How to Say It to Seniors: A Narwhal Book Review

This month, we had the opportunity to read a book from author David Solie, M.S., P.A., titled, How to Say It to Seniors: Closing the Communication Gap with Our Elders. David Solie is an expert in geriatric psychology and the CEO and Medical Director of Second Opinion, a life insurance brokerage corporation. Solie provides the reader with tips and strategies to becoming a legacy coach for our elders. The premise of the book is to teach readers how to conduct a “life review” on our elder family members, clients, or patients. Solie explains that a life review isn’t about the need for someone to create a monument in their honor by reliving the past, but it is about reviewing what occurred in life and assigning new or different meanings to these events, then considering how those recontextualized events become the way an individual wants to be remembered. This is a huge task and one that most elderly people may not be able to manage on their own, which is why the author’s insight around the idea of a life review is so important. While elders feel a subconscious urge to hang on tight, they are also challenged with the intimidating task of discovering how they will be remembered. How exactly do these two needs conflict? If seniors feel they do not have enough control over daily events, they will spend all their time fighting for it. That fight leaves them without physical or emotional energy to relax, keeping them from entering the reflective mode that is needed to review past events. The ability to enter the into this reflective mode is the preliminary step necessary to form their legacy. If we are fortunate to live long enough, we reach a stage where our strength recedes, losses accumulate, and the main event we face is the end of life. It is at this stage of life that we pause to reflect, to look backward, maybe for the first time, and try to assess what our lives have meant, to us and the world. To prepare for this, we must resolve our need for control with our need to let our energy, thoughts, and emotion go to have the strength and clarity that is necessary for what we are compelled to do.

Solie reminds the audience that what we as a culture have failed to recognize in the theories about personality development is, simply, that personality development is a lifelong event. We seem to understand the personality driver of children and younger adults, but we often fail to appreciate what happens when we get old. Seniors’ developmental tasks require them to maintain control over their lives in the face of almost daily losses, while also discovering their legacy, or what will live on after them. Solie describes this conflict as needing to hang on tight while also needing to let go and discover the meaning of their lives. When this conflict is trying to be resolved, this conflict produces a difficult communication style. The elderly will wander from subject to subject, go off on tangents, or describe something in endless detail. This often causes frustration within our communication style, and this is due to the clash of two different age-based agendas. As a younger or middle-aged adult we don’t spend much time or energy thinking about control. We have it. We exercise it. But this other developmental task, searching for our legacy, is not something we understand so easily. Prior to old age, a life review is only done when we suffer from a devastating loss such as a loss of a parent, job, friendship, or a relationship.

One type of loss of control that Solie discusses is the loss of financial independence. Many seniors fear being poor, especially widows or widowers who depended on their spouses’ incomes. Solie provides a thought-provoking example to drive home the impact this can have on an elderly person: You work all your life to build up that nest egg and some thirty-year-old high potential financial advisor comes up with a plan to save your heirs a bundle in inheritance taxes. The lawyers say that if you redraft this document and transfer that amount to someone over there, it’ll make a lot more sense. But does a transfer really make sense to the older person? That older person is already dealing with substantial losses and thought these financial matters were already settled years ago? This plan may make sense to a younger, more focus minded person, but all the elderly person can do is say no!

How do we discover legacy?

When we start to realize that we’re not going to be here forever, we become aware that it’s not clear what it meant to be here at all. Discovering legacy implies two things: (1) We’ve arrived at some understanding of our life, and (2) we want to pass along what we’ve learned. We may not know the shape of the legacy we’re going to lay down, but we’re clear about the desire to do so. Legacy is not simply a summary of what we’ve experienced. It is partly what we lived, and what we may not have lived, but what we admired. Both parts of legacy consist of values for which we would like to be remembered, and legacy coaches facilitate both needs.

What communication habits exist in our elders?

