Getting Help: When Your Parents Won’t Acknowledge They Need Assistance
Your mom opposes in-home help or caregiver, certain that you can wait on her and help her all the time. Your father’s eyesight is failing and he still does not want to quit driving. Your mother-in-law insists she does not need any help with ADL’s (Activities of Daily Living) nor does she want a personal care aide or any other assistance in the home. She maintains this position despite her unwashed hair, soiled garments and the generally disarray and clutter building up around the house.
Does this ring a bell? Nothing is harder for a family member, especially a son or daughter than when they have a parent or other senior loved one who declines assistance when it is offered (and needed).
"This is a prevalent issue and one of the most widely recognized and troublesome senior care challenges that adult children confront when they start to recognize that their seniors need a little extra help around the house," says Nadine Fish, (LMSW, CAADC) a clinical therapist and owner of the Hope Reborn Counseling practice in Portage, Michigan.
Empathy Goes A Long Way
Before pushing your mom too forcibly to acknowledge help, try to walk in her shoes first. Try to understand her feelings and trepidation as she gets older, says Fish: "Like numerous other seniors and established individuals our elders consider themselves to be stoic and strong survivors. They think 'Not only have I experienced some great things but I’ve endured difficult and trying circumstances and still survived, so I'll be fine without anyone else.' In addition, they believe that their youngsters comprehend the physical, mental, emotional and spiritual toll that aging can have on a person.
A senior who is just starting to experience some cognitive decline might be the hardest to help. "Your irate father or upset mother knows about this painful change in their mental faculties, they just don't fully comprehend," Fish adds. Comforting and consoling them will not only open lines of communication but will better prepare and enable them to adapt to what can feel and seem like an alarming loss of capacity to them.
Taking The Right Approach
It's common for family caregivers to feel anger, rage, frustration and even a little shame or guilt when they try to help a stubborn but adored love one "You may revert to similar methods you had for dealing with stress when you were younger and engaged in power battles with your parent - shouting, screaming, or storming out of the room," Fish says. "You have to recognize and comprehend what parental actions are triggering your own emotional response and acknowledge you have other options." (And Fish adds, consider seeking an advisor or counselor yourself if needed to cope with managing and assisting a troublesome parent.) Here are some ways to enable you to overcome objections of a stubborn loved one:
In a perfect world, families have informal loose discussions about providing care well in advance of needing a caregiver, well before an accident or unexpected medical emergency. Look for chances to ask your mother or father things like, "Where do you see yourself as you get older?" or "How do you feel about hiring someone to help around the house or getting a driver so you could remain here (at home) and still be independent?"
Ask gentle but probing open-ended questions and give your seniors ample time and opportunity to reply. Some questions to consider: you can ask your father how your mother is doing, how she’s feeling, and, if he’s dealing with taking care of your mother 24-hours a day, how he feels about that.
However, just know up front that the conversations may sometimes feel dull, distracting and even repetitive. Often going off topic and talking about other items besides your parent’s care. That’s okay too – getting your parents to talk openly about all issues related to their situation as they age helps facilitate later conversations.
It might take a few conversations with one of your parents to figure out the real reason your mother, who is normally fastidious about keeping the house clean, has terminated five home health care aides in a short period of time. Especially if the reason given was something like they failed to empty the trash can in the guest bathroom or didn’t vacuum around the television one day.
Ask Probing Questions
Try to find out why your senior does not accept help - then you can tailor an answer.
- Is it about a lack of security?
- Loss of privacy?
- Are there concerns about the cost of care, loss of independence?
- Is it having someone they don’t know in the house?
Being able to build trust will take time. By listening, being compassionate about their feelings and empathizing instead of judging your loved one’s sentiments you will go a long way towards learning more about their needs, concerns and beginning a discussion about in-home care.
Whenever possible, include your seniors (and depending on circumstances, siblings) in interviews with care agencies, caregivers or in setting up a plan of care or scheduling caregiver visits. Give them a chance to pick certain days of the week or times of day to have a home care provider come.
It should also be clear to them that this person will not just be a caregiver but will be their buddy or companion for evening strolls, shows, trips to the art gallery, concerts, and other activities they enjoy. Not only can a caregiver help them with daily living activities but also assist them with grocery shopping or a ride to a doctor’s appointment.
Recruit A Specialist or 3rd Party Early
Frequently, it’s easier for a parent to talk to someone besides their children about some of the issues they are concerned with. Seek out a qualified social worker, a geriatric specialist or even a close friend to talk to your parents about their needs and what kind of assistance at home would help them out.
Create a couple of lists: one for your senior’s issues and concerns and another for the actions you have taken or plan to take on their behalf. If you don't itemize and prioritize your efforts than finding and providing your senior some in-home care can become a huge mental burden and amplify the stress. By listing what the concerns are and how they are being addressed you can eliminate a great deal of the stress associated with aging in place and accepting outside help.
Sometimes Less is More
If your father or mother has dementia or Alzheimer’s, offering less data may be advised. You could tell your parent that the caregiver is somebody who is extremely accommodating and helpful and can go with your mom or dad on walks, prepare meals for him, do laundry and help him during the day. You don't have to clarify each part of care the caregiver will be involved with before he/she starts helping. This will go a long way in helping your senior feel less threatened or overwhelmed.
A Moderate Pace
Bring in a new home care worker or caregiver slowly, start with short home visits or meet for coffee or lunch at a place familiar and comfortable to your senior. Maybe the next time have the caregiver join you on a ride to a doctor’s appointment. Depending on you and your senior’s comfort levels, you may consider leaving the appointment early and ‘asking’ the caregiver if he/she could take your parent home when they are done.
Accept Your Boundaries and Limits
If your seniors are not a danger to themselves or others, then let them reach some of these conclusions or decisions on their own. You can't always be at your parent's side and bad things can happen. As much as you want to be there constantly, all you can do is be supportive and encourage them where you can - you should accept that there are limits as to what you can do or achieve on your own and not feel regretful about your efforts. It might sound brutal, but perhaps going a day or two without a freshly cooked supper or lunch is the rude awakening a senior needs to consider and accept a much needed senior caregiver or home health aide for some assistance at home.