Karen McPhail, RN, MSN
How to Assist a Loved One in Accepting Help at Home
The holiday season is behind us. The holidays are often marked by special moments, get togethers and family time, but it is also sometimes an unpleasant eye opening experience. Many notice while visiting their family members that they are not doing as well in caring for themselves as they used to...
Sadly, many people as they grow older become resistant to having help. Change can be difficult for most people, but especially when adapting to or coping with some sort of loss, be it mental, emotional, physical, situational, or the loss of their independence. Often times people become set into a specific routine and do not want it to change. Or a sudden illness has made them angry, defensive, or longing for the past. Accepting help may be viewed as a sign of weakness and can make individuals feel as if they are no longer in charge or in control of their lives. Culturally some aspects of care may be upsetting or even confusing for them. Many people long for their privacy and want their old life back. They start to grieve the past. In addition, mental health and cognitive issues often times effect ones emotions and the ability to adapt. These changes can cause an elderly individual to feel scared, apprehensive, depressed, angry or even leave them with a sense of guilt as they do not want to be a burden to others. Along the same lines, the cost of health care can be a significant worry for many seniors and cause them to be averse to change. Even individuals with long term care insurance are often times confused about the specifics of their policy, how to access care, when they can use care, etc. Resistance to care is therefore a common problem in the elderly and a huge challenge for primary care givers. However, if time is taken to understand the source of their resistance, a plan can be put in place and they can begin to embrace change.
The first steps:
If you suspect that your loved one will be resistant to care, then they probably will be! However, do not fear, this can usually be turned around with some simple steps and interventions. Most family members dread bringing up this topic with their loved one! However, it must be done, but in a respectful, yet direct manner.
1. First, do some initial preparation. Think about and determine what help is really needed for your loved one. What is essential from a safety or care standpoint? Make an honest assessment of what type of assistance and services they may accept and that they really need. You can consult a Care Manager to help with this if needed. Remember to keep in mind that safety is key.
2. Set a date! Choose a specific date and time to meet with your family member. Do not keep procrastinating! Make the setting a happy one and try your best to create a relaxed environment for both parties. This will make it easier for all involved. Remember that your role is not only to speak and inform, but to listen!
3. Value the input and suggestions of your family member. They may have put more thought into this than you realize. Ask about your loved one's wishes and preferences. Does your your family member have a preference about care? Do they want a specific family member or service provider to provide them with care? Are there cultural preferences to consider? Consider their input and allow them to drive the process as much as possible, keeping in mind the primary goal of getting them help.
You may not be able to make everything unfold as they would prefer, but if they feel that they are being able to make choices and that their input is valued, the process will be successful in the end. They need to understand that there will be give and take in this situation and some adjustments.
4. Try not to pressure or overload them with too much info or too many decisions to make at once. If your family member has difficulties understanding things, try to be patient. Simplify your explanations. Focus on the primary goals and decisions that you feel need to be made. Priorities...
5 . If it is going to be helpful for your family member, enlist the help of others. This can be a tricky decision as you do not want to come across as you are ganging up on them. This is not an intervention. Select carefully the family members or friends that you feel should be involved in the process. A positive environment must be maintained throughout interactions in order to get achieve a successful outcome. Family and friends might be able to help you persuade your loved one to consider options and accept help if the right approach is taken.
6 . Finally, keep your goal in mind! Do not procrastinate or give up. However, be gentle in your approach! Your family member may not be ready to have all decisions made after one or even two discussions. They may not want to discuss the topic the first time it is brought up. Give them time to process things and then re-approach in a positive and helpful way.
7. After the initial talks, it is time to follow up and help all parties to cooperate! We all want the same thing right? Reinforce that you are in this together! Ask them to just give it a try; they can always stop having help! Reinforce that a final decision about the kind of care he or she receives does not have to be made right away. A trial run will help a resistant family member to test things out and hopefully see the benefit of assistance. Try to plan out the first week to include activities that you family member enjoys. Try to choose a care provider who has similar values and expectations. Ensure that care providers really know your parent. An individualized, client focused plan will help to avoid any misunderstandings and set up the path to success for all!
8. Describe care in a positive, upbeat way. A new adventure! Refer to respite care perhaps as a refreshing change that your loved one may enjoy; describe it like a vacation. This new environment could provide them with a chance to socialize more, meet new people and try new things. Explain that a home care provider will be like a new friend or companion, someone to do things with and talk to. Adult day care or an elder care program could be referred to like a club or social group. Try to draw comparisons from their life. Try to model things in a way that your family member can relate to and embrace in a positive way.
9. Explain how you are feeling to your family member. Tell your family member how much you care! Explain how accepting care will make all your lives richer, easier, so that you all can truly enjoy time together more. Everyone can stop worrying about the tasks that need to be done and focus on each other.
10. Be patient and try to understand their perspective! Listen to their feelings. Focus on the big picture. Avoid quarrels and disagreements. This will only make things more difficult and lead to more resistance.
11. Explain how care can perhaps prolong their independence and enhance their quality of life. Accepting some assistance might help your loved one remain more social, active and in their home long term.
12. Assist your family member to cope with the loss of independence and health. These changes are scary for them and for everyone. Help them to stay engaged, active, maintain friendships, relationships with family, and develop new interests. Try to make changes positive and help them to explore new activities and outings as appropriate.
Keep in mind that these strategies may not be effective or realistic when dealing with a family member who has dementia or other cognitive issues. A Care Manager can provide support and assist with these types of needs and transitions.
Finally, if you have made several attempts to move things forward in positive way and your family member is still negative, angry, or resistant to care and is clearly endangering themselves, then you may want to ask for help from their doctor, or a geriatric care manager. These individuals can reinforce further the importance of receiving assistance. Many individuals are more willing to listen to the advice of a professional!
In addition, you are not going to change personality types... stay positive and know that you are making good choices and doing your best for your loved one!