When They Say No Dealing with Resistance in Caring for the Elderly

One of the toughest challenges you can face when caring for the elderly is resistance to care. How do you help a loved one who doesn’t want help? Understand how resistance to care can develop and strategies for fostering cooperation when caring for the elderly.

If your loved one is in need of care, he or she is likely dealing with loss — physical loss, mental loss, the loss of independence. Accepting care may mean relinquishing privacy and adjusting to new routines. As a result, your loved one may feel frightened and vulnerable, angry that he or she needs help or guilty about the idea of becoming a burden to family and friends. In addition, your loved one may be stubborn, have mental-health concerns, or simply think it’s a sign of weakness to accept help. He or she might also be worried about any associated costs.

Approaching a Loved One

If you suspect that your loved one will be resistant to care — whether from family, other close contacts, or a service — you may be hesitant to bring up the topic. To start communicating with your loved one about his or her need for care:

• Choose a time when you and your loved one are relaxed. This will make it easier for you and your loved one to listen to each other and speak your minds.
• Ask questions about your loved one’s preferences. This will help you provide the type of assistance your loved one wants. What type of care do they want or need? Does your loved one have a preference about which family member or what type of service provides care? While you may not be able to meet all of these wishes, it’s important to take them into consideration.
• Enlist the help of family members. Family and friends may be able to help you persuade your loved one to accept help.
• Don’t assume that your loved one is unable to discuss care preferences. While your loved one may be ill, he or she may still have care preferences and be able to make some decisions regarding care. If your loved one has trouble understanding you, be sure to simplify your explanations and the decisions you expect him or her to make.
• Don’t give up. If your loved one doesn’t want to discuss the topic the first time you bring it up, try again later.

Strategies for Managing Resistance

Getting an aging loved one to accept help can be difficult. To encourage cooperation, you might:

• Suggest a trial run. Don’t ask your loved one to make a final decision about the kind of care he or she receives right away. A trial run will give a hesitant individual a chance to test the waters and experience the benefits of assistance.
• Enlist the help of a professional. Your loved one may be more willing to listen to the advice of a doctor, lawyer, or care manager about the importance of receiving care.
• Explain your needs. Consider asking your loved one to accept care to make your life a little easier. Remind them that sometimes you’ll both need to compromise on certain issues.
• Pick your battles. Focus on the big picture. Avoid fighting with your loved one about minor issues related to his or her care.
• Explain how care may prolong independence. Accepting some assistance may help your loved one remain in his or her home for as long as possible.
• Help your loved one cope with the loss of independence. Explain that loss of independence isn’t a personal failing. Help your loved one to stay active, maintain relationships with caring friends and family, and develop new, physically appropriate interests.

Keep in mind that these strategies may not be appropriate when dealing with a loved one who has dementia.

What Else Can Be Done?

If your loved one continues to resist care and is endangering himself or herself, you may need to take steps to protect their health and safety. Consider consulting a lawyer about elder-care issues.

Resistance to care is a challenge that many caregivers face. By keeping your loved one involved in decisions about his or her care and explaining the benefits of assistance, you may be able to help him or her feel more comfortable about accepting help.