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Nov 14, 2023

4 Questions to Ask if Older Adults Refuse Care


Most of us go through life generally self-sufficient. So, when mobility or sensory loss issues, forgetfulness, or even dementia-related behaviors begin to surface, it can be difficult acknowledging that we or a loved one needs help. Elaine discovered this truth when she tried to hire a caregiver for her husband in the early stages of Alzheimer’s disease.

“I thought it seemed perfectly logical to get a professional caregiver for Roger after he left the stove on while I was at work one day,” Elaine said, “but he got very upset when I brought the subject up. He said he was getting along just fine on his own, even though he agreed he didn’t always remember to turn off the stove or keep the front door locked.”

A kettle left boiling on the stove, missed medications and poor personal grooming all are signs more help may be needed at home. Resisting help isn’t necessarily a case of stubbornness. There can be valid reasons for refusing care.

4 Questions to Ask if Care or Help is Refused

1. Are you concerned about the financial impact of caregiving?

Caregiving costs range and many considerations are factored into determining the cost of care and how to pay for care. People can overestimate the cost of caregiving at home, or they may underestimate their own financial position.

If paying for care is an issue, consider the following to help fund caregiving

· Take an honest financial inventory examining monthly income, expenses, cash reserves, and investments

· Produce an accurate financial picture to ensure all involved know the facts

· Look for untapped resources, such as a mortgage-free home or veterans’ benefits

· Enlist a trusted financial advisor to create an unbiased budget

· Apply for a dementia home care grant

· Find ways to stretch your dollars

2. Are you worried about losing your privacy?

There are many factors that can make it challenging to conduct activities of daily living, such as bathing, dressing and meal preparation. A dementia diagnosis can layer on more complexity.

If invasion of privacy is an issue, consider trial and error a valid option

· Pledge to start slowly, by hiring a caregiver for just a couple of hours a week, on a trial basis. This allows time for both to develop a trusting relationship and reduces angst about an intrusion of privacy.

· Ask if a loved one would rather have a family member provide bathing or toileting assistance. The senior may not want to burden a family member and may prefer a professionally trained caregiver to help them with these tasks.

· When helping to ensure someone living with dementia is safe at home, watch these videos with tips for managing incontinence and bathing, as well as, other home safety considerations.

3. Under what circumstances can you see yourself getting caregiving help?

Many people refuse professional home care out of a sense of pride. They have always taken care of themselves, and they imagine they always will. Of course, that is a rather rose-coloured view of the future.

By phrasing the question of caregiving as an expected future development instead of a “now or never” proposition, you give a loved one a sense of control – the ability to set some criteria under which professional caregiving will be considered. During these conversations, remember to be compassionate, not confrontational – the point of this exercise is to obtain information, not to badger your loved one.

If planning for care is challenging, consider taking a “let’s cover our bases” approach

· When phrased appropriately, a question like this can guide care planning conversations: I know you like to plan for unexpected events, so how would you like to handle your home care if something happens to you medically, like a debilitating stroke?

· Work together to complete the Action Plan for Successful Aging to detail future care plans.

4. What advice would you give a friend in these circumstances?

Sometimes, due to dementia or simple human frailty, an aging adult just doesn’t recognize the need for caregiving help. But it’s often easy for them to see when others need help.

If help continues to be refused, consider the “asking for a friend” angle

· Leverage the tried-and-true “asking for a friend” situation by creating a scenario similar to that of your loved one to gauge their stance on caregiving help.

· Use this insight when bridging the topic again.

Navigating the complexities of interpersonal relationships (and, sometimes, family politics) can lead to power struggles over deciding whether or not an aging adult needs caregiving. However, by patiently asking a few key questions you may be able to identify why a loved one is refusing care and then gently persuade him or her to reconsider. Remember, the goal should always be to work together keeping the best interests of the aging adult top-of-mind.

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