Why Won’t My Loved One Accept Care Assistance?

January is the time when many families realize that an older relative needs help! Maybe holiday visits revealed that your mom’s formerly immaculate home is dusty and cluttered. She’s not showering very often, and she’s wearing the same clothes day after day. She doesn’t get out much, and she left the stove on all night.

Or maybe your dad insists on driving, even though he’s had several fender benders. He forgets to take his medications, and he missed his latest doctor appointment. The family notices a pile of unopened mail on the table—and some of those envelopes contain overdue bills.

These are scenarios faced by millions of families each year. An older loved one’s condition can change gradually, or suddenly due to a fall injury, a heart attack or stroke.

In many families, adult children step in to help. Often this is a workable arrangement at first. But then, the task list expands. Family ends up managing their loved one’s health care appointments, taking care of the house, and as experts tell us, performing hands-on health tasks that seem more suitable for a trained medical professional. Now they’re feeling overworked, and they’re at the risk of burnout.

And sometimes, their older parents don’t even want them to help! According to a poll from the Aging Life Care Association, 80% of their aging life care professional members (formerly called geriatric care managers) say they regularly encounter cases where older adults resist help or assistance from adult children.

If this describes your family, it’s time to step up the conversation about care support. Maybe moving to an assisted living or other supported living community is the best choice for your loved one. Most older adults want to stay in their own home, and for them, professional in-home care can be a good solution. Professional caregivers provide homemaking assistance, companionship, transportation and personal hygiene care.

These can be sensitive, emotionally fraught conversations. But you can help. Geriatric psychologists say it’s important to empathize with your loved one.

Download the RightConversations^SM Guide by Right at Home to help your family develop a communication plan that ensures a positive experience for your aging loved one while limiting your stress.

Here are seven reasons they might offer for refusing care, and how you can put their mind at ease.

Most likely you—or your parent’s spouse, or another family member—have been providing informal care. When this has been the status quo, it’s understandable that your loved one would resist change. Talk to your loved one about the effect the growing task list is having on you and other family members. Most parents want what’s best for their children, and hearing how their situation is affecting your life might be the motivation to accept professional help.

Gerontologist Dr. Suzanne Salamon of Harvard Medical School explains that people who have saved for years may resist spending money on care. “But if you have the money available, a social worker would say, ‘the rainy day is here,’” says Dr. Salamon. Encourage your loved one to consult with a financial planner to understand their financial situation and to learn about veteran’s benefits, long-term care insurance, home equity loans, a reverse mortgage or life insurance benefits.

There’s a cliché we often see: a baby boomer with a “We’re spending our children’s inheritance” bumper sticker on their RV. But in fact, many older adults hope to leave something to their children, whether that is money, the house, or other items of value. But most adult children place a higher priority on their parents’ well-being. If expressing that doesn’t work, remind your loved one that your own career and income may be affected by the care tasks you’re currently providing.

Most people value their privacy. But remind your loved one that they’ve no doubt had people in their home before to make their lives easier, such as house cleaners and home maintenance personnel. Professional in-home care is just that—professional. Be sure to hire through an agency that provides background checks and screening, and holds its caregivers to standards of confidentiality and privacy.

Most of us do—and it’s emotionally distressing when health challenges mean we’re less likely to be able to keep up with the house, safely bathe or shower, and get around—all the things we once took for granted. The conversation with your loved one might go like this: “The professional caregiver is an assistant to let you do the things you want to do, when you want to do them. You’re not dependent—you just have resources to help. This care support can make it possible for you to live at home longer—not totally self-sufficient, but closer to it.”

It’s true that as we grow older and experience health challenges, our self-esteem can take a hit. Part of the goal here is to help your loved one overcome the effects of ageist thinking. When your loved one goes to the grocery store with the caregiver, can confidently invite friends into a tidy home, or is able to manage medications and health appointments, this is a sign of strength and taking charge. Facing and overcoming age-related challenges is something to be proud of!

Sometimes, all it takes for an older adult to accept care support is for family members to say, “Mom, we would sleep much better at night if we knew you had help!” But this is a time of difficult generational power shifts. Family dynamics and old grievances all around can resurface. Many families find it’s best to bring in trusted third parties to provide an unbiased perspective. This might include friends, your loved one’s faith leader, an elder law specialist, your loved one’s health care provider, or an aging life care professional.

Here are a few more tips from those who have navigated this stage in a loved one’s life:

• Start these conversations early. If your parents don’t need help yet, consider this a wake-up call! Discussing care as a future possibility is better than tackling the topic during a crisis.
• Compromise with small steps. Arrange for a consultation with an in-home care agency, where your loved one can find out about available services. Maybe a caregiver could come for a trial period for several hours a week. Assure your loved one they can change their mind. For the most positive experience, hire through an agency that matches clients with compatible caregivers.
• If your loved one is legally competent, these are their decisions to make. However, if your loved one is living with Alzheimer’s or another cognitive impairment, you will likely need to step in. An elder law specialist can decide if a guardianship or other arrangement would be appropriate, and whether it’s necessary for a court to intervene.
• Once the new care system is in place, continue to “be there.” The goal is to reassure your loved one that you’ll still be spending time together—and that the time will be spent doing things you enjoy, in an arrangement that feels familiar and normalizes the generational dynamic.