Talking with the people in our life about what is most important — in our life, and in our health care — can bring us closer together. It also helps us create the foundation of a care plan that’s right for us. But what if someone you care about doesn’t want to have these conversations or is having a hard time getting started?
That’s okay. Don’t force or pressure someone into talking about what matters to them. There are ways to do this informally that might feel more comfortable. Sometimes the idea of one big conversation is overwhelming — instead, you can have a bunch of short conversations. Pay attention to your tone – this is a time to be gentle, curious, and humble.
Here are a few ideas:
- Help the person feel comfortable, both physically and emotionally. These conversations are about them and what matters to them, so put them at the center. For example, if they might prefer a private discussion, don’t bring up these conversations suddenly in public. Pay attention to both their words and their body language, and watch out for signs that they feel stressed or upset.
- Focus on what is most important (in life) right now, not on future medical scenarios. Try talking about what’s going on in this moment – their current health, circumstances, wants, and needs.
- Pick one question from our guides. Think about which one might feel most important to know the answer to if you need to advocate on this person’s behalf for the health care that is right for them. For example, you might ask this question:
The answer to this one question could be helpful in making lots of different health care decisions, if needed.
- Use current events or TV shows. Jumpstart a conversation by talking about a health care situation happening on television or to a famous person. Ask, “What do you think about that? How would you feel if you were treated that way?”
- Bring up stories from the past. Talk together about a time when someone you love went through a health episode where decisions had to be made. What was it like? Were the person’s wishes known and respected? Stories can be more useful than statistics.
- Make it simple. One community member we worked with said her husband was really uncomfortable talking about his wishes for his health care, but he was willing to answer a few yes/no questions. She finally said to him, “If you couldn’t speak for yourself, I really want to know what to do. Here’s what I think you want….” She listed her assumptions about his wishes and needs. Then she asked, “Is that okay with you?” He confirmed that she had it mostly right and clarified one point. This conversation was over quickly, and she felt a lot of relief after checking her assumptions with him.
- Confirm who will make decisions. Maybe the person isn’t willing or able to talk about their wishes, but can say who they want to be responsible for advocating on their behalf if needed. Try saying, “I understand you don’t like talking about this. Are you comfortable with me making decisions if you can’t speak for yourself? Is there someone else you want to make decisions?”
For example, one woman shared that she didn’t have preferences for her care. What she wanted was for her adult children to make decisions using their best judgment if she was unable to speak for herself.For resources that might help your person pick a proxy — someone who would make decisions about health care if the person could not make those decisions themselves — read our guide to choosing a proxy.
- Keep an open mind. Listen to what matters most to them and keep those wishes at the center of these conversations, even if it’s not what you would choose for yourself. Do your best not to pass judgement. Don’t try to convince the person to choose something else.
- Offer to talk more than once. This is an ongoing conversation and wishes can change overtime. Help your person feel confident that they can adjust if they want to or if they get new information about their situation.
- Walk the walk. Show that YOU have had conversations about what matters for you and your health. Doing it yourself can encourage your person to join you — and it can help you have empathy when you’re on the other side of these conversations.
- Try some of these phrases. Use whatever language feels right to you that might help your person be more comfortable. For example:
- “I need your help with something.”
- “What does a good day look like for you?”
- “I want to make sure I know how you feel.”
- “There are no ‘right’ or ‘wrong’ answers.”
- “We’ll figure this out together.”
If your person really doesn’t want to talk, you may take a pause. You can still leave the door open for possible conversations in the future. You might say:
- “Sounds like you don’t want to talk about this right now. I’m going to respect that.”
- “Most of all, I want you to know that I’m here for you and want to be sure your wishes are honored. If you’re up for it another time, I am really eager to understand your wishes. For example, you could send an email to me later, pick someone else to talk to, or bring a note to talk about with your doctor.”
It’s a balance to bring up these conversations again without overdoing it. It doesn’t help anyone to pester your person over and over. If they really don’t want to talk about this, please be kind to yourself. Remember that you tried. You can’t force anyone to talk if they don’t want to.
What has been helpful for you to engage people you care about in talking about what is most important to them? Share in the comments below.
You may also be interested in: How to tell someone your wishes when they don’t want to listen.
Want to keep connected to The Conversation Project? Sign-up for our newsletter(s), follow us on social media (Twitter, Facebook, Instagram), download our conversation starter resources and feel free to reach us at ConversationProject@ihi.org.