The Care Conversation

Many older people are incapable of running their own lives and homes, but often are reluctant to admit they need help. Failing eyesight, memory lapses, confusion, fatigue, sadness, drug and other substance abuses and appetite changes can account for a diminished ability to manage a home. There are definite signs that indicate some kind of assistance may be necessary.

Based upon your observations, if you have concluded that your loved one’s situation demands attention, it’s time to take the next step and talk about it.

Before you start the conversation, be aware that talking about getting help may feel very threatening to your loved one. He or she may tell you to mind your own business, or insist that everything is fine when it is not.

First, consider why those needing assistance may reject the idea of accepting help. She may feel uncomfortable with having others see her increasing needs. After years of independence, the loss of certain abilities may feel too sad to face. Some people feel ashamed, embarrassed, or vulnerable. Others worry about becoming a burden. Some people are resistant to the idea of needing to invite a new person, such as a professional caregiver, into their lives.

It is important to remember to be sensitive. Speak gently and with compassion. Let your loved one know that you are worried. You can give specific examples of things that have happened that have caused you to worry. Be careful that you don’t blame the person for what is happening. Remain calm to help defuse any anger or defensiveness.

Listen to your loved one’s point of view. Ask him what he wants as he ages. If you haven’t already done it, this is an excellent time to talk about his advanced care directive. Open up the conversation to include care preferences, housing alternatives, and end of life goals. The more you listen and let your loved one share, the more you will learn about what she hopes for the last years of her life.

If your loved one continues to be resistant, let him know that it is about you, not him. You can say, “I know you don’t want help yet, but I am worried and this would help me to worry less when I can’t be with you.”

Trust yourself and your evaluation of your loved ones care needs. Also pay attention to your own needs for breaks if you are the primary caregiver. Then move forward giving your loved one as many choices as possible. If your loved one refuses to get in-home care, discuss the option of moving to a facility. Be gentle and firm in your conviction that some type of help is needed.

If your loved one makes a decision to try in-home care or move to a facility, ease the transition by allowing her to make as many choices as possible. This might include touring facilities, picking the move date, or meeting an in-home caregiver before care begins. Choices give people control in the midst of the frightening and uncontrollable circumstances of aging.

If you need help with initiating this conversation with a loved one that you are worried about, call Help at Home Senior Care. We will be happy to help you evaluate the situation, walk you through the process of seeking help, and consider the options available to you and your loved one.