I can set my watch by it. After the holidays, my phone always rings because people have spent extended time with their elder loved ones and have realized that their living situation is not optimal. They'll say things such as: "I tried to talk about in-home care with my dad, but he kept brushing me off. What do I do?" I always respond by asking why they are resisting care, because understanding the "why" can be helpful in getting past it.
Someone in need of help has probably experienced a loss of physical or cognitive abilities. Grieving this personal loss takes them through the emotional stages of denial, anger, bargaining, depression and acceptance. Accepting help in any of these stages of grieving, other than acceptance, can feel like the surrender of competence, privacy and independence. There are also practical barriers such as the cost and logistics of care. Emotional and practical fears combine in a worry about becoming a burden on loved ones.
Resistance to care is compounded by individual personality traits. Some people value independence more than others. Some are more stubborn than others, and some people may just see accepting help as a sign of weakness.
Here are some thoughts to consider when encouraging your loved one to accept any type of help.
1) Timing is important. Approach any suggestions about change in short time frames at non-eventful times (hint: not over turkey). Avoid being in a rush for these discussions. Make a specific date and give enough time for the conversation to expand, should that happen. Try, "Dad, I am coming over on Wednesday and I'd like to talk about some options around getting the house cleaned through the winter."
2) Everyone wants to feel useful. Make Mom an agent in her own care, one who is helping you. Honestly state the impact that your mother's care issues have on you and ask for her help. Mom will probably find it easier to accept outside care if she is doing it to help someone she loves. "Mom, I am struggling to manage my month end and get food to you. Would you consider accepting Meals on Wheels or grocery delivery a couple of nights a week so I can stay late at work?"
3) We can live with our own ideas. Involve your loved one in the solution process as much as possible. "We" is a powerful word, as any good negotiator knows. "How can we manage?" is a question that will get a much more collaborative response than "What am I going to do about you?" No one wants to be the problem. But we all want to feel we are part of a solution.
4) Pick your battles. Choose the immediate safety issues that need to be addressed and let the rest go. If Nana agrees to home modifications that will help with her mobility but does not want to talk about in-home care, drop it for now. Be glad you won one point and be prepared to come at the idea of in-home care again later.
5) Trial periods are magic. Ask your loved one to try receiving care for a short period of time. "Dad, can you try the cleaning service this weekend? If it does not work out, we do not have to hire them again. It is up to you." This will give time for your loved one to see what receiving help feels like, without a sense of permanence. Often the trial period will be a positive experience and can seamlessly continue.
6) Enlist the professionals. Professionals that are respected by your elder loved ones can have a strong role in providing support and perspective. Use your family doctors, clergy or other professionals to provide validation, support and encouragement.
It is important to acknowledge that there are times when people are putting themselves in unacceptable danger by resisting care. Seek the counsel of an elder-care lawyer or other professionals in these circumstances to ensure the safety and legal boundaries for your loved one and yourself.
Meeting resistance to care can be one of the most difficult parts of the care-giving process. Spending the time to involve your elder loved one in the decisions and solutions, and emphasizing the benefits of care will improve the care experience, your loved one's sense of independence and quality of life, and your peace of mind.
Renée Henriques is a registered nurse and the owner and managing director of ComForcare Home Care Toronto, providing personal support services to seniors. Her passion for seniors and their families stems from her past work as a neurosurgical nurse, and her experience going through a lengthy caregiving journey with her own family members.