How to Talk to Parents About Aging Discussions with your aging parents about the future can be filled with tension. How do you approach the subject of elder care without upsetting everyone involved?
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How to Talk to Parents About Aging

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This is TALK OF THE NATION. I'm Lynn Neary in Washington, sitting in for Neal Conan.

If you visited your parents over the holidays, some of you might have noticed that they've aged since you last saw them; perhaps they seem more frail or more vulnerable; maybe it's harder for them to get around town or even to navigate around their own home. You might be wondering if they should quit work or stop driving the car. Maybe you're feeling the time has come to sit down and talk about the future. But the talk is rarely easy.

Parents want to hold onto their independence and their dignity. And children want to make sure that their parents are safe and healthy and cared for. But planning for the future is important.

Have you had the talk with your aging parents? Are you planning to? Our number here on Washington, 800-989-8255. And of course, you can send us an e-mail. The address is And you can also comment on our blog. It's at

Later in the program, using the Web to find your perfect candidate. We have links to several sites that match you with one of the presidential hopefuls. They're at Try them out and be ready to tell us what you think of the results.

But first, the talk about getting older. Amy Dickinson is with us from the studios of Cornell University in Ithaca, New York. She writes the syndicated Ask Amy column for the Chicago Tribune. And she joins us every other Thursday.

Hi, Amy. Nice to talk with you.

Ms. AMY DICKINSON (Columnist, Ask Amy, Chicago Tribune): Hi, Lynn. You may not know this but I'm actually back in my hometown. After my daughter went to college, I started spending more time here to help take care of and sort of look after and look out for my elderly relatives. So, I'm (unintelligible)…

NEARY: So, this is something you're in the thick of it - I was about to say - you're in the thick of it. And I imagine, I would guess, you get a lot of letters about this or certain number of letters about this. And I'm wondering, what kinds of problems you hear about? what kinds of problems are inherent in this kind of discussion?

Ms. DICKINSON: Well, I get a ton of letters about this, especially, actually, at this time of year because a lot of adult children have just visited their hometowns and seen their parents maybe for the first time in a few months. And just as - you know, when you visited and you see your little nieces and nephews, they shoot up so quickly. Well, sometimes, three or four months, an elderly person can decline in a way that becomes surprising or even alarming. And so I do hear from a lot of people they don't know what to do. And often there is tension between siblings about what to do.

NEARY: Yeah. We have a caller on the line. Let's take a call right away. And then we can flush out some of the issues involved here with callers.

Jenna(ph) from Detroit is on the line. Hi, Jenna.

JENNA (Caller): Hi.

NEARY: Go ahead.

JENNA: I have tried approaching this with my mom in a number of ways and she will not hear of it. She gets very upset, and it doesn't matter. She won't consider - she won't even consider a lifeline. She won't - doesn't want to pay for a lifeline.


NEARY: But she won't consider moving at all. And she cannot keep up the house that she's in. She can't deal with it anymore. There's a lot of things. Her…

Ms. DICKINSON: Okay, Jenna, I've dealt with this personally. And here's the thing that I think a lot of us do - we, adult kids. We sort of go for the big solution when maybe some smaller solutions might work to keep her in her home happily for a little while - longer, at least. For instance…

JENNA: Like someone coming to the house once in a while?


JENNA: Well, like someone coming to the house once in a while.


JENNA: She won't do this.

Ms. DICKINSON: This is - well, now, let me just make a suggestion. This is what worked in my family. I said to my mother, you know, I am wondering if this would be helpful to you - having a cleaner. And of course, like many women of that generation, they've never had any help, so they don't like having a stranger in the house. So, what I did was I said, how about if I come and we'll just meet this person together. And then after the person leaves, we'll talk and, you know, I wasn't tying her to this or forcing her. But I said, well, let's just see together what we think and then we'll talk and then you make a decision. Actually, as it turned out, it turned out really, really, really well. And for a lot of elderly people, having a once-a-week cleaner is a huge - talk about a lifeline because that person can make a very basic assessment of what's going on in the home. They can be your second pair of hands and eyes and ears.

JENNA: Well, I have - there already is someone that she said she would consider. And she knows this person. She comes and does things on the outside of the house for her. But every time it comes up, she won't do it. She - if she think someone is coming over to clean, she have to clean the house first.

