Intro (00:00):

Welcome to Seniors' Care Matters, part of the Qod Pod network. Each week, Seniors' Care Matters provides inspiring interviews and insights to help you lead, connect and engage with your teams and your residents' families. We focus on ways to enhance your leadership approach and presence with practical tips, to build a relational culture and create breakthrough results. And now here's your host for Seniors' Care Matters, Deborah Bakti.

Deb (00:30):

Today we're going to talk about conflict and share a different, more productive way to think about conflict, and perhaps even inspire you to lean into conflict, to use it to create different and better outcomes and experiences. I recently had a conversation with Liane Davey, author of The Good Fight, and it was such a great conversation, I'm bringing that interview to share with you here in this podcast. We talked in a previous episode about conflict avoidance as one of those strategies that people pleasers use and how it can end up delaying the inevitable or creating even more issues, when we let things fester and go unresolved. I'm someone who typically prefers to avoid conflict. I'll bite my tongue rather than tell it like it is if my viewpoint, perception or my truth, as I see it, if I think that will create a debate or a disagreement that will create stress and tension, and just that yucky feeling of disagreement and maybe even hurt feelings. I think it started as lots of things do with my upbringing. My dad had pretty strong opinions and it never worked out well for any of us who disagreed with him or tried to challenge his way of thinking. Maybe that was the era, right? Children were to be seen and not heard. My mother would typically say, just leave it. You don't want to upset your father. And maybe some of you had a similar experience. Liane's perspective on constructive conflict gives me hope and perhaps will give you hope as well that there is a way to embrace conflict as an opportunity to problem solve in a more collaborative way - that we don't have to endure a combative and stressful interaction. We can seize the opportunity to co-create solutions. Liane shares a four step approach that you'll want to try the next time you're feeling yourself leaning away from a conversation for fear of it spiraling into a no win situation. There is a way as Liane says to use productive conflict to get your team and organization, and I'll add relationships with your residents' families back on track. Here's a bit about Liane.

Deb (02:56):

Liane's a New York times bestselling author of three books, including "The Good Fight: use productive conflict to get your team and your organization back on track" and "You First: inspire your team to grow up, get along and get stuff done". Known as the water cooler psychologist, she's a regular contributor to the Harvard Business Review and frequently called on by media outlets for her experience on leadership, team effectiveness and productivity. Liane has advised on strategy and executive team effectiveness at companies such as Amazon, Walmart, TD bank, Google 3M, and Sony. Liane has a PhD in organizational psychology. I hope you enjoy this conversation with Liane Davey.

ad (03:47):

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Deb (04:02):

I think it would be great to be able to share with people who work in seniors care some ways that they could be approaching this, reconnecting and being able to reintegrate the families into the home as well as be able to rebuild that connection and that relationship.

Liane (04:20):

Yeah, fantastic questions. And there's no easy answers to any of these things. But one of the things that I think, folks in long term care really have going for them relative to some of my corporate clients, is that in long term care, you're very accustomed to problems without easy answers. You're used to no guarantee that things will work. If I think about family members with dementia, you can have a good day where there's all sorts of positive interaction and a bad day, and no idea what caused one or the other. So dealing with ambiguity and dealing with situations where you're never quite sure what to expect. The good news is for people in long term care, that's something you're very accustomed to. Definitely not true when I'm talking to bankers or folks where things have been much more predictable. So just know that you have it in you.

This is how you're wired. This is what you're accustomed to. And now it's a different kind of unexpected outcome and yet dealing with ambiguity and uncertainty, it's a core skill of yours. So you should feel good that it's there to draw on when you need it. So that's, that's a good place to start.

Deb (05:34):

Okay. So yes, as you're saying, they're hard wired for this. And so, they do work in a, I mean it is a life and death business, long term care home typically has 50% of their residents leaving either through relocation or through passing away.

