One of the most challenging issues you are likely to face when caring for an ageing or ill loved one is resistance to additional help, especially when they get to the point of needing consistent in-home care.
At the end of one of my dad’s stays in rehab, we were told he couldn’t go home without 24/7 care. He would rather be home, so he didn’t object. However, until after Dad was home with a caregiver, his wife kept it to herself that she was adamantly opposed to having someone else in the house. Then she made it perfectly clear how she felt by not letting the caregiver do anything to help. Needless to say, we had to make other arrangements.
If your loved one who needs outside help doesn’t want it or strongly resists it, how can you get them to accept that it’s a necessity for them and for you? The situation could progress to the point where there is no other alternative. My dad’s situation came up suddenly. Hopefully, you will have more time to consider some of these strategies and gradually ease your loved one into a situation that is helpful for all concerned.
1. Communication: Don’t hesitate to bring up the topic because you suspect that your mom will be resistant to in-home care. It’s important to start talking about the need for additional help while you still have time to discuss it.
a. Try to understand the source of the resistance. Some people value independence, some are scared, and some see accepting help as a sign of weakness or a loss of privacy.
b. Ask your mom about her preferences. You might not be able to fulfill all her wishes, but it’s important for her to know that you are taking them into consideration.
c. Describe care from someone other than a family member in a positive way. For example, introduce respite care as an enjoyable activity. Refer to an in-home caregiver as a friend.
2. Timing: Schedule a time to talk. Let your mom know that the topic will revolve around how to get more help for them because you can no longer do everything that they need to keep them safe and healthy. Choose a time when you can both be relaxed.
3. Focus: Everyone wants to feel useful. Focus on why you need help. Point out how in-home care will help you. Ask your mom to accept additional care to make your life a little easier. She might find it easier to accept, if she thinks she is doing it to help someone she loves.
4. “We” Solutions: Involve your loved one in the solution process as much as possible. Use “We” when you are negotiating. For example, “How can we work out the best solution for both of us?” vs. “What am I going to do about you?” No one wants to be labeled a problem. We all want to feel we are part of a solution.
5. First Things First: Bring up immediate safety or care issues first. If your mom agrees to home modifications that will help with her mobility but does not want to talk about in-home care, drop it for now. Tell her she’s made a wise choice and bring up the idea of in-home care later.
6. Independence: Explain how in-home care could prolong your mom’s independence. Knowing that accepting some assistance will allow her to remain in her home for as long as possible might be a mind changer.
7. Trial Periods: Don’t ask your mom to make a final decision about the kind of care she receives right away. Ask her to try having extra help for a short period of time. A trial run gives a hesitant loved one a chance to experience the benefits of assistance. If the trial period is a positive experience, the help can continue uninterrupted.
8. Professionals: Professionals who are already respected by your elderly loved one can have a strong role in providing support and perspective. Ask the family doctor, clergy, or another professional to provide validation, support and encouragement. If your mom is putting herself in danger by refusing care, seek the counsel of an elder-care lawyer to ensure safety and legal boundaries are being met.
9. Coping: Accepting in-home care might mean relinquishing privacy and adjusting to new routines. Your mom might feel frightened and vulnerable or angry. Help her cope with some loss of independence by explaining that this isn’t a personal failing. Tell her the ways that she can still stay active, maintain relationships with caring friends and family, and develop new physically appropriate interests.
10. Memory Loss: Dementia or Alzheimer’s disease might make it difficult for your mom to understand why she needs help. Keep in mind that the above strategies might not be appropriate when dealing with a loved one who has dementia. (See our blog on How to Maintain Relationships.)
Resistance to care is a challenge that many family caregivers face. Spending the time to involve your elderly loved one in the decisions and solutions and emphasizing the benefits of in-home care will improve the care experience, your loved one’s sense of independence and quality of life, and your peace of mind. Contact Dakota Home Care at (877) 691-0015 for a private consultation on how one of their caring and informed aides can help.
By Marti Lythgoe, DHC blogger