Ms. DICKINSON: Yeah, I understand that. I do that a little bit myself but…

JENNA: Right. It's pride and stubbornness. She just won't budge. And we're getting concerned about her safety.

NEARY: Now, let me ask you this, Amy. In a case like this where - and it does happen - where older parents really won't even begin to have the discussion, and really won't make concessions, what then does their children do? Do they go ahead and make the decisions for them?

Ms. DICKINSON: Well, one thing I think they can do is try to have the conversation in another way. For instance, asking questions saying, well, mom, when you look around, you know, you probably notice this and that. And what, you know, how do you think we could help you? My siblings and I actually do a lot of the home, kind of, maintenance stuff ourselves with our spouses. But maybe she has suggestions or ideas. I mean, she already has somebody who helps on the outside of the house. Maybe if you - maybe if Jenna agreed to come over to the house while the cleaner worked that first time, you know, I just think there are - obviously, I know you've tried a lot of different approaches. But I wonder if there are other ways to approach this where, basically, you say our goal is to keep you here, mom. How can you help us do that?

NEARY: And let me ask our listeners if you have confronted this problem as well and have come up with some good solutions to it. Maybe you might want to give us a call at 800-989-8255 and let us know what you've done.

Jenna, one other question I have for you is do you have any siblings or is this - are you on your own with this?

JENNA: I have a sister who lives in another state. And I don't even live near my mother. I'm about five hours away.

NEARY: So, that makes it more complicated.

JENNA: Yeah.

NEARY: Let's talk about that with Amy. And thanks so much for giving us a call.

JENNA: Thank you very much.

NEARY: So, right here in the first call, I think, Amy, we can see, you know, so many of the issues that come up. Jenna is not near her parents. Her mother doesn't want to talk about this at all. This is really something that many, many people of middle age and a little bit older are really dealing with now, and sometimes feel like they're just banging their head against a brick wall.

Ms. DICKINSON: Right. And it's very typical. And one thing I would suggest is that Jenna and her sister, perhaps, both come home - not just for two days to try and whip everything into shape - but really for an extended period, if they can. You know, maybe even up to a week, to just try to make a basic assessment about what they can do for their mother. You know, a lot of people don't realize, there are so many local services that are very low-cost - can be very low-cost. You know, there's a whole new booming industry of people who are making their livings assisting with the elderly. And that includes bookkeepers, house cleaners, home health aides. And a lot of these people can be found through the local office on aging. And one thing I would suggest - and this is something I've done myself - is to call your local office on aging and just ask for advice. Because, you know, you learn so much just by talking to a supervisor about, you know, can a case worker pop in and just pay a visit and you know, what can they do? What can the community do to help this person?

NEARY: Let me ask you this one big question I have is when does a conversation like this take place? When do you know that the time has come? Do you wait until you really see the parents failing or do you try and have it sooner? What's the right time?

Ms. DICKERSON: Well - Right. The right time, you know how we always say you shouldn't sit down with your children and talk about sex and have one big sex talk, you know, that's - but that it's a lot of conversations. It's a lot of conversations starting with how are you feeling today, you know. Like this is the first piece of it when you check in with your parents and when you don't present them with a lot of overwhelming choices to make but you ask them how they are, you ask them what you can do. Maybe they need help managing their health records. A lot of older people get kind of overwhelmed by their paperwork.

And one thing about siblings is that siblings can kind of divvy up these jobs, even if they don't live nearby. One sibling can take care of the taxes and the paperwork and another can, you know, look into home repairs. And you can assign various jobs that people feel comfortable doing. But this is not a big talk. That's - it scares me just to think about it.

NEARY: Right. Let's take a call now from Marsha in Boston. I think she might have some ideas on how to help out with some of the questions we've been raising.

Marcia, hi.

Ms. MARSHA FRANKEL (Clinical Director of Senior Services, Jewish Family & Children Services): Hi. My name is Marsha Frankel and I'm wearing two hats. I'm the clinical director of senior services at Jewish Family & Children Services and have an 89-year-old dad in Florida. And what I have found to be successful often is enlisting the parent in helping you out, or in my case, helping me out that it would really increase my ability to get through my date to know that something was taking care of and that he was accepting some service or help as way of easing the burden on me.

NEARY: And that was successful with your father?

