When seniors say ‘no’ to help
A few weeks ago, I met a family caregiver. That’s not unusual for me, but Rose stays top of my mind.
Rose was caring for her husband 24/7 and because of his dementia, he no longer remembered that she was his wife. She jokes, “He told me he really liked me, but he could never marry me because I’m too bossy!"
He was very resistant to her redirection, and she would patiently try different approaches until she knew he was again safe. She kept extremely busy, as you can imagine, with not only caring for him, but also keeping up all the jobs of a typical household. As we talked, she constantly kept an eye on her dear husband of 57 years.
My heart goes out to family caregivers! Their job, by definition, is already a difficult one. Whether you’re caring for a spouse, like Rose, or another senior in your life, not only the worry of caring for them, but time away from work and family can take a toll. But when you consider that many seniors often resist help, that job becomes overwhelming.
Resistance is at the root of many senior care issues. Why? If seniors admit they need help, they feel their independence is in question. Seniors believe that once they acknowledge they need help, they’ll lose control of their affairs. They are trying to maintain dignity. Unless they feel they can trust someone, they resist change. I also believe it’s the fear that life as they’ve known it will be taken away from them.
Sometimes seniors only want help from a spouse, son or daughter, which can put undue pressure on that family caregiver. Most family caregivers can go into “crisis mode” to rally around a loved one in the short-term, but you can’t be totally immersed in a crisis mode long-term without your own family, work and health suffering. The strain can take a particular toll on working family caregivers. Many caregivers spend more than 30 hours a week caregiving. That’s the equivalent of a second full-time job. Family caregivers say they are getting ill more frequently and that their loved ones’ needs are becoming overwhelming.
And that’s what makes countering that resistance to assistance so important. Many times family caregivers make assumptions but never ask: “Mom, I’ve noticed that every time I bring up having someone come in to assist, you don’t want help. Why is that?” Sometimes the parent doesn’t realize they’re being resistant.
Also, reassuring a senior loved one that you have the same goal in mind will help. Start with: “My goal for you is to be independent, too. You know I can’t be here all the time. A little extra assistance will help you stay at home.”
Following are strategies to help family caregivers turn resistance into assistance:
1. Understand where the resistance is coming from. Ask a senior parent or loved one why he or she is resisting.
2. Explain your goals. Remind an older adult that you both want the same thing. Explain that a little extra help can keep her at home longer and will help put your mind at ease as well. Have a candid conversation with him about the impact this care is having on your life. Often times seniors don’t understand the time commitment of a caregiver.
3. Bring in outside help. If a relationship with a senior is deteriorating, ask a professional, such as a geriatric care manager, for an assessment. A third party professional can provide valuable input. A wonderful resource for tips on how to talk with a loved one can be found at www.4070talk.com. If you are having problems getting through to your older adult, consider asking another family member or close friend to intervene. If you’re not making headway, perhaps there’s someone better to talk to that older adult.
4. Research options to find the best resources for a senior in the community. The local area Agency on Aging or geriatric care managers are great community resources. Also, contacting senior care providers at home care agencies, assisted living facilities or long term care facilities can be beneficial.
5. Respect a senior’s decisions. Sometimes you won’t agree with an older adult’s decisions and that’s OK. As long as that senior is of sound mind, he or she should have the final say. Please remember that if a senior has dementia, a doctor or geriatric care manager should be consulted. Logic often will not work and other strategies must be used.
Once again, unless a senior has dementia, he or she has a right to make the final decision about care, even if a family caregiver or professional doesn’t agree. The flip side is that family caregivers have the right to suggest limits on behaviors that they think are risky.
Without additional resources and education, the desire to be a perfect family caregiver leads to burnout. Perspective can come from friends, support groups and professional and informal support networks. The battle to turn resistance into assistance can be fierce. Education can help arm family caregivers with the tools they need to create a win-win for everyone.
Rose is the ultimate model of a devoted family caregiver. Rose shared with me in her husband’s last days he actually kissed her good-bye, even though he still did not remember her as his wife. Rose also shared with me that she missed him very much, especially since most of her time was devoted to his care. But she added that she was very tired: “I know he’s happy now, and I need to rest and be happy also.”
Thank you, Rose, for your wonderful dedication.
DEB CRANNY is the executive director at Home Instead Senior Care in Brainerd.