Liane (05:56):

And, I think to a certain extent, that's, what's been really, really challenging about these situations is, death and, having a good death. Just like we try and have a good life is the business that long term care providers are in. And so when all of a sudden, COVID affects your ability to give someone a good death, it's not that people in long term care are afraid of death. It's their business. It's their unique contribution in the world, but it's so often about a good death. And COVID for many, has not been a good death. It hasn't been holding the hands of people they love. It has been dealing with your care provider behind frightening masks. And if people are not fully lucid, then that can be intimidating. So, it's not the death per se, as it is for most of us, right, who've never seen death and who don't, you know, it's terrifying. That's not the issue in long term care. It's just that the control is taken away in terms of being able to manage that death or have it be as positive a transition as I think most people would and are professionals at making it an effective transition.

Deb (07:10):

And I think for families, I mean, we understand that the intensity of course in long term care, just because of the demographic and all of the rules and requirements, and yet families are feeling frustrated because they're not able to be there, particularly if it's in a palliative situation/end of life. But also to be able to maintain what they would have provided for some family members, the daily care and so this frustration that they're feeling that they're not being listened to - hasn't yet changed what the protocol is. And so therein lies this lack of feeling heard and understood that is contributing to the conflict.

Liane (07:55):

Yeah. And that's the number one place to start. So in any conflict, in any scenario, whether it's at work at home, anywhere, the number one thing you can do to change the trajectory of a conflict from being a very unhealthy, unhappy conflict to being at least a constructive conflict, is to make people feel heard and feel understood. So let's get to something really practical, which is what I call the validation technique. So when we're overworked exhausted, stressed out and a family member is telling us their little piece of the puzzle, that seems maybe irrelevant, or even horrible to us that they're even bringing this up. Our tendency is to want to say, do you even know what I'm coping with right now? Or that is so not what your father needs or any, or whatever we want to contradict. We want to, we want to be heard. And of course that's the worst thing that we can do. So the first thing we want to do is to try and catch that two second breath. When someone says something that is causing us to react, maybe we can notice our palms get sweaty or our heart start to race or whatever your own physiological indicator is that ruh - oh! And to just take one centering moment to then say, okay, I need to make this person feel heard and understood. I need to validate them before I say a word about myself or the greater context or anything. So you don't have to do that by agreeing with them. And that's a really, really important point. I'm not saying you need to agree with somebody if they're wrong, not at all, but you do need to make them feel heard and make them feel understood.

Liane (09:48):

So, you're really worried about your mom getting enough wool to do her knitting. You may be thinking you kidding me... knitting? But simply just saying for you, you're really concerned about your mom, having her hobbies, being able to maintain some things that are normal. Simply saying that doesn't mean you agree doesn't mean you have a solution for how to do that, but it does mean that I've heard you, so say something, and if what they're coming at you with is something hurtful. You know, your team is callous. They don't care. You know, they may say something like that. You don't care. You know, you're not even working, unless you get four bucks extra, you know, whatever comes at you. And there's likely to be lots of emotion that comes at you. Again, say something that makes them feel heard and understood. It's really hard for you to see the staffing levels. It's hard for you to know that your mom is going, four hours in a day where she's not seeing anyone, whatever it is, say something that validates them. So that's step one. And if they say something that's really hurtful to you, like you don't care or you're callous, then you can simply validate them by saying it feels to you. Like we don't care. And, that's really, really hard for me to hear, but thank you for being honest with me, or thank you for being candid or thank you for saying that to me.