Ms. FRANKEL: Absolutely. (Unintelligible)…

Ms. DICKERSON: I totally agree. Actually, that's a wonderful technique. I mean, it's not a technique it's just a really nice thing to do and we need to remember that a lot of the times our parents are so concerned about worrying us or burdening us that they actually burden us more by not paying attention on what they need to pay attention to. For instance, you can ask your parent, you know, it would really be helpful to me if you could just make a list, you know, just sort of organize your needs so that when I'm in touch with you, you can let me know you keep it near the phone and let me know what you need just very little things. But I agree. Ask them for their help.

NEARY: Marsha, I just wonder before you took that approach, was your father resistant to you?

Ms. FRANKEL: Yes. I just recently tried this with him in terms of his allowing me to get a driver to take me from the airport to visit him at his home in a couple of weeks instead of his having to drive and pick me up at a busy Fort Lauderdale airport. And I said this is something I can do to ease the burden on you. I'd really appreciate you're letting me hire somebody to do this so that I can feel I'm making life a little easier for you.

NEARY: And it worked.

Ms. FRANKEL: And it worked. Whereas previously, it hasn't worked.

NEARY: All right. Marsha, thanks so much for calling in with that tip.

Ms. FRANKEL: You're welcome. Thank you.

NEARY: It's a good one.

Amy Dickinson is with us today with some advice on talking with aging parents about their future. If there's something you have dealt, how did it go? Give us a call 800-989-8255 or send us an e-mail to

I'm Lynn Neary. It's TALK OF THE NATION from NPR News.

(Soundbite of music)

NEARY: This is TALK OF THE NATION. I'm Lynn Neary in Washington.

Ask Amy's Amy Dickenson joins us every other Thursday this week to talk about the difficult issue of talking with older parents about the future. When may be the time to give up the car keys or write a living will or even move out of the family home. If you have had the talk with your parents, how did they respond? You can share your stories or your advice at 800-989-8255 or e-mail

Joining us now is Joseph Coughlin. He directs the AgeLab at MIT in Cambridge, Massachusetts. It's the only kind of lab in the world dedicated to the study of aging. Joe Coughlin joins us from a studio on the MIT campus.

Good to have you with us, Mr. Coughlin.

Professor JOSEPH COUGHLIN (School of Engineering, Massachusetts Institute of Technology; Director and Founder, MIT AgeLab): Hi. It's great to be here. Thanks for having me.

NEARY: Now, we just heard somebody suggest that one way you might approach these conversations is to say to a parent it would really help me if you would take some steps to plan for your future. Do you have any other recommendations for how grown children might approach these conversations with their parents?

Prof. COUGHLIN: You know, one of the things we need to think about is that on the surface, it appears that we're talking about home safety or safe driving or…

NEARY: I'm afraid we might have just lost the satellite. So Amy, we're going to come back to you and hope that we get that satellite again so we can…

Ms. DICKERSON: Okay. Well, I know Joe well?

NEARY: …get (unintelligible) Coughlin in here.

(Soundbite of laughter)

Ms. DICKERSON: I know Joe well so I could speak for him.

NEARY: Okay. Go ahead then.

Ms. DICKERSON: All right. So, I know that one of his specialties is in studying how people deal with their own aging but also the aging population and one of the things that interested me in his work is that MIT has developed, for instance, a lot of adapted technologies that can help elder drivers drive safer so that, for instance, you don't have to have that huge talk about taking the car keys away.

You can say, let's see if we could get you a different rearview mirror so that you can see better, you know. There are convex rearview mirrors where older people who don't have neck motility. For instance, they can see much better also side mirrors. You can help them assess their own driving by their - the AARP offers safe driving courses and there are - in my town, there's at least one rehabilitative driving specialist who can go out and teach your elder parent techniques for staying safe.

NEARY: All right. I think we have Prof. Joseph Coughlin back on the line, is that right? Are you here?

Prof. COUGHLIN: Yeah. I'm back.

NEARY: Oh, great. As you about to join in, I don't know if you heard what Amy was saying, she was telling us a little bit of some of the approaches that you take at MIT to an issue like, for instance, aging parents and driving and that sort of thing. Maybe you want to tell us a little bit where you were going before we lost the satellite.

