Handle with Care: How to Broach Sensitive Subjects with Your Loved One

^{Written for caregivers.}

When you’re caring for someone with a serious illness, the added sprinkle of fear and uncertainty can make communication that much more difficult. Especially when sensitive, avoid-by-all-means subjects are involved. There’s so much to discuss, and so many decisions to make – so how do you get around the roadblocks that hinder good communication?

We’re here to give you some guidance on how to confidently start sensitive conversations and chat about anything from future treatment decisions to expectations for the end of life. Your loved one will feel respected and listened to, and you will all be better prepared for the future, no matter how uncertain it might be.

I’ll be honest. Certain topics won’t come up naturally in conversation. Unless your small talk effortlessly integrates the uncomfortable, it’s up to you to find the right time to bring up more sensitive topics. A quiet moment when your loved one is feeling relaxed is ideal. If they’ve been in pain that day, feel tired out from visitors or are anxious about their appointment, hold off on the serious stuff. You should also take your own emotions and energy levels into consideration, and pick a time when you’re feeling calm and patient.

The setting plays a role as well, so try to avoid starting up a conversation in the hospital waiting room between appointments. Instead, try over a cup of tea at the kitchen table, or even on a walk or drive.

You’ll also want to consider who to involve in which conversations. For example, it will be helpful to invite a social worker to join your conversations about finance, or certain family members or children to chat about planning a potential family event.

Go easy on yourself and only tackle one topic at a time. Do you want to discuss how much information to give the kids? How they want to spend their final days or who they want to be around. Be honest and emotive, and try phrases like this:

“I’m worried I won’t know what to tell the doctors about your treatment if you get more ill. Can we talk about your preferences with that?”

“I’m planning a family dinner, and I’d like your input on who you want there. It’s important to me that you feel comfortable and not overwhelmed by it all”.

Be sure to listen, be present, and empathetic. Some topics can be pretty confronting to talk about – like end-of-life planning, finances, funerals or treatment decisions – so be sensitive and understanding. Turn towards your loved one, keep eye contact, and avoid distractions like your phone. Remember, you’re having a conversation, not extracting information, so make sure to leave enough pauses for thinking, reflection, and replies.

That said, you will want to keep a note of any important decisions made by your loved one. You could use a notebook, google docs to easily share with others, or a specific whatsapp group that includes more family members.

Make sure to check in with your loved one and ask them how they’re feeling, and whether they have any worries or reservations about the topic in question. If it’s a difficult topic, you might comfort them with, “I understand that this is upsetting, and I appreciate that you’re sharing your feelings with me. Let me know if you need a break.”

Most of all, be gentle. If you go all in, determined to cover ten different heavy topics, it might be overwhelming – for both of you. Expect to hit bumps. You’re in unknown territory, after all, and your loved one might get defensive, upset or angry. Don’t let that dishearten you – offer to take a break or continue the conversation another time.

Always leave room to revisit some of the conversations, and make space for them to reassess their priorities or change their mind.