By Lisa M. Petsche
If you have an aging parent or other close relative who lives alone, at some point you may become worried that he or she is not managing well.
Typically, family members’ concerns center around one or more of the following: mobility, nutrition, housekeeping, grooming, financial management, medication use, safety, energy level, mood and mental status of their senior relative.
No matter how difficult it may to be to look after their day-to-day needs, some older adults are reluctant to ask for help or accept it when offered. The most common reasons are included below.
- Denial. They have difficulty accepting the reality of aging and the prospect of increased dependence on others.
- Pride. They don’t want to appear weak or incompetent.
- Discomfort. They don’t like the idea of strangers coming into their home, or the role reversal involved in accepting help from younger generations, particularly their children.
- Guilt. They don’t want to worry or inconvenience their family.
- Anxiety. They fear they will be pressured into leaving the comfort of their home, end up in a care facility and generally lose control over their life.
- Resentment. They perceive concerned family members as critical or intrusive.
- Personality. They have always found change difficult or been fiercely independent, stubborn or private.
- Finances. They are concerned about the cost of recommended equipment and services, due to limited means or frugality.
- Cognition. They are in the early stages of dementia and lack insight into their needs and capabilities.
While a certain degree of reluctance is to be expected, if your relative continues to resist needed help, they may experience a crisis that lands them in the hospital.
How to prevent this from happening?
The approach with your relative depends to some extent on their personality and the nature of your relationship, but here are some general guidelines.
- Before talking with your relative, research resources in their community that may be of help. This way you’ll be prepared with solutions. Information can be obtained from the local office on aging.
- Raise concerns gently and gradually. Use “I” statements – for example, “I notice that ___” or “I’m worried that ___.” Provide concrete examples.
- Emphasize your relative’s abilities and how these can be supported. A strengths perspective helps preserve their self-esteem. Stress that your aim is to help them remain at home and maximize their independence.
- Organize a family meeting if your relative denies problems or resists suggestions. Consider including someone from outside the family, such as a trusted physician or a good friend of theirs who shares your concerns. Your relative may perceive them as more objective and consequently take their concerns to heart.
- If your relative objects to help, gently probe to learn their reasoning. Listen and respect their point of view. Be attuned to underlying feelings (such as sadness or fear), acknowledge them and demonstrate empathy.
- Share brochures or information from the Internet about medical equipment or community services that may be of help.
- Focus initially on the least intrusive options, such as setting up an emergency response system or obtaining medical equipment.
- Acknowledge how uncomfortable it may initially be to change their habits, alter their environment or allow strangers into their home. Remind them of their resilience, drawing on their past life experiences.
- Offer to pay, or contribute to, the cost of medical equipment, day programs or home healthcare services if your relative has limited income.
- If your relative appears physically unwell or cognitively impaired, arrange a check-up with their primary physician. Call ahead to alert him or her to specific concerns. If your relative refuses to go or accessibility is an issue, find out if there’s a geriatric outreach program that performs in-home assessments.
Bear in mind that choosing not to follow the recommendations of healthcare professionals or family members does not mean a senior is mentally incompetent.
Recognize, too, that opinions about what constitutes an acceptable standard of living and quality of life can vary considerably, and that frail seniors – struggling to maintain control in the face of declining health, relationship losses or other difficulties – often have a different perspective from family members.
Since mentally capable seniors have the right to put themselves at risk, at some point you may need to agree to disagree with your relative about what’s best for them, in order to preserve the relationship. But even if your relative continually refuses help, there are some things you can do.
Stay in close contact and make regular visits to monitor their safety and well-being. And keep collecting information about community resources so you’re ready to jump in and assist your relative in making informed decisions and necessary arrangements should they have a change of mind or a crisis occurs.
Lisa M. Petsche is a medical social worker and a freelance writer specializing in health and elder care issues.