Prof. COUGHLIN: Sure. I mean, it's - this is a, if you will, a conversation as the devil's triangle of family discussions, whether it's the home safety issue or the driving issue or frankly, longevity planning. But I think things that we have to think about as adult-children, we're not talking about the cold, calculated issue of home safety or driving safety. We're really talking about the home as independence and dignity or driving is really about personal freedom.

And frankly, longevity planning is not talking about the future in a positive way. It's making preparations for, shall we say, the end. So as a result, we've really got to redefine our discussion with our parents to reflect what is that they are trying to protect - their independence, their freedom, their sense of appositive(ph) from the time that they may have, and so…

NEARY: How do you do that? How do you redefine the conversation of…?

Prof. COUGHLIN: Well, frankly, there's a number of strategies that we've done research on with older adults and their children, which is, you know, first off, do your own homework, and that is that one holiday dinner where someone looks frail or may not be as fast as you would hoped may only be one incident. All of us have a bad day, and so what you want to look for is the patterns - patterns of how they're feeling in the house or patterns of how they're not doing very well with driving, so really getting in there and understanding that you need to have multiple observations and multiple discussions overall.

NEARY: Let me ask you this because we talked about this earlier with Amy and that is the question of when do you have this discussion. And when I'm listening to what you're saying if you were watching a pattern, is it possible that you can watch the decline go on just a little bit too long and then you reach a place where the person may be really is beyond being able to make that decision and yet quite stubborn?

Prof. COUGHLIN: Yeah. In fact, some of the research we've done with the Hartford and DOT in a number of other - people indicates that a lot of older adult children feel that they may have waited a little too long. But - so what we need to think about is that longevity both for ourselves and our parents means that we should start making these observations much sooner that we know that it's going to happen so this needs to be part of our planning. So in addition to doing your own homework, there's a second thing: We need to really empathize and care the person that needs to have this conversation.

The adult - older adult wants to know that the person that is talking to them is not the family heavy but the person who actually cares about their emotions, their sense of self, their sense of dignity and the like, and that's the one whose more unlikely to understand that about their lives and lifestyles as much as our concern about the safety and financial future.

NEARY: Oh, I got a caller in here but I just want to follow up on something that you just said because it sounds to me like you're saying within the family, let's say there's three siblings, you might really want to take an honest look and say, who's the most, who's the kindest of us here who could, you know, maybe handle that conversation and then who's the toughest who could handle the - I mean, set out what the roles are is that…

Prof. COUGHLIN: Sure, absolutely. I mean, there's also gender differences as well. I mean, husbands may not like to admit it very often but they'd prefer to hear from their wife than their children. Mothers, frankly, would more likely than not, want to hear from their children than hear from their husband. So it's not just who's the kinder or who really understands what's going on and frankly who has the legitimacy? Who has seen me drive the most often or see how I lived in my home the most often.

NEARY: All right. We're going to take a call now from Mary(ph). And Mary is calling from St. Johns, Florida.

Hi, Mary. Go ahead.

MARY (Caller): Hey. How are you doing?

NEARY: Good. Thanks.

MARY: My comment in listening to this - a little background for the last eight years I have taken care of my parents, they moved to Florida from Louisiana. They chose me to take care of them. Four, five years ago, my dad died and it's been my mom. But I think what we're saying here - I've read the books and get all that to prepare myself for this - but it's naive because what I have found in my own family and in my friends' families because there's a little support group of us that get together is very naive that if there is a dysfunction in the family and all American families, all families have dysfunctions to one degree or another.

It's going to explode at this point between siblings, between the parents and the children and a lot of these techniques, which I have tried just flat don't work. And what I have seen that does seem to work is just persistence, just dogged persistence in trying to just continuing to be there, continuing to make your point, continuing to make your point and then just sometimes, saying no. We're not doing this anymore.

NEARY: I mean, we're doing it my way, is that what you're saying? Only we have to do it…

MARY: Well, yeah. If there, I mean, I've been warned over and over again about, you know, don't take the parental role but sometimes, you just need to take the parental role. And also I would like to say my mom's now under hospice care and through her hospitalizations, her doctor, her friends, relatives and the hospice people all tell me that I'm a very exceptionally good caretaker. I'm not quite sure about that. I don't feel like I am but - to give myself some credibility on this. But yeah, you do just finally have to say, I'm the one that's rational here, not you.

