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When an aging parent says no to much needed help

Miles J. Varn, MD
Conditions
February 27, 2020
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The first signs are often subtle — missed appointments, unpaid bills, or a once immaculate home that now has an unmowed lawn and dirty dishes on the counter. It’s easy for adult children of aging parents to miss these first signs that their parents need help with tasks they once handled easily on their own. In fact, many older people take great pains to cover up these problems and insist everything is fine. But for most families, the day will come when parents need help with a variety of daily tasks and activities. It’s an expected part of the next phase of life.

What’s unexpected for many children and family members is when parents refuse offers of help and even seem offended, interpreting the offer of support as a suggestion that they cannot handle their lives on their own anymore. Rather than feeling frustrated and getting into heated conversations about the issue, it’s helpful to first consider why parents may be loath to accept help.

The most common reason parents reject help with tasks they’ve managed all their lives is a desire to maintain their independence and control over decisions. Others are concerned that help with tasks like bill paying and physician’s appointments decrease their privacy. And for some, conversations about accepting help raise the unwelcome specter of decline and death.

Moving past objections to solutions

The best-case scenario is to start the conversation about providing parents with help before they need it. At this point, parents are a bit less likely to feel that their children are suggesting that they are no longer able to manage on their own. Proactive conversations are more likely to be calm and productive since parents can view them as hypothetical or part of building a plan where they are equal partners in the decision-making process. A good approach is to ask open-ended questions about what concerns they have and what solutions they’d suggest to make their lives easier.

If the situation doesn’t come to light until parents need help and support, assess what their most immediate and urgent needs are — the ones that have the potential to cause real problems like falls or illnesses that aren’t being controlled properly because of failure to take their medications.  Also, notice changes around the household, such as a lack of food in the house due to an inability to get to the grocery store, or serious financial problems such as bills going to debt collectors or utilities being turned off for non-payment.

It may be effective to start with offers of help that don’t feel to parents like a sign of weakness. For example, if parents don’t want their children shuttling them to appointments or shopping, suggest you set up an Uber or Lyft account for them, a type of help that people of all ages use. Other similar types of services used by people of all ages include housekeeping help, online grocery ordering, and delivery, auto-pay for key bills and lawn maintenance services.

Don’t push parents to agree to a plan immediately, which could make them feel like they’re not active participants in the decision. Listen to their input, ask for their suggestions on what type of help they’re comfortable accepting, propose a plan that addresses their most immediate needs, and give them a week or two to think about it (unless, of course, they’re at imminent risk of harm). Suggesting a trial period can also be effective. Parents don’t feel locked into a solution they may not like, and they have the chance to see the benefits of accepting help in action.

It can be beneficial to highlight how accepting help can, in fact, increase parents’ ability to continue to live independently and do what they want. Depending on the parents’ outlook, it may also be effective for children to share how parents’ acceptance of help has a positive effect on their own lives, for example, less worry about their parents.

The conversation about accepting help should be an ongoing one to ensure that parents’ changing needs and wishes are addressed. To prepare for this complex conversation with parents, adult children and relatives can tap a wide range of resources, including geriatric care managers and local agencies on aging so the discussion is one informed by the knowledge of experienced experts.

Miles J. Varn is chief executive officer, PinnacleCare, and can be reached on LinkedIn.

Image credit: Shutterstock.com

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