With our children, we look for a greater meaning in their communication patterns. With older adults, we assume there is less meaning, not more, and we become annoyed when they don’t respond to our attempts to keep them on task and get things done. With our children we show creativity and patience; with our older adults we tend to express frustration or concern. What we fail to recognize is that seniors are on a journey that is exploring and assessing an unfamiliar world. They are leaving the familiarity of the task-driven years and moving into the reflective and monumental terrain of their older years. The younger and middle-aged may sense a lack of urgency with our older adults and we often ask why can’t they make a decision? Because making decisions is not what life is about. It’s about understanding what has happened and what it all means. They know something that we don’t, that in the end, no matter how many phone calls we’ve returned, how many deals we’ve completed, how much money we’ve made, life always has a way of working out.

Solie stated the two communication limitations of professionals:

1. They have a defined goal and need to meet preset objectives
2. They usually have time restrictions, which limit their opportunity for the kinds of open-ended, nonlinear conversations that can reveal the insights that may be applicable to the task at hand.

He suggests the following techniques when trying to reestablish the connection with older clients and patients:

1. Breathe and refocus. Did we expect to hit a home run the first time? If we did, was that a reasonable expectation?
2. Try a different approach. Maybe interview a family member.
3. Rethink the goal. Is the elderly person capable of understanding and agreeing to a new plan? Can the plan be modified or described in a different language that might resonate with the client?
4. Redefine progress. Progress with the elderly takes the courage to know we tried something, whether it worked or not, and that we’re committed to reengagement that can bring us closer to the goal.

Solie also provides the reader with five communication strategies for prompting life review:

1. Ask open-ended core questions. These questions are open-ended because the answers don’t seek facts. They rely on interpretation, memory, and values.
2. Harvest responses to Open-ended Questions. Look attentive but say nothing. Reinforce the value or theme expressed and listen for repeated details, people, or entire stories.
3. Listen for the Values. Once we listen with legacy coach ears and ask the right questions, we can hear the values for which seniors want to be remembered. Because these values fill every conversation, there is ample opportunity to forge meaningful connections.
4. Note the Legacy Vehicles. These can be any of the following:
   • Acts of courage
   • Decisions to forgive or repair a relationship
   • Reflection on such questions as “Have I been a good parent, friend, boss?” “Have I done enough for others?” “Have I contributed to my community?”
   • Impact of declining health
   • Family stories
5. Start with “Tell me about…”. Using this type of statement helps us discover. This type of statement always rings a legacy bell.

Solie provides a checklist for legacy coaches to help with the process of recontextualizing our seniors’ experiences.

• Focus on values. Facts give us information, but if we can detect values, we can form a connection that could come part of the person’s legacy.
• Recognize that formulating legacy is an intense, active process.
• Note a person’s developmental uneasiness. Sorting a lifetime of experiences can feel daunting or overwhelming. If the person is having difficulty, we need to come to his or her aid.
• Conduct these conversations in a variety of settings. This can help stimulate different memories to the surface.
• Prevent the degradation of a person’s experiences into a default legacy. We don’t manage the legacy; we manage the process by which legacy is discovered.
• Feel the emotional gravity of our seniors’ attempts to review their lives. If we can imagine how seriously seniors take this look back, then we start to understand how important it is that life review in old age moves forward.
• Tune into an elderly person’s radar. Our elders know that we’re not old people, so how do we know anything about their concerns? When we can convince them, through our legacy-coach approach, that we understand this process, we can feel their relief.
• Raise any subject that seems relevant. Most of the skills needed to facilitate life review involve the ability not to question and prod, but simply to listen and ask the right follow up questions.

Our goal is to give senior adults the support they need to focus on their end-of-life tasks. If we are successful, we are rewarded in ways that not only diminish our frustration, but also make real communication possible and enjoyable. Solie reminds us that we don’t need to become our elders’ therapists, but we do need to develop an ability to choose the right words so that our meaning is clear and supportive. Some of us are not that far away from the time when we’ll begin to search for our own legacies. Why not gain the skills to help ourselves as well as others, as we discover what there is to our histories that might become part of our future? As their facilitators, we reap the rewards of the review process by developing skills that enhance our enjoyment of the person, enrich and clarify our lives, and encourage the formation of our own legacy.