NEARY: All right, Mary. Let's see if we can get our guest to respond to this. First of all, I mean, two things I'd like to hear you respond to, one is this idea that a family's dysfunction is going to explode under these circumstances, I think there's a great deal of truth to that.

Joseph Coughlin?

Prof. COUGHLIN: Yeah. There's nothing more and emotionally charged in this conversation. I mean, you're talking about a person's self-identity, their independence and their freedom. But part of what we have to think about is this is more than just saying stop doing this whether it's driving or I want you to move out of your house. We have to impart - plan ahead, so if we see the driving is a problem, for instance, start planning how they are going to get around not just stopping their mobility. How were their friends and family going to provide an alternative network? If you want them to move out of their house, remember, they're not just losing their house. They're moving their social network, their memories, their friends around the house. So, as we start to say we want you to do X, we should really plan what that means about their lives.

NEARY: Let me interrupt because I think the point Mary was making is in terms of the dysfunction, we are being very rational talking about this and there's a huge amount of emotion and the emotion can be a lot of anger, you know, it can be all kinds of emotions can come to the surface as a result of this. So, how do you handle what can be a really explosive situation? I mean, if you have a parent who you have had an anger relationship with them. Now, you're trying to convince, you know, let's plan. All that sort of calm talking may go nowhere.

Prof. COUGHLIN: Well, it also depends on how you have the conversation as one of my colleagues is fond of saying about the driving discussion over Thanksgiving dinner. You don't want to say, pass the peas and hand over the keys. It has to be a conversation that is well planned multiple times but also sensitive to what's being given up.

And what we find in the research we've done around the country is that, yes, the emotions are going to be there. There's going to be anger. There's going to be sadness. There's going to be depression. But for the vast majority and the work that we've done, we found eventually there is relief. Only, however, if you do the planning appropriately to replace what I'm losing, not just my driver's license, but my freedom.

NEARY: Amy, maybe you can get in here and respond to some of the points that Mary raised and I guess the other point that she raised was that at times you have to, in fact, become the parent and say, it's just - I just have to tell you, this is how it's going to be done.

Ms. DICKINSON: Right. Just as we do that with our kids, you know. And actually, I can tell that Mary is a skilled caregiver for a bunch of reasons. One is she was persistent, and she knew she needed to be persistent. And when the time came to be firm, she did the hardest thing in the world, which was to be firm. And it sounds like she was successful.

She also has found support. I can't say how important that is.

NEARY: Yeah.

Ms. DICKINSON: If you don't have it from your siblings. I love that she has found a group of people, friends. And, of course, in Florida, where there is an aging population, you're going to find adult children to share your story with. And her mother's physician, also being very supportive of her, and so I give her so much credit.

You know, it's - there is no way around how painful, sad and challenging this is. There's just no way around it. And, yes, we can sit here and say it's a series of small conversations. And I think everything Joe and I have to say is helpful to people to plan.

But at the end of the day, there's no way around, and it's hard.

NEARY: Yeah.


NEARY: Let's get another caller in here from Helen(ph). She's in Portland, Oregon. Hi, Helen.

HELEN (Caller): Hi, Lynn and everyone else. This is really hard, actually, having listened to all your callers. I'm in my 20s, and my mom and I had already the talk a few years ago.

It started as a joke. She was asking me, what are you going to do for me, you know, when I'm old and can't feed myself. And at the time, I had been living on my own for a couple of years, having runaway at 20. I've been working low-waged jobs. I've never gone to school. I'm not in college. I wasn't, you know, academically gifted as a teenager. And my parents were so busy involved in their drawers(ph) and everything else that I never even took SATs. So here I am, still working in this low-wage job.

And my mom, I told her, I had to, you know, be firm and everything that your callers are talking about. I said, you know, I'm going to help you just as much as you helped me so that I can afford to take care of you. And which is really hard and, you know, that's a quite a discussion. But I've seen since that my mom, she's remarried. Well, yeah, before we had that talk. But she's working now. She's saving. I really should ask her for some help but, you know, I won't.

Ms. DICKINSON: Wait, wait. How old is your mom when you had this talk? I'm just curious.

HELEN: Forty-five.

Ms. DICKINSON: Forty-five. That's kind of early.

HELEN: Yeah. It's early.

Ms. DICKINSON: Well, you know what? Or is it?

