Communication for Caregivers: Tips for Using Respectful Language

“Communication works for those who work at it.” - John Powell, English composer

The above quote is as accurate as it is simple –– the only way to get better at communicating is with practice, practice, and more practice. While this message rings true in all relationships, for family members who care for a loved one, it’s especially important.

Many new caregivers are pushed into their roles out of necessity. Life-changing medical diagnoses and serious accidents often occur suddenly. The weight of these issues and the challenges they present can leave you feeling overwhelmed and unsure. You used to rely on Mom and Dad in these very situations, but now the roles are reversed.

You can’t go back in time or magically cure a terminal illness, but by strengthening your communication skills, it’s possible to be the best caregiver you can be. In this article, we highlight various tips, tricks, and suggestions you can use to reduce conflict, strengthen your caregiving relationship, and keep the lines of communication open.

Introducing our panel of communication experts

While researching this article, we had the opportunity to interview several experts, including:

• Howard Petersen, owner and CFO of Professional Caretakers, a seasoned in-home care provider founded in 1998 that offers a variety of specialized individual care across Texas.

• Ashwini Bapat, MD, a Yale University-trained palliative care doctor, who worked at Massachusetts General Hospital and Harvard Medical School. Dr. Bapat founded EpioneMD, a company that provides virtual advance care planning and serious illness support to individuals, including caregivers, and tele-palliative care to healthcare organizations. 

• Katelyn Carey, RN, a nurse clinical educator, currently working in hospice as a Case Manager for both facility and home-based patients.

• Ilysse Rimalovski, MA, a Care Coach, founder of ThriveWell Care Coaching, helping adult children begin conversations with aging parents, and a Conversation Champion for the Conversation Project.

• Jenna Rosenau, LCSW,  a licensed clinical social worker at Better Life Therapy. Rosenau has many years of experience working in the hospital and health system. She regularly provides therapeutic and community support to the chronically and terminally ill and their families.

Keep reading to learn more about the things you can do at home to build a strong, communicative relationship with your care recipient.

1) Establish some basic rules for communication

One of the easiest ways to prevent arguments in the future, is to set some basic rules for communication. To do that, consider your relationship with your care recipient and if they have any preferences or standards. For example, certain words and terms might be interpreted differently, depending on who hears them.

“I didn't know until it became a trigger that I shouldn't use the word "dementia" while caring for my grandmother,” said Carey. “She associated it with schizophrenia, because in her generation that's the label that was given to people committed to mental health institutions for paranoid schizophrenia. As such, it was an incredibly distressing term to use around her, because she thought was going to be committed to an asylum.”

It’s also important to talk about medical issues, including bodily functions. If your loved one suffers from incontinence, potentially sensitive topics like toilet use, diaper changes, and accident prevention need to be discussed. These topics can be difficult to broach, but it’s important you don’t avoid them.

Another important rule for communication: own your emotions, and use “I” statements instead of “you” statements. For example, “I am feeling frustrated today” instead of “you’re frustrating me!”

“Speaking in “I” statements allows you to express your feelings without blaming someone,” said Dr. Bapat. “It’s also important you listen. Most people just want to be heard. If you’re able to give your care recipient the space to express themselves, 90% of your job is done.”

What may feel difficult or awkward at first gets easier over time. “Talking about caregiving is like working a muscle that needs to be exercised,” said Rimalovski. “These conversations are about having an empathic mindset and developing a caring dialogue that adapts to the changing needs of the family.”

What’s more, “These ongoing caring conversations are essential for your loved one’s long-term wellbeing. As circumstances evolve due to health or age-related concerns, you’ll have a foundation of trust and understanding in place,” she added.

2) Make respectful communication a priority

As a new caregiver, it’s easy to feel stressed out, anxious, and overwhelmed. Without an outlet to express these emotions, you might be tempted to act out by saying something rude or hurtful. While it’s perfectly normal to get frustrated, you can’t let those feelings spill into your caregiving responsibilities or daily routine.

“Communicating respectfully is crucial, because it sets the new dynamic up for success,” said Rosenau. “Having an open dialogue with your care recipient creates a sense of trust and support. Sentences like “You can’t do that alone anymore” can be replaced with, “Can I help you with that?”

In situations where children care for their parents, roles may seem to shift. “But without the sensitivity and awareness that comes with mutually-respectful relationships, there’s danger of communicating in a way that undermines parents’ autonomy,” said Rimalovski. “Be aware of acting impatiently, dismissively, or condescendingly, affirming that parents are still parents first. Ask them what they want.”

3) Know that arguments and disagreements will occur

Communication can be challenging in even the best circumstances. Add caregiving into the mix and disagreements are bound to arise. Know this is normal and not a reflection of your caregiving skills.

If it helps, “discuss potentially sensitive topics when other family members are present,” said Petersen. “Remember too, that most challenging topics revolve around safety. So, try to explain the importance of safety when discussing these issues. For example, “Dad, it’s important to use your walker. If you fall, you might break your hip and lose your mobility.”

If you notice that a conversation is getting heated or that your care recipient gets defensive, don’t hesitate to call a timeout and step away so you can both cool off. 

Another way to deescalate a situation is through mirroring. “If you want someone to feel understood, reflect back to them not just the ideas they are expressing, but also the energy level and general posture they are reflecting it with,” said Carey. “This is a great initial tactic: call out what the other person is feeling or expressing. If they say you have it correct, ask for more information. Then, express sympathy for what they're going through before moving toward a solution. This alone can de-escalate quite a lot.”

4) Do more listening than talking

One of the most important, but often overlooked aspects of communication, is the ability to listen. When you make time to listen, you can better understand your care recipient’s needs, strengthen your relationship, and build trust.

If your loved one has dementia or another neurodegenerative condition, it’s important to understand that your conversations will look different. Don’t try to guide your discussions in a particular direction. Smile warmly, make eye contact, and hold your care recipient’s hand. If they become agitated or upset, end the conversation and revisit it at a later time.

5) Limit distractions

The natural aging process makes it difficult to absorb, process, and remember new information. It also causes the loss of neurons and receptors, affecting your ability to concentrate. It’s no wonder then, that distractions are one of the biggest communication challenges family caregivers face.

If you need to have an important conversation, turn off devices like the TV, radio, and computer. If your care recipient has poor hearing or vision, make sure they’re wearing hearing aids and eyeglasses too. It’s much easier to get your point across if the person you’re speaking with can see and hear you.

6) Arm yourself with resources

Lastly, we wanted to provide you with some excellent communication resources. All of the books and articles linked below were recommended by our panel of communication experts.

• Communication Tips for Caregivers - Heart.org

• The Conversation Project - guides

• The Care-Prepared Checklist

• Communication Tools for Caregivers - Cancer.org

• The Caregiver’s Encyclopedia

• National Family Caregiver Support Program

• The 36-Hour Day by Nancy L. Mace and Peter V. Rabins

• The Emotional Survival Guide for Caregivers by Barry B. Jacobs

• Crucial Conversations: Tools for Talking When the Stakes Are High

Entering the role of family caregiver can be stressful for you as well as your care recipient. There’s a big learning curve and everyone has to make adjustments.

“By engaging in honest, ongoing conversations where each family member can openly discuss their needs, fears, concerns, questions, wishes, and what-ifs, you can actually cultivate trust, meaningful connections and peace-of-mind,” said Rimalovski.

Remember, communication can be challenging, but practice makes perfect!