Liane (11:12):

Then the second stage is to ask them some questions to really get at and to understand what's underneath. Cause when we're emotional, when we're feeling all of those things all at once, we tend to be pretty inarticulate about what's actually going on. So the families are probably not telling you in their first pass, you're getting some bluster of emotion and not getting something helpful in terms of what you can do. So you want to in the second step, inquire, ask some questions. So, what would you like it to look like for your mother? What would you like her day to look like? What are the three most important things if we can only take care of three things, what would they be? What's one thing you would love for your sister to have every day, whatever it is, ask some questions, get them talking, get them telling you the things that help you understand in the grand scheme of things, what really matters to them. What's going to make the biggest difference. And as you're doing that, reflect back to them what you're hearing. Okay. So I'm hearing that some of this is about feeding time where you're worried and concerned that normally there's better staffing levels to make sure that there's assistance during eating and you're concerned about choking or whatever it is, paraphrasing those things back. So once you've done those two things, once you said something to validate, make them feel heard. Once you've asked some questions to understand then comes the key moment.

Liane (12:40):

And that's the moment when you speak their truth. You say for you, this is about X, Y, and Z. The most important thing is this. And what you'll find is that is the inflection point of the entire conversation. When you speak their truth, either they'll be so relieved that somebody heard them and listened to them that they'll do something sort of big and obvious, like yes or finally, or they'll say something like that, or you'll just see them like, okay, like I can stop yelling. I can say, cause I feel like it landed. That's a really great moment when you get it right. Then, and this is the key thing is that then you have earned the right to share your truth. So human beings work on reciprocity. And so when you've taken all this time to validate them to listen, to reflect back, there will be a very, very strong impetus for them to do the same for you. It doesn't mean a hundred percent of the time, but with most people, once you've done that, they will then be willing to hear you out. You don't want to state this as a but or as an or. You want to state this as this is something that's also true. So if you've said it's really important that your mom has extra care. If we can really only focus on one thing, it's mealtimes that there is the kind of support because you think that's a safety issue. I hear you. And right now we have 20 people in the dining room, or we have three staff away on isolation, right? You can now share your truth, sharing it as a second truth, not as an Or, but as another truth, And then say, let's brainstorm about what our possibilities might be. Let's talk about, maybe we're careful about what food, what have you learned about what foods she can cope with easily? What, might we take off of her menu? Those kinds of things. So that, because what happens is, as soon as you get into that problem solving mode, it's pretty much impossible to be combative when you're being collaborative in problem solving mode. So the faster you can make the family member feel part of the solution that you're, co-creating this solution together, you're going to be in a great place.

Liane (15:00):

So validation is the number one technique you want to be using many times a day. It certainly with family members, but as much with your staff, whatever situation. And then when you go home and you're stressed out and you're tired and your teenager says something to you and you just want to invalidate them, use it there as well. So that's the most practical thing that you can do. Step one, say something that says, I hear you and it's landed with me. Step two, ask a question, dig a little deeper then state their truth as best you understand it. And then you can pivot, share your truth as an additional truth and then engage them in some problem solving. So we get out of that combative mode and into collaborating to find a solution.

Deb (15:48):

You continue to adapt and adjust with all the pandemic policies and protocols with admitting and moving in new residents. You are dealing with limitations in building a connection and relationships with your new residents' families. If you're looking for powerful ways to connect and build trust with your new families during COVID-19, please head over to my website at www.deborahbakti.com or click the link in the show notes, and I'll send you 10 great ideas that you can implement immediately to create trust and connection with your family.

Break (16:21):

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Deb (16:50):

And it sounds to me, Liane this is, what you teach your clients as far as when you talk about productive conflict, which probably you hear all the time. That sounds like an oxymoron.

Liane (17:03):