Dr. COUGHLIN: I'm not sure…

Ms. DICKINSON: But, you know, my daughter and I do this. And I love what Helen has to say because it starts as a joke. You're watching something on television or you're dealing with, maybe a grandparent, and this fantastic conversation can start as a joke about, in our case, will you put me on the ice flow like we talked about, honey. You know…


Ms. DICKINSON: Which is - this is a great way to do it, and I love what Helen has to say about how she's inspired to do well in life so that she can take care of not only her mother but herself. So, that's fantastic.

Dr. COUGHLIN: And I think we ought to also think about the baby boomers. We're turning 62 I guess this year one every seven seconds. And as we're caring for our parents, we really should take this as looking at the older generation today as from, maybe the canary in the coal mine. And that is how are we planning about our future?

Our kids are probably going to be living out of the town that we live in. So, they're all going to be distance care giving. Baby boomers in general had their children later in life. That means our kids are going to be far younger at the time of need that we need it.

So, as we're talking about what our parents need to do, or having the talk with them, how many of us are doing our homework about where we're going to live, play, work…


Dr. COUGHLIN: …and the like.

NEARY: Helen, thank you so much for your call. And I just want to remind our audience that you are listening to TALK OF THE NATION from NPR News.

See, I think Helen's call open up a whole other discussions that I really hadn't thought of. And Amy, you really made it clear to me, which is, this is a lifelong discussion. You can start - you can be talking about this for a really long time instead of thinking of it as the talk you have when you notice that your parents are not doing well anymore. And that's - that may be when it's too late to have it.

Ms. DICKINSON: And, you know, Lynn, what - in our family, what we've done - my sisters and I - we've involved our children in because we're close family. Our children are seeing their grandparents and that generation age. And it is sparking lots and lots of conversations about it as it should.

NEARY: Let me just read this one e-mail and get your reaction quickly before we have to go. Here is a suggestion, and this is from John(ph). And he says - in Milwaukee - he says, we use Web cams and Internet. My father lives about two hours from where I live. I have four older brothers. None of us live nearby. I had DSL for Internet installed, set up three large standalone Web video cameras. The whole thing cost $300 for the three cameras, 15 per month for the DSL. Now, everyone can watch my dad.

(Soundbite of laughter)

NEARY: Is that a good idea or not?

Ms. DICKINSON: That is awesome. Well, if your dad like - if, you know, if dad consents to that. I would hate to do that if somebody was reluctant or, you know, didn't consent. But, you know, if we did that with my mom, she would be like editing feature films in a week. So, I think that's a fantastic idea.

Dr. COUGHLIN: Yeah. I think the exchange should be that it increases the connectivity with family rather than it's Big Brother watching you.


NEARY: And so, to get back again to the emotional part of it, something that we've alluded to but haven't really gotten into yet, and that is, the tension that can erupt among siblings sometimes.

Amy, it sounds like you and your siblings are working together as a team. But that doesn't always happen.

Ms. DICKINSON: Well, it doesn't always happen. And what we did, which I think is our natural tendency and that of a lot of siblings is we divvied up the jobs, and they're pretty distinct so that if one sister is handling the paperwork, for instance, I would defer to her and ask her advice about it. I tend to do more of the kind of shopping and cooking, and like, I'm more of the - I also just show up and have coffee, like, all the time. That's like my gift. But we do have a leader among our siblings. And she is the one who's lived here the longest. And…

NEARY: Can I ask you a question?


NEARY: Do you have a pretty functional family to begin with? Not a dysfunctional family?

Ms. DICKINSON: I would say. This is how one becomes an advice columnist, Lynn.

(Soundbite of laughter)

Ms. DICKINSON: From a functional family. Well, you know, divorce. Yeah, we've seen it all. But sure…

(Soundbite of laughter)

Ms. DICKINSON: …we're functional.

NEARY: It sounds like you are. So it gets tougher when there are more problems in the family. But that would be the case I guess with everything.

Thanks to both of you for being with us.

Amy Dickinson writes a syndicated column Ask Amy for the Chicago Tribune. Joseph Coughlin is a director and founder of the MIT AgeLab.

Good to have you with us. And…

Dr. COUGHLIN: Lynn, thank you.

NEARY: Up next, have you tried out one of the online candidate quizzes? It's TALK OF THE NATION from NPR News.

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