5 Tips for Handling Difficult Family Caregiving Conversations







As a provider of care services to elders, you know all too well that difficult conversations with family members are a common course of business. There are many situations where a family member is unable to physically visit their loved one except when traveling or off of work or school around the holidays. Naturally, after not seeing their loved one for a length of time changes will have taken place, and this can cause a variety of responses – all of which necessitate a helpful and informative reply. The goal is to make them feel comfortable and at peace like after the first sip of hot cocoa on a cold winter day. How do you prepare for those tough interactions? Do you feel as though the conversations are effective and well-received? 

According to Caregiver.org, each year, 1,383,700 elders receive support from skilled nursing communities; out of a total 8,357,100 elders receive support from the 5 main long-term care services. That’s a lot of family members to support and guide through the ever-changing care needs of the elderly loved one!

If you see changes before (or even after) the holiday visit, how do you react as the care provider? What is the next step you take to keep the family informed? If you will, how do you start to make their hot cocoa?

A few action items to consider:

  1. Assign a staff member to be the care plan update point of contact. This doesn’t have to be social services or the RN unit supervisor. Empower your staff by appointing a lead nursing assistant, activities staff member, or shift supervisor.
    In doing so, the appointed person on the team can develop a trusting relationship with the family. This in turn will allow the family member to confide in them and have a more positive outcome for the resident themselves.
  2. Ask how directly the family wants information provided can be helpful. Eldest sons/daughters may want to be straight to the point and very frank, but other family members may need a little more time and information added slowly.
  3. Have partners like hospice or unit managers with the specialty care unit be introduced to them after the discussion is held.
    Remember to position that person as a new resource to the family and as an ally in caring for their loved one. Having the whole interdisciplinary team present for a care meeting being held to cover a tough topic will put family on the defensive and feeling ganged up on.
  4. Review the Family Communications Empowerment Tool (link) with your staff before the holiday visits happen.
    Use it in your daily team meeting or staff huddles to remind everyone how to respond to family members who might be frustrated, angry, sad, or unaccepting of the changes with their loved ones.
  5. Ensure you are responding with respect, understanding, and empathy.
    After time in the industry, responses can become objective and insensitive entirely unintentionally. Pre-planning what is to be discussed and how to focus the conversation can help ensure observations and concerns are addressed in a sensitive & respectful way with the family.


    Responses that could be used:

    • I can understand that this update may be difficult to hear. But it is important so we can collectively make the best decision for the next steps.
    • We realize that seeing mom having less physical capabilities is difficult when she was always so active.
    • Is there any of this information that doesn’t make sense to you or that we can explain again or in more depth?
    • How are you feeling with the plan we have suggested for mom? Is there anything you disagree with?
    • What have you noticed during your visits/phone calls with dad?

Remember, you are in a unique position to serve, help and support the elder and their family in their greatest time of need. Use your resources to plan out tough conversations and make the situation less stressful for yourself, your staff and the elder & their loved one – especially those resources you have access to as a program coach. Support your staff by teaching them these tools so that they each can create that hot cocoa experience.