Youâve 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. Youâre frustrated because you want to make their lives easier. Theyâre angry because they think youâre 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 theyâre 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 (âYouâll need home health aides several times a week for the foreseeable futureâ), professionals learn to elicit whatâs most important to older adults and approach arranging care as a collaboration, not an edict from on high.
âPeople get into so many arguments when they get older. Itâs something I see every day in my work,â said Lee Lindquist, chief of geriatrics at Northwestern Universityâs Feinberg School of Medicine, whoâs 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.
âYou get thrown different situations, different emotions, and you get to play the game of negotiation as often as you want,â Lindquist said. Nearly $4 million in funding for the project comes from the National Institutes of Health. After evaluating the programâs 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 Northwesternâs Kellogg School of Management and a member of the NegotiAge team. âYou 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 partiesâ positions on each of these issues? Why do you believe theyâre taking those positions? And whatâs going to happen if we canât reach an agreement?â
It's 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? Letâs say you want your father, whoâs in his early 90s, to stop driving, because heâs started getting lost and his vision isnât great. The people with a stake in the discussion include your father, your elderly mother, you, your two siblings, and your fatherâs physician.
Your mom may be concerned about your fatherâs safety but hesitant to raise the issue for fear of provoking an argument. One of your siblings may agree itâs 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 partiesâ 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 doesnât 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 âIâm not going to stop driving,â 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. Donât adopt an adversarial approach. Rather, emphasize that youâre on the same team. The goal isnât for one side to win; itâs for people to work together to find a solution to the issue at hand.
Ask Questions
Donât assume you know why your parent is taking a certain position (âI donât want to go to the doctorâ). Instead, ask follow-up questions, such as âWhy?â or âWhy not?â
If an older person snaps, âI donât want to talk about it,â donât back away. Acknowledge their discomfort by saying, âI understand this is difficult,â while adding, âI care about you and I want to know more.â
Lindquist favors starting difficult discussions with patients with open-ended questions: âWhat are some things youâre having issues with? What are you doing that you wish you could be doing differently? What would make your life easier?â
Listening carefully and making the person youâre negotiating with feel heard and respected is essential. If one of Lindquistâs patients tells her, âI make my own choices, and this is what I want,â she might respond, âI agree youâre the boss, but weâre both here to make your life better, and Iâm worried about you.â
Brainstorm Strategies
Negotiations with family members are often charged with emotions that can easily spiral out of control. But donât reciprocate if someone gets angry and lashes out.
âWhen youâre buying a car, if you canât agree with the dealer youâre talking to, you can go to another dealer. When youâre in a conflict with a family member, you donât have this option. Youâve got more stubbornness and more defensiveness about disabilities,â Brett said, âand preserving relationships is even more important.â
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 âWhy?â or âWhy not?â again as needed.
If you find yourself going round and round without making progress, try saying something like, âWe could argue about this all afternoon, but neither one of us is going to give in. Letâs set aside our arguments and come up with five ways that you can get to activities without your car,â Brett said.
Donât expect to agree on a strategy right away. âYou can say, âLetâs bring in Mom and talk about this later,â or, âLetâs think about this and check in with each other next week,ââ Lindquist suggested, noting that many negotiations take time and canât be rushed.
Bring In a Third Party
If all else fails, appeal to a third party. This was Brettâs strategy when her husband, who has Parkinsonâs disease and compromised vision, wanted to resume driving in 2021 after recovering from a serious fall. Brett and the coupleâs daughter couldnât 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 doesnât worry about safety â an outcome both can live with.
Weâre eager to hear from readers about questions youâd like answered, problems youâve been having with your care, and advice you need in dealing with the health care system. Visit  to submit your requests or tips.
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