How to provide care to someone who doesn’t think they need it.
There may come a time when we notice our parents having difficulties with everyday activities, such as dressing or cooking, doing laundry or other housekeeping chores. Bills may be left unpaid or mail is left unopened.
We may assume they are getting old and need help, but just bringing up the subject for discussion may spark anger – “What? You think I’m too old to do these things for myself?” Or denial – “I’m fine. Leave me alone.”
Talking to parents in denial is difficult and can lead to hurt feelings or guilt. If the message you are hearing is: “There is nothing to talk about,” it may be helpful to keep the following in mind:
- Sometimes it is best to leave the subject alone if you are not in crisis. You can return to it another day – don’t give up. Talking to elderly parents is a process, not a one-time chat.
- Prepare yourself for the discussion. Talk about what you have observed and be honest about your concerns. Know what some options are so you can present choices. An example might be getting a housekeeper to come in twice a month vs. a personal companion who can prepare meals and do light chores.
- Explain that what you want is to prevent the possible consequences of doing nothing. These consequences may be things no one wants to have happen. Getting some help could mean staying in the family home vs. going to a nursing home. A regular medical checkup could catch something early while it can be treated effectively.
- Talk to siblings beforehand to be sure you agree on how to address the situation. If only one of your parents needs assistance, be sure to talk with your other parent so you are all of like mind.
- It can be very useful in such situations to talk to a geriatric care manager, clergy member or counselor who can give you guidance or help lead or mediate the conversations.
- Temporary help after a hospitalization or illness can give your parent a chance to get used to having assistance at home, so be sure to take advantage of opportunities to introduce the idea when situations like this present themselves.
If attempts to discuss options are met with denial and anger, there may be underlying causes. Unless you understand the reasons, you will not make much progress toward solving the problem. Here are some reasons behind denial to accept help:
Pride: Independent individuals do not want to admit they can no longer do many of the things they need to do to live independently. They don’t complain, despite pain or hardship.
Embarrassment: Elderly parents may become self-conscious or ashamed they can no longer do what they once accomplished with ease. They may need help with activities that are very personal and private such as using the toilet or bathing. They may be having financial trouble and are embarrassed to say so. They may not be able to afford food or medications or to make needed household repairs.
Fear: Parents may be afraid they will no longer be able to drive or will have to go to a nursing home. They may be afraid of death or of suffering and pain.
Depression: Elderly parents who are depressed may not talk as much as they used to. They may smile less of the time and look sad. They may have lost the joy of life and say such things as “You’d be better off without me” or “I wish I were dead.”
Any one of these underlying causes may be preventing you and your parents from having meaningful discussions about how to provide them with the help they need. Begin your discussion by validating their feelings. Let them know you think you understand what may be going on and ask them how they feel.
Think about these additional tips:
- Be totally mindful when talking to them. Don’t think about the past or the future — concentrate on the here and now. Eliminate distractions and potential interruptions from phones, TVs and young children. Don’t multitask. Pay careful attention without judgment. Be totally present, not just physically, but mentally and emotionally as well.
- Begin the conversation with something like: “Do you mind if I ask you about some things I’ve noticed that concern me?” It gives your parent a moment to think and to plan emotionally for what might be a touchy conversation.
Be an active listener.
- Focus your attention on and maintain good eye contact with your parent to show understanding and empathy.
Using your own words, summarize what your parent said and repeat it back to them to be sure you understood them correctly. If you didn’t understand, ask them to tell you again so you can get it right.
- Gently remind your parent that it’s OK to ask for help. No one (who matters) is going to think less of them.
Giving up driving is another very difficult conversation. Some of the reluctance to stop driving may be because your parent has rarely or never used alternate means of transportation such as cabs, buses, volunteer drivers, or Uber. To overcome this, you might ride along with your parent for the first few times to demonstrate just how easy it is to make the necessary arrangements. The article on How to Talk with Your Parent about Driving may help.
If you are not making progress towards getting them the help they need, gently, but firmly set your own boundaries. Let parents know if they choose to do nothing to help themselves, you will be the one having to deal with the repercussions. Let them know what you can and cannot do in that situation.
If things regress to a crisis or if there is a question of competency, undue influence or self-neglect, you may need to talk to an attorney about guardianship proceedings.
These difficult discussions will be less frustrating for everyone if there is a sincere understanding you are concerned for their safety and health … that your responsibility is to open the discussion and bring options to them, so they can make the decisions best for all.
In addition to housing, health care, and programs for seniors, SALMON Health and Retirement communities offer support groups and resources for caregivers and family members. To learn more about the options available to you and your loved ones, contact us today by calling 800-446-8060 for more information.