Ask Vanessa: Take a Few Small Steps to Make Things Better

DEAR VANESSA,

My mother had a fall and was in rehab for a while. Her doctor recommended in-home support, but my mom’s resistance to care has kept her from getting the help that she needs. She has always been independent and I’m afraid that her indifference or reluctance to accept outside help can and will compromise her safety and wellbeing.

-ANGELO

DEAR ANGELO, It is not uncommon for seniors to refuse help, especially if they have been independent. You mother may find it hard to admit or recognize the fact that she cannot do things as well as she used to do. David Stephen, PhD, wrote: “Elders often deny they need assistance or that their abilities are diminishing. It is difficult to admit that one needs help, because that may be perceived as indicating a loss of independence and a loss of self worth.”

Have a heart-to-heart talk with your mother. Probe deeply why she refuses help. Besides losing independence, is it about a lack of privacy, fears about the cost of care, or having a stranger in the house? Gently explain to her that getting older (and accepting help) is nothing to be ashamed of. Depending on the level of assistance that she needs, hiring an experienced in-home caregiver may be a good option at this point. Patiently explain to her that having someone by her side would not mean losing her independence and privacy. The transition need not be as drastic. Each person needs a period of adjustment to become accepting of care, to trust a caregiver, and to let down barriers of privacy. Let her know that having a caregiver does not have to be round-the-clock; she can pick certain times of the day when she prefers a caregiver to come in. The caregiver can start making her life easier by doing light housekeeping or running errands for her. As the rapport is gradually established, your mother will become more accustomed to the idea of accepting or paying for care; she will even welcome the support that she has resisted for some time. Research has shown that two-thirds of those who experience a fall will fall again within six months. Look at what home health care agencies in your area can offer; do a research on the type of services and flexibility in terms of hours required.

If therapeutic communication fails, consider hiring the services of a geriatric care manager. A geriatric care manager is trained to assess, plan, coordinate, monitor and provide services for the elderly and their families. Advocacy for older adults is a primary function of the care manager. His or her expertise and guidance lead families to the actions and decisions that ensure quality care and an optimal life for those they love.

-VANESSA