© 2003, Forefield, Inc
Here are suggestions from AARP:
Plan the conversation. It's always helpful to plan a sticky conversation. One of these ways to break the ice might work for you and your family.
Approach the subject indirectly:
- "I know you're taking lots of pills. How do you keep track of them? Would a pill organizer from the drug store help you?"
- "John says his dad has given up driving. How would you get around when you can no longer drive?"
Be direct, but non-confrontational:
- "I'm worried that you seem to be unsteady on your feet. I'm wondering how I can help protect you from falls."
- "If you ever get to the point where you can't live at home, where would you want to live?
Watch for openings:
- "You mentioned having problems with your eyesight. Have you seen the eye doctor lately? Does it seem to affect your driving?"
- "After you said last week that you had trouble turning the handles on the water faucets, I wondered how you were managing with the shower."
Share your own feelings about your changing life:
- "You've always been so independent. I imagine it's now hard for you to ask for help. Is it?" Let your spouse know he or she can always ask you for help when they need it.
- "It's hard to see you give up reading now that your eyesight is getting bad. Do you miss it? Would you like to try a book on tape?"
Make a list. Family members are sometimes uncomfortable jumping right into a talk about sensitive topics, such as finances,
If so, consider writing a list of questions or concerns and provide some time to think about the kinds of help he or she may need and prepare for the conversation.
Dealing with resistance. Some resistance to talking about independence is normal. Your spouse may put you off with reassuring statements. But experts advise:
- Respect your spouse’s feelings if he or she wants to avoid a subject. Try another time.
- Push the issue if health or safety is at risk, while recognizing your spouse’s right to be in charge of his or her own life.
- Act firmly, but with compassion, “We can't ignore this any longer. We have to deal with it."
- Involve other people who your spouse respects, such as a minister, lawyer, or a family friend.
- Hold a family meeting where everyone discusses concerns and jointly develops a mutually agreeable plan. Make sure your spouse feels a sense of involvement and control over his or her life. Listen to opinions and recognize the right to make decisions. Stay focused on current needs and avoid past resentments.
- Look for community resources that can help a your spouse remain independent, such as transportation, home health care, meal delivery. Share the options with him or her.
Focus on key points. Guessing your spouse’s wishes for the future can lead to bad mistakes and hard feelings. Ask about his or her own thoughts about needs and concerns, worries about the future, and hopes and goals.
While you don't want to ask all these questions in one conversation, focus your talks on these major areas.
Where to live: Is your home still ok for your needs? Can you still manage the stairs? Would making some simple home modification help? Should you think about living somewhere else?
Everyday activities: Do you need help with running the house and doing chores? Yard work? Can you hear a knock at the door or the phone ring?
Getting around: Can you get to your doctor visits? Is driving getting hard? Are you getting out to see friends? Getting to the store ok? Can you get to religious services?
Health: What health problems do you have? Are your prescriptions current? Are you having trouble paying for your medicine? Do you need help remembering when to take your pills?
Paying for health care: What kind of health insurance do you have? Has it paid your bills so far? Do you have long-term care insurance? Would you like some help filling out insurance claim forms? Do you have questions about Medicare?
© 1995–2007, AARP
Here are some guidelines to help you communicate with your spouse:
Get attention. Begin your statements and questions with an identifier. This doesn’t necessarily have to be your spouse’s name, but should be a common greeting used between the two of you (very often, a term of endearment will work).
Wait till you have her attention before continuing, especially if there is a great deal of background noise. Very often, it is difficult for impaired individuals to understand when people are talking around them, or to them.
Speak at eye level and enunciate. In addition to getting your spouse’s attention, you also need to retain that attention. Before beginning a conversation, get to his or her eye level. If someone is in a wheelchair or lying down, pull up a chair.
Be sure to retain eye contact and try not to occupy yourself with other things while you’re engaged in conversation. Enunciate your words so that each is differentiated from the other.
Use simple, direct statements. When communicating, you may need to use statements that are short and descriptive. If, “I would appreciate it if you finished your breakfast and got ready because we’re running late,” does not work, try, “Please finish up so we can leave on time.”
The latter may sound curt, but it needn’t take an angry or frustrated tone. It is simply a direct way of communicating your needs.
Ask. Try not to tell. Keep in mind that you are still communicating with an adult. And most adults like to be asked to do something, rather than told what to do. As such, utilize the three magic words: “can,” “will” and “please.” “Can you stand up so I can fix your dress?” “Will you sit in this chair?” “Please join me in the living room.”
Move closer. If you are talking to a loved one and they can’t hear what you’re saying, try moving closer to the person rather than raising your voice.
Be respectful of a person’s “personal space” (or distance at which she/he likes to communicate). But remember the ultimate goal: making yourself understood.
Listen. A simple point, but one not to be overlooked. You know your loved one better than anyone else; use this to your advantage. As a caregiver, very often your most important role is as a listener.
And listening can be done even if your loved one does not speak; you can communicate your interest with as little as holding their hand.
Give yourself plenty of time. Time, and the freedom to take your time, is a necessity. For example, if your spouse needs the time, allow an extra 15 minutes for travel, enough to assist him or her in getting to, from, into and out of the car.
This is especially important if your spouse is particularly resistive or hesitant to participate in her or his own care (taking a shower, for example). Try not to get into a power struggle and maintain your other communication skills.
Try, try again. A little trite, but important nonetheless. If you find yourself in a struggle with your spouse, it is okay to let go. Come back later. Your spouse might need to think about what you are suggesting and the reasons for them.