Youve reached a standstill with your mother and father, who are in their late 80s. You think they need some help in the home, but they vigorously refuse. Youre frustrated because you want to make their lives easier. Theyre angry because they think youre interfering in their affairs.
Can negotiation and dispute resolution techniques used in the business world help defuse these kinds of conflicts?
Yes, say a group of researchers at Northwestern University. And theyre on to 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 resistant older adults. Materials for family caregivers are being developed, too.
Instead of avoiding difficult issues or simply telling people what to do (Youll need home health aides several times a week for the foreseeable future), professionals learn to elicit whats most important to older adults and approach arranging care as a collaboration, not an edict from on high.
People get into so many arguments when they get older. Its something I see every day in my work, said Lee Lindquist, chief of geriatrics at Northwestern Universitys Feinberg School of Medicine, whos leading the project. Its goal is to de-escalate conflicts and make it easier for older people to receive needed support, she said.
In May, Lindquist and her team planned 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 early-stage dementia. The program, called NegotiAge, features avatars of older adults and allows caregivers to practice negotiation techniques under different scenarios.
You get thrown different situations, different emotions, and you get to play the game of negotiation 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 programs effectiveness, Lindquist hopes to make NegotiAge widely available.
In the meantime, there are several steps family caregivers can take to forestall or resolve conflicts with older parents.
Prepare
Preparation is essential for any type of negotiation, advised Jeanne Brett, professor emerita of dispute resolution and organizations at Northwesterns Kellogg School of Management and a member of the NegotiAge team. You want to think through answers to several fundamental 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 believe theyre taking those positions? And whats going to happen if we cant reach an agreement?
Its helpful to write down answers to these questions in a planning document. Be sure to include yourself among the parties and spell out your goals for the conversations to come.
What might this look like in practice? Lets say you want your father, whos in his early 90s, to stop driving, because hes started getting lost and his vision isnt great. The people with a stake in the discussion include your father, your elderly mother, you, your two siblings, and your fathers physician.
Your mom may be concerned about your fathers safety but hesitant to raise the issue for fear of provoking an argument. One of your siblings may agree its time to take away the car keys, while the other may think Dad is still fine on the road. The doctor may recommend a driving evaluation and subsequently offer his professional opinion.
Look for common interests
Your job is to find areas where these parties interests intersect and work from there. Everyone wants your father to remain active and see his friends on a regular basis. Everyone wants to ensure he doesnt injure himself or anyone else on the road. Everyone wants to respect his desire for independence. No one wants to label him incompetent.
Brett distinguishes between positions, such as Im not going to stop driving, and interests, or the reasons why someone takes a position. In this case, Dad may be afraid of becoming isolated, losing autonomy, or giving up control over his affairs. But he, too, may worry about hurting somebody else unintentionally.
Negotiations have the best chance of success when they address the interests of all the parties involved, Brett noted. Dont adopt an adversarial approach. Rather, emphasize that youre on the same team. The goal isnt for one side to win; its for people to work together to find a solution to the issue at hand.
Ask questions
Dont assume you know why your parent is taking a certain position (I dont want to go to the doctor). Instead, ask follow-up questions, such as Why? or Why not?
If an older person snaps, I dont want to talk about it, dont back away. Acknowledge their discomfort by saying, I understand this is difficult, while adding, I care about you and I want to know more.
Lindquist favors starting difficult discussions with patients with open-ended questions: What are some things youre having issues with? What are you doing that you wish you could be doing differently? What would make your life easier?
Listening carefully and making the person youre negotiating with feel heard and respected is essential. If one of Lindquists patients tells her, I make my own choices, and this is what I want, she might respond, I agree youre the boss, but were both here to make your life better, and Im worried about you.
Brainstorm strategies
Negotiations with family members are often charged with emotions that can easily spiral out of control. But dont reciprocate if someone gets angry and lashes out.
When youre buying a car, if you cant agree with the dealer youre talking to, you can go to another dealer. When youre in a conflict with a family member, you dont have this option. Youve got more stubbornness and more defensiveness about disabilities, Brett said, and preserving relationships is even more important.
Redirect your focus to brainstorming strategies that can help solve the problem at hand. Get creative and put lots of options on the table. Invite your parent to respond and ask Why? or Why not? again as needed.
If you find yourself going round and round without making progress, try saying something like, We could argue about this all afternoon, but neither one of us is going to give in. Lets set aside our arguments and come up with five ways that you can get to activities without your car, Brett said.
Dont expect to agree on a strategy right away. You can say, Lets bring in Mom and talk about this later, or, Lets think about this and check in with each other next week, Lindquist suggested, noting that many negotiations take time and cant be rushed.
Bring in a third party
If all else fails, appeal to a third party. This was Bretts strategy when her husband, who has Parkinsons disease and compromised vision, wanted to resume driving in 2021 after recovering from a serious fall. Brett and the couples daughter couldnt convince him this might be risky, but the older man, then 89, agreed to get a driving evaluation at a facility associated with a Chicago hospital. When they recommended he stop driving, he gave up the car keys.
Brett later hired a neighbor in the small town in France where they now live to ferry her husband to appointments several times a week. Twice a week, she drives him to a nearby village where he has coffee with friends. He gets out into the world and she doesnt worry about safetyan outcome both can live with.
KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFFthe independent source for health policy research, polling, and journalism.