Yes. And it just isn't. Conflict is absolutely necessary. Let's just go back and define conflict because a lot of people will say to me, could we use a different word? And I say, well, we can, but the taboo word just suggests it's a taboo subject. So let's actually get clear on what we mean and maybe we can then not be afraid of it. So conflict is just the struggle between opposing needs and wants and demands. And we have a dozen of those a day working in organizations, living in families. So let's not be afraid of conflicts, but let's understand that there are tensions. So if I'm running a long term care facility, I am under huge tension. I am under the tensions around safety. Number right now, safety, safety, safety, safety, safety of my staff and of my residents. I am under huge pressures then for all of the quality of life and quality of death issues for the people who are entrusted to my care. I am worried about having adequate staffing levels. So I want to be empathetic and kind to caregivers about their shifts and being flexible. But at the same time, I know I'm risking safety or care if I let someone have too much latitude, I feel that tension. So those conflicts and the different stakeholders you have to deal with - their different vested interests. There is going to be conflict all the time. It's not a bad thing if we can keep it productive, if we can think about it as I got multiple truths that I have to wrangle here to come up with an optimal solution, then conflict is really about making sure we understand what all the different truths are, making sure we have a forum to weigh them and to kind of jockey around, to figure out an optimal solution.

Deb (18:49):

Yeah, but you've really nailed it as far as those competing priorities and where we know and the spotlight is on them. So everything is being scrutinized, whether it be through the press, through families, coworkers and looking at all of that. And so, when we're looking at this rebuilding of the relationship, because there are families who may be feeling worried and anxious and maybe their trust level has decreased, they don't know what's been going on because they've not been able to be in there. And the communication hasn't, the value of those casual conversations, when you're walking down the hall to visit your loved one,with one of the staff that's not happening right now. The communication is much more structured and formal. So I think this is really helpful as far as reframing, what can be challenging conversations, feel very conflict oriented to have a framework, to be able to approach it as an opportunity to actually create a better outcome through the steps that you've outlined and then getting into that place of co-creating the solution together.

Liane (20:05):

Yeah. And it's, co-creating a suboptimal solution. It just is going to be a suboptimal solution. But if you've been willing to listen to what ideal looks like or what all the factors are that the person's paying attention to, then you can engage them with understanding. Okay. If our resources are constrained, help me understand, which is more important to you. Is mealtime more important than hobby time, help me know which is it more important that there's some social interaction or more important that we keep your family member isolated, like whatever. But if you've allowed them to share their perspectives, it's going to feel much better as you come to a suboptimal solution, that's your joint suboptimal solution than imposing a suboptimal solution on someone.

Deb (21:01):

And I think that also opens up the opportunity to be able to have that conversation of adjusting the expectations. I tend to not call it lowering, but it is adjusting because it is a new reality. We all had to adjust our expectations when it comes to the everyday customer service we are experiencing in our world. Right? With all of the new constraints that have been put on in place, and I think that it's a bit different in seniors care, long term care, it's a very intimate, personal relationship. So yes, it's customer service and it's also a big life change. Any last thoughts Liane on to add to the model that you've just described and helping them with their family.

Liane (21:50):

Maybe one point, which is that and if I think about nurses as one group and just my experience over all the years with nurses, what makes nurses often really, really good at their job is they're able to keep emotion kind of compartmentalized because it's too hard a job to do if the emotions are bubbling up all the time. So I find nurses are pretty good at keeping the keep calm and carry on kind of approach. And, and so they, what I would encourage folks, particularly if you come from a background as a PSW, as a nurse, as a social worker, whatever your background is, just know that emotions are a given. They're how the human brain works. They're not something people can turn off. And what happens is when we deny somebody else's emotions or we try and make them smaller or squish them, they tend to get bigger and they get bigger in one of two ways. One, if they get bigger, somebody feels invalidated. If somebody feels they don't have an outlet with you, then one is they might go underground. And that's where you need to be pretty worried about them, whispering about your home, to their neighbors, posting things on social media about your home, phoning their MPP. You need to worry if you do not make a place for that, it's going to possibly go underground and come out in a much, much, much more dangerous place. The other possibility is if they try and suppress it, it could come erupting out into a big emotional outburst. So I'm really gonna encourage your listeners to think about how the more you can make room for the emotion in the moment before it boils over the better.

