How about using the "ask for permission to broach a tough topic" strategy to calmly discuss issues? I'll give you one example from my professional life as an ER Doc. When I had difficult/painful news to share with patients and families (ex. we just discovered that you have cancer, or, it's highly likely you're going to die soon) I would sit bedside and ask "are you able to hear, or have a discussion about, some difficult or painful news?" This would not only focus my audience but also allow them choice. Often the answer was "yes" and then off we'd go into a tough topic they'd agreed to hear about. If the answer was "no" I would not proceed until patients or their families were ready. This was rare.