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Tips to Guide Your Elder into Accepting In-Home Care
When the time comes to consider in-home care for your loved one, you will more than likely come up against resistance, sometimes open hostility.
Resistance to change is a natural, human reaction. For elders change is much harder, as they are already in a continual state of change. Their relationships are in constant flux. Their friends have slowly disappeared as they’ve moved to institutions or in with their children. Friends have died; perhaps a spouse has died. Their bodies are changing, and their sense of control on their world is unraveling. And now, you bring up the subject of having someone in their home to help with the everyday things they’ve always taken care of themselves.
Some Do’s and Don’ts
Many elders genuinely feel they don’t need help, and may resent the suggestion that they need to have a stranger in their home, intruding in their private lives. Here are some communication tips that may help ease your elder into acceptance:
- Don’t reciprocate their anger and/or frustration. This will only lead to more opposition from your loved one.
- Don’t make your loved one feel even more powerless by threatening a nursing home, if they don’t accept in-home care. Once you go there, you will lose ground you may never again regain.
- Do empower your loved one and show them how an in-home caregiver can offer a better quality of life.
Give Empathy, not Anger
Rather than rising up against their resistance with your own arguments, take a step back and acknowledge their feelings. Resistance is a symptom of fear. Explore the reasons behind the resistance to gently expose their concerns. Some common fears are:
- Your loved one is afraid that receiving in-home care places him or her one step closer to nursing home placement. Assure your elder that home care agencies actually prevent nursing home placement. The goal of in-home care is to prevent them from ever having to go to the nursing home.
- Your loved one is frustrated and angry because of a compilation of situations. For example, is their chronic pain getting worse, causing an inability to make it to church on Sundays? Explain to your elder that a home care agency caregiver is available to drive them where they need to go, as well as help make a doctor’s appointment for the increased pain.
Once you get to the underlying fear or frustration causing their resistance, consider how you would feel in their shoes. More than likely you’d feel the same way. Literally take a moment and visualize yourself in their situation, and actually allow yourself to feel what it would be like. This empathy can open up a whole new way of communicating with your loved one.
Express Concern Without Accusing
When expressing your concerns about your loved one’s living situation, do so in a way that doesn’t put them on the defensive. Empower them to feel in control of their situation, by asking them what they’d like to do. Some negotiating tips are:
- Leave out the words “should” and “you” as much as possible. These words tend to put people on the defensive. Try saying, “I would love to spend more quality time with you” versus “You should let someone help you with this stuff.”
- If you use the word “you”, don’t use it in the beginning of a sentence. Doing so is equivalent to blatantly pointing at someone. Instead of saying, “You always complain that I don’t come over often enough” try, “I hear you miss spending time with me”.
- When you express your concerns, take on the responsibility for those concerns by expressing them as “I” statements. To do this, take a moment and ask yourself why something concerns you. Does it make you sad? Are you scared something might happen to your loved one? When you’ve figured out the underlying reason for your concern, state your reason. For example, instead of saying, “It’s obvious that you’re having more trouble getting around. Your floor is filthy, and your hair is dirty” try, “I’ve noticed you haven’t been to church in a while. I’ve also noticed you’re not wearing your hair in your usual bun. I miss the bun. Every time I see a bun, it makes me think of you, and I feel sad to not see your bun anymore. I’ve also noticed the floor isn’t being swept. It hurts me to think you’re not getting the support you need to live your life the way you like to. What do you think we can put in place so that you can keep doing the things that make you, you?”
Give a Little, Take a Little
Convincing your loved one to allow in-home help is a process, not a one-time shot. It will take compromise, understanding, knowing when to push forward, and knowing when to back off. It’s a dance toward the best possible outcome for all involved. Here are some moves for your two-step:
- Plant little seeds, in intervals. If your loved one remains resistant to the subject of in-home help, don’t push it. Back off and pick up the conversation again later.
- Present the idea that getting a professional caregiver would allow you and your loved more quality time together. Then follow through on this, if they agree to allow a caregiver in the home. A broken promise will compromise any further negotiations.
- Place the responsibility of needing extra help on yourself. For example, if you’re already helping your loved one with activities of daily living, explain to your loved one that you need help. For example, “I just got this new opportunity at work, and I’d love to be able to spend more time on it. Would it be ok if I asked someone to come in and help me by delivering groceries once a week?”
- Start small, then work your way up. If you’re in a position where you have some time to plan ahead, introduce the idea of an in-home caregiver gradually. Perhaps your loved one will allow a caregiver deliver groceries. Then as trust begins to build, perhaps the caregiver can eventually begin putting the groceries away. Eventually, maybe your loved one will allow the caregiver to drive her to the grocery store to help with the shopping.
- Respect your loved one’s autonomy regarding their care. As long as they feel they have a choice in the matter, they will be less resistant.
In preparation for your conversation with your loved one regarding an in-home caregiver, mentally prepare beforehand. Anticipate possible arguments your loved one may make, and how you’d like to counter those arguments. Some common objections by elders are:
- “I don’t need any help”. Counter this by using gentle reality checks. For example, “I remember three occasions last week that something was left in the oven and burned, causing the smoke alarms to go off.” Another approach may be, “I’d rather spend time with you going to a movie, while someone ran the vacuum once a week”.
- “I like things done my way.” Tell your loved one they will be actively involved in supervising and training the caregiver.
- “I don’t want a stranger in my house.” Reassure your loved one that the home care agency has performed extensive background checks on their caregivers, and that you will check in regularly to make sure things are going well.
- “I can’t afford it.” Oftentimes, elders underestimate their assets. Many want to save so they have something to leave behind. Remind your loved one that what they’ve worked for, now needs to work for them. What they have, is for them, not you. You have built your own financial stability for your future. If they don’t have an awareness as to where they stand financially, ask an accountant to do an assessment. For example, what equity do they have in their home? A reverse mortgage can help with care expenses.
- “Absolutely not.” Subtly arrange to “bump” into another elder who is happy with their in-home care. Perhaps their positive experiences will motivate your loved one to agree to an in-home caregiver.
What other ideas do you have to make this conversation easier with your loved one?