Liane (23:41):

So think of it. I maybe this'll be helpful to people in the healthcare field. I like to think about emotion in that sense, much like I think about pain. I had bursitis in my shoulder all last year and when I give speeches, I like to wave my arms around and I would wave my right arm around and get a shot of pain right down my side, which was so helpful because it reminded me, Liane, you're injuring yourself, stop. There's an injury. And so acute pain is very helpful as a symptom that something is wrong and a chance to actually do some work, to diagnose what's going on. Well, the same is true when we see emotions, if we see it from an employee, if we see it from our customer or a family member. So I want you to reframe how you think about an emotion. And what I want you to do is use this line because it's a line that's free from judgment. And it's a line that will make a little bit of space for emotion and then allow you to move beyond it. And all I want you to say is this is important.

What do I need to understand? And if someone is in tears, you don't say, I know you're upset because we don't want to tell somebody else how they feel. That's not a good idea, but we can say, this is important. What do I need to understand? And that person in tears within about 60 seconds, will probably be giving you the information you need to do something to make it better. And you'll have the chance to say, okay, where do we go from here? And you'll be able to move them towards something constructive. Alternatively, if they are yelling at you and you say, this is important, what do I need to understand? It's really hard for someone to keep yelling at you when you make space for their emotion. We get people yelling because they aren't feeling heard and they get so desperate to be heard. So if you get quiet and you say, this is important, what do I need to understand? Again, within about 60 seconds, that tone is going to come right down. And I know people tell me that, you know, Liane screaming is not appropriate and you know what, we're in COVID people's family members are trapped. They can't see them. They can't hug them. They can't touch them. They can't hold their hands. You know what? There's going to be some bad behavior. The question is, how fast can you move the customer, the family member from that bad behavior into something constructive. So whether they're in tears, whether they're yelling, I really encourage you to simply say, this is important. What do I need to understand? And to really reframe that this is pain, that if I use it to understand what's the injury being done here, it's really going to help me with the prescription for what would make things better.

Deb (26:21):

That sounds like the perfect formula to, as you were describing it, I was thinking it's deescalating a disproportionate reaction, right? But then what you're suggesting, it opens up that level of curiosity and it's a softening way to engage with the person. And it kind of takes the wind out of their sails a bit.

Liane (26:41):

Cause you want, all you're getting from the emotion is symptom. You're not getting diagnosis, right? So you get the symptom. And if you lean into that, then you have a chance of the curiosity to get the diagnostic. And only from the diagnostic, can you then get the prescription? Right? So we want to go in that level. And I think if we cut off with the symptoms without actually trying to figure out, because we all know we can get pain somewhere that has nothing to do with where the injury is. So let me understand the difference between the pain, as a symptom, what's actually the injury and what can I diagnose as the problem? What do they care about or value that's not happening in the home right now? And then I can get to, would this solution work?

Deb (27:23):

Yes, that's fantastic. Wow. Lots of really great insights. And where can people find you, Liane?

Liane (27:30):

Yeah, the easiest place is just lianedavey.com. So it's very easy. The good thing is when you have a crazy spelled name, you can get your URL. But if you thank you, Deb, because it's LI just like Diane, but with an L and Davey with an E, Lianedavey.com. And there are about 500 articles on the blog page there that are all searchable about things like passive aggressiveness or trust issues or things like that. And anything that there's not an answer for there, the email comes right into my inbox and people are welcome to send me a note, just asking questions. Or if you have something where I might be able to help you work through a prickly situation, because we are incredibly grateful to all the folks caring for our loved ones right now, it is an unenviable position. But you're making more of a difference now than than ever. So thank you.

Deb (28:25):

Well, and thank you for taking the time to share all of this with the folks who live in seniors care that would really benefit from this.

Liane (28:32):

My huge pleasure. Okay. Bye bye. Bye bye.

Outro (28:41):

Thanks so much for listening to Seniors' Care Matters part of the Qod Pod network. For more information on today's episode, please check out our show notes and visit www.deborahbakti.com Join us next week for another great episode of Seniors' Care Matters.