Starting the Home Safety Conversation:
Nearly everyone wants to stay in their home as they age. Discussing home safety with the older adult early gives you more time to get information, consider options and make changes. Before you talk with the older adult, ask yourself:
What are my specific concerns about the older adult's health, abilities or home environment?
What have I seen or heard that makes me have these concerns?
What don't I know? What assumptions might I be making?
Am I trying to convince the older adult to do what I think is best? Am I open to other possibilities?
Set a small goal for your first conversation. For example, your goal could be learning whether any areas in the home are challenging for the older adult, or seeing if the older adult shares any of your safety concerns. Good conversation starters include home safety facts, friends' or family members' experiences, or news stories. For example:
"I've been thinking how great it was that Grandma stayed in her home for so long. What helped her do that?"
"Did you hear that George fell and broke his hip? Do you ever worry about something like that?"
"Did you know that home accidents are more than twice as likely as car crashes to cause injury? But there are lots of ways to improve home safety."
Be honest about your reasons for wanting to discuss home safety. Acknowledge that the older adult might see the situation differently. During the conversation, focus on understanding the older adult's point of view. Don't push for decisions or actions right away. Don't try to cover too much in your first discussion. Try to end on a positive note. If you can, agree on next steps with the older adult, like having another conversation, scheduling an appointment or doing a home safety assessment together.
Responding to Negative Reactions During Home Safety Conversations:
No one is against being safe at home. However, sometimes home safety discussions can bring up strong emotions. Older adults might be embarrassed that they're struggling with something that used to be easy, or afraid that they might lose their independence. They might feel like their judgment is being questioned.
During difficult discussions, do your best to calmly and clearly share your thoughts, using phrases like, "I am concerned" or "My feelings are." Focus on what you can agree on and how you can work together to improve home safety. Listen carefully and consider what the older adult says. Remember that what you're talking about probably affects their life every single day.
You and the older adult might have different ways of speaking or thinking about home safety. Home safety discussions can be difficult when:
You disagree about whether there is a home safety problem, or what the problem is.
You disagree about what's most important. For example, you might be more concerned about safety, but the older adult might be more concerned about staying independent.
You disagree about what's a good solution.
You use or hear words differently, so that you say and mean X, but the older adult hears Y.
You have different communication or decision-making styles.
You want different people to be involved when you discuss home safety.
How you respond to each other is shaped by family patterns or social roles.
If the older adult has a negative reaction, it can help to ask them why. Try to understand their point of view. If the older adult doesn't want to discuss it, don't push. You might need to agree to disagree on some things. It's usually better to drop the subject and discuss it again later. If you understand why the last conversation was difficult, you might be able to find a different way to approach the topic next time.
Keeping the Home Safety Conversation Going:
Your follow-up conversations can help you and the older adult work together to improve their home safety. Follow-up conversations can be good opportunities to:
Share and discuss new information
Weigh the pros and cons of different options
Ask if the older adult's needs or feelings have changed since the last time you talked
Involve professionals, family or friends whose experiences and opinions you both value
If you and the older adult agreed on next steps during your first conversation, it can be easy to start the next discussion. For example: "How did your eye exam go?" or "I heard back from the city about home accessibility resources." If the first conversation didn't end with clear plans or on a positive note, there are other ways to start a follow-up discussion. You might want to:
Build on a specific point from the previous discussion: "You said that some kitchen shelves are a bit high. Would it help for us to reorganize the kitchen a little, so things are easier to reach?"
Discuss a different home safety topic: "I know you want time to think about bigger changes, but how would you feel about adding a few lights?"
Try to understand their point of view: "You said you don't want to have your medications reviewed by a pharmacist. Why? Does it seem like too much of a hassle?"
Explain why this is important to you: "It may seem like I'm overreacting, but I know from Mike's family that situations can change quickly. I just want you to be safe and stay in your home as long as possible."
Highlight how other things might affect home safety: "I know some days your arthritis gives you problems. What do you think about adding railings to the outside steps?"
Space out conversations: "It's been a few weeks since we talked about how a cane might help you get around. Do you still think that's a good idea? Do you want to look at different canes?"
You can encourage the older adult to share their thoughts and opinions by asking more open-ended questions, like "What changes would you like to make around the home?" If you ask lots of "leading" questions - like "Wouldn't you feel safer if you used a cane?" - it can seem like you're just trying to get them to go along with what you want.
Try to have smaller, more frequent conversations, rather than a few big ones. That gives you both time to get information and consider options before you discuss home safety again.
Avoid launching into a home safety conversation every time you talk with the older adult. Try to balance the "serious" talk with time spent simply enjoying each other's company.