What is the conversation that you need to have?

Mar 6, 2023 | Aging Successfully, Conversations

Would you rather listen instead? Click here for the 10-minute audio recording.


Two heads. One with a missing puzzle piece in the brain.I am going to ask you straight up for a self-check.


Is there a conversation that you need to have?


Is there a conversation that is waiting to be held? Do you owe someone an important conversation? Might there be a conversation that you have been avoiding? Why?

We will talk about that today and then what to do about it.

Could that conversation be with a loved one? Could there be a need to cover something with your client or co-worker? Something that needs to be said, a need to set something straight? Or, might that needed conversation be a conversation with yourself?

For this occasion, I use one of my made-up words that y’all know me for. It sure fits here. In your self-check, when you think of a conversation you may need to have, you may sense or experience what I call GNOW, G-N-O-W. GNOW is my word for those times when you have a general sense of what is known, and it is gnawing at you. A GNOW is something you feel. Something is known, yet something is amiss.

Maybe you tamp it down. But do check.

It’s been my experience in life and as a Patient Advocate that often we ourselves struggle with this phenomenon of GNOWING in two ways: realizing that a need does indeed exist and then feeling a tug, an “ought to”, or “really should” in your desire to have this conversation. To clear it, to clarify, to complete the action.


So many times, we do not act on our GNOWs. Why?


Reluctance, even fear? It could be a tricky conversation with an unclear or volatile outcome or with volatile people.

Perhaps we lack information, even if that information is for “our purposes,” but a conversation never held does not get us any information from the other party, either. We stay lacking.

Other times we see, oh, we feel it alright, but it is too uncomfortable. That is why much of my work and many of my videos and blogs are about bettering our abilities here, in conversation.

Conversation fixes so much. Simple or complex, it clarifies. It enlightens (did you see/hear the “light” in that word, can you picture yourself lighter, or have you ever been lighter, relieved to know the other side was not the ugly monster you had built it up to be)? It alleviates. It brings us together and delivers us onto the same page. It gives us the floor, and we are heard. We learn how another feels and perhaps are introduced to new information and its impact.

Sadly, there are many among us who, in their denial, will not be able to even see the need for a conversation, nor will they realize the solution, relief, or results of conversations. And so I work.


Have you ever needed to have a conversation with yourself?


In the past, I’ve realized conversations that I needed to have were with myself. Ever been there?  

The conversations we may need to have with ourselves can range from “What’s stopping me? What’s stopping me from the starting? Why does this scare me? Is that real or realistic thinking?”

“What if I screw up? What if what I say causes some kind of harm? And besides that, how do I even begin?”

“How do I come to learn about self-advocacy, finding the ways and the words to help get the healthcare I deserve? How exactly do I push that envelope?”

The list is not exhaustive.


Examine the intersections in conversation where you find yourself perpetually confounded.


It all boils down to examining the intersections in conversation where you find yourself perpetually confounded.

Pursuing a greater understanding of that which is confounding you is a logical first step.

Plenty of people sense when “something is off” or not quite right. There is something wrong that is preventing them from what they want. In response and in my work, many people need help to explore and determine why that ‘confound’ is there in the first place. We figure that out and get past it. Then we make a plan and implement it, all in conversation.


Communication can be both the problem and the solution.

How ironic is it that the problem, conversation, is also how we get to solution? Whether interpersonal or in self-advocacy, in the home or in the workplace, that conversation is, at first, the problem. We use conversation as the way to learn the solution, and ultimately is the solution itself.

I submit to you that helping others with the conversations they need to have is a big part of my advocacy. Unlocking things. Learning things. Planning solutions and then helping folks to execute their plans. Nothing is finer to me than helping folks learn how to get what they want, need and deserve. Solution is very satisfying on both our parts. 

What to do now when you realize you have a conversation you need to have (i.e., when you GNOW)? Let’s talk about how we can get you from here to there. You owe this one to yourself.


Let’s enter Solution, in the form of helpful tips.


  • Think – Give some thought to the conversation that you GNOW you must have.
  • Visualize. Visualize the outcome.  
    • Visualize yourself doing it, being in the process.
    • Visualize the gain.
  •  Go back to the Crafty Lead-Ins For Difficult Conversations segment, it’s on my website. There you will   find tips to set up for conversation, and you may incorporate the many tips within.  
  • Remember that this is doable because it is.
  • Focus on the outcome, and go get what you deserve. You can bring this to the outcome.
  • Touch briefly on that which scares you and use your desired outcome to overcome that reticence.
  • Focus on the benefits. Allow yourself to be bolstered by not only the outcome but your sense of having done so.
  • Contact me. I help a lot of people through communication sticky spots.
  • Lastly, feel good about this one. Enjoy your progress. Mark your success, you’ve got a notch in your belt.

Did you know that these last few segments about communication and talking have been for a reason? Next month we celebrate one of the most important days of the year, in my opinion. I’m talking about ‘NHDD’, National Healthcare Decision Day, a day designed to raise public awareness of the need to plan ahead by making some healthcare decisions and building your team.

To quote a good friend of mine:

“We can all have a say about how things will go and where we’ll end up.”

That is a “Yep” in my book, and we are going there. I can show you how to have your say.

Finish that conversation with yourself and then have one with me! I invite you to Book a Call with me today.


Nancy Ruffner is a Patient Advocate, former agency owner, educator and speaker who consults with clients regarding advocacy, healthcare navigation, eldercare matters and successful aging. Set your Complimentary Consultation toward engagement today – 919.628.4428 nancyruffner.com