6/4/07
When the Elderly Refuse Care
Author: Jo Nelson, R.N.
You've spent hours pouring over information regarding elder care; you've researched and developed a plan of care for your elderly loved one that should be etched in gold! You're feeling so relieved, knowing that they will now be safe at home, and a caregiver will be there with them when you can't...until the day arrives when the caregiver comes to meet them, and your loved one refuses to open the door! What do you do now?
There can be many causes for this reaction to your plan. Perhaps they feel a loss of control in their lives. Maybe they resent feeling like they aren't trusted to be alone at home any longer, and their self esteem is hurting. Maybe they're afraid of having a stranger in their home. Maybe they want their privacy and don't really understand why they need help in the first place! The way you respond to your loved one's concerns may eventually determine if your "golden" care plan is going to be successful or not.
Before you even begin to initiate your care plan, include your loved one in the "research project." Make sure they feel like they are a part of making the decisions as to who to hire, when the caregiver should come, and what type of care they may need. Even if they aren't completely sure they need the help, it may give them the added confidence they need to know that you still value their input and respect their opinions.
If your loved one is fearful of having strangers in their home, listen to their concerns and let them know you understand. When deciding who to hire, make sure you go to a reputable agency that does criminal background checks and has good referrals and testimonials. Reassure your loved one of those things when you make your final choice. Make sure the caregiver comes to meet them for the first time when you are there with them, and give them a chance to form an initial impression before you insist on keeping that particular caregiver. Usually after just a few visits, the apprehension dissolves into a cheery, trusting relationship that your loved one will truly enjoy.
If they just don't agree that they need the help, you have unfortunately entered into the greatest challenge of all, especially if your loved one is suffering from altered thought processes and is unable to identify with your concerns. This may be the time to be loving but firm with them, and let them know that there really isn't a choice when their safety is at stake. Reassure them that your motive is to help them live at home for as long as they can safely do that, and let them know you're on their side. Make compromises if you can safely do so; for instance, have the caregiver come the same number of visits per week, but maybe for shorter time periods. Try referring to the caregiver as the "cook" or the "housekeeper" ...let them know you want to pamper them! Make sure your loved one realizes they aren't expected to entertain their "guests", and they can go about doing whatever they would normally do if no one was there. On the other hand, if your loved one enjoys socializing, suggest a lively game of cards when their caregiver is there, or some other activity with them that your loved one would enjoy. Persistence is the key...in time, your loved one will grow to accept their new lifestyle and the friction will dissipate.
Remember, in the midst of all these issues, your own health and lifestyle are also important. Caregiver burnout can be a real threat to you and your family if your loved one doesn't cooperate with the plan of care you have worked so hard to design for them. Don't allow yourself to be manipulated by a false sense of guilt if your loved one has difficulty making these adjustments. In time, they will realize that you have their best interest at heart, and they may even grow to appreciate you for it!
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Author: Jo Nelson, R.N.
You've spent hours pouring over information regarding elder care; you've researched and developed a plan of care for your elderly loved one that should be etched in gold! You're feeling so relieved, knowing that they will now be safe at home, and a caregiver will be there with them when you can't...until the day arrives when the caregiver comes to meet them, and your loved one refuses to open the door! What do you do now?
There can be many causes for this reaction to your plan. Perhaps they feel a loss of control in their lives. Maybe they resent feeling like they aren't trusted to be alone at home any longer, and their self esteem is hurting. Maybe they're afraid of having a stranger in their home. Maybe they want their privacy and don't really understand why they need help in the first place! The way you respond to your loved one's concerns may eventually determine if your "golden" care plan is going to be successful or not.
Before you even begin to initiate your care plan, include your loved one in the "research project." Make sure they feel like they are a part of making the decisions as to who to hire, when the caregiver should come, and what type of care they may need. Even if they aren't completely sure they need the help, it may give them the added confidence they need to know that you still value their input and respect their opinions.
If your loved one is fearful of having strangers in their home, listen to their concerns and let them know you understand. When deciding who to hire, make sure you go to a reputable agency that does criminal background checks and has good referrals and testimonials. Reassure your loved one of those things when you make your final choice. Make sure the caregiver comes to meet them for the first time when you are there with them, and give them a chance to form an initial impression before you insist on keeping that particular caregiver. Usually after just a few visits, the apprehension dissolves into a cheery, trusting relationship that your loved one will truly enjoy.
If they just don't agree that they need the help, you have unfortunately entered into the greatest challenge of all, especially if your loved one is suffering from altered thought processes and is unable to identify with your concerns. This may be the time to be loving but firm with them, and let them know that there really isn't a choice when their safety is at stake. Reassure them that your motive is to help them live at home for as long as they can safely do that, and let them know you're on their side. Make compromises if you can safely do so; for instance, have the caregiver come the same number of visits per week, but maybe for shorter time periods. Try referring to the caregiver as the "cook" or the "housekeeper" ...let them know you want to pamper them! Make sure your loved one realizes they aren't expected to entertain their "guests", and they can go about doing whatever they would normally do if no one was there. On the other hand, if your loved one enjoys socializing, suggest a lively game of cards when their caregiver is there, or some other activity with them that your loved one would enjoy. Persistence is the key...in time, your loved one will grow to accept their new lifestyle and the friction will dissipate.
Remember, in the midst of all these issues, your own health and lifestyle are also important. Caregiver burnout can be a real threat to you and your family if your loved one doesn't cooperate with the plan of care you have worked so hard to design for them. Don't allow yourself to be manipulated by a false sense of guilt if your loved one has difficulty making these adjustments. In time, they will realize that you have their best interest at heart, and they may even grow to appreciate you for it!
About the Author:
Jo Nelson is a Registered Nurse and the owner and administrator of Servant's Heart Home Health Service in North Central Indiana. Servant's Heart offers a variety of home care services, from 24 hour care to skilled nursing. Visit them on the web at
servantsheartservices.com
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