How to Help Elderly Parents Who Don’t Want Help

​Managing care for an elderly parent can be emotionally draining and logistically exasperating under the best of circumstances. I consider myself lucky because my mother, in her final years, was generally appreciative of the care my sister and I provided either directly or with the help of a series of home-care aides. She had her moments, but for the most part, my mom gladly accepted help.

Unfortunately, that’s not always the case with older people grappling with deteriorating health or mental function. Consider the case of Ed, whose health and cognitive abilities went into sharp decline after his wife died. His stepdaughter Jan jumped into the fray, quitting her job to help take care of her father, who suffered from diabetes.

“When his blood sugar spiked to a dangerous degree, Ed refused to go to the hospital,” writes Jody Gastfriend in a newly published book, “My Parent’s Keeper: The Guilt, Guesswork and Unexpected Gifts of Caregiving” (Yale University Press). “Jan, upset and alarmed, pleaded with her stepfather and eventually called 911 against his wishes.”

Soon, Ed had to have two toes amputated. Then a leg. “Although Ed was able to put on his own prosthetic, he refused to do so and was confined to a wheelchair,” Gastfriend reports. Compounding the challenges for Jan: “Ed would not agree to an outdoor ramp, making movement in and out of the house a Herculean task. He was stuck -- physically and emotionally. And so was Jan.”

Gastfriend has accumulated a wealth of knowledge about caring for the elderly based on both her personal and professional experience. She has been a social worker for more than 30 years and currently is vice president for senior care at Care.com, the leading online marketplace for home-care services.

In “My Parent’s Keeper,” Gastfriend examines all aspects of caring for an elderly parent, from dealing with difficult siblings to hiring professional caregivers to managing the financial burden. But she’s particularly insightful when it comes to dealing with the parents themselves – especially those who refuse to acknowledge they might need help after a lifetime of helping others. (If you want a sample, Forbes just published an excerpt of the relevant chapters.)

“One of the biggest frustrations for adult children is that they come up with a plan that makes perfect sense to them but their parent says, ‘Thanks but no thanks,’” Gastfriend writes. “When our parents’ refusal to accept help puts their safety and well-being in jeopardy, we feel compelled to act, yet our good intentions are often thwarted. I have heard countless stories of caregivers who tried strong-arming their parent to accept help – only to feel angry and dismayed when their efforts failed.”

Gastfriend has two simple but wise pieces of advice if you have a parent who clearly needs help but refuses to accept the fact. First, try not to take their rejection personally. It’s not you they’re rejecting, but the notion that they may not be as capable and independent as they once were. And second, try to empathize with their fears and insecurities. Literally, try to imagine being in their place and how you might react under similar circumstances. The exercise can help turn an adversarial process into a partnership.

“Offering choices and ceding a little control along the way may help break down the walls of resistance,” Gastfriend observes.

Sometimes all it takes is a change of terminology. Gastfriend cites the example of one family who initially had trouble persuading their father to accept help from a professional caregiver. The father, you see, was a retired corporate CEO who was not accustomed to relinquishing control. Wisely, his children stopped using the term “caregiver” and started saying “assistant” instead. That was enough to satisfy their father.

If, despite your best efforts, a parent refuses to budge, you may need to seek help from a professional, Gastfriend advises.

“Aging life-care professionals, elder-law attorneys and professional mediators can provide an objective perspective about financial and legal matters and lay out options for care. They may also dislodge entrenched parents from unreasonable and unsustainable positions that put them and others at risk.”

In an appendix to “My Parent’s Keeper,” Gastfriend distills her experience and insights into three useful tips:

● Start early: Bring up the topic of long-term care when your parent is still active and healthy. That way, you’ll have a framework for putting a plan in place if and when the time comes.

● Recruit an outsider: It may take an outside voice (or two) to get your parent to agree to help. Recruit doctors, healthcare professionals and other family members to persuade him/her to accept the care he/she needs.
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● Take it slow: If possible, slowly integrate a paid caregiver into your parent’s routine. Have the caregiver come a couple of times a week to help with laundry and food prep, then gradually increase the number of visits, if needed. Giving your father or mother time to develop a positive relationship with a care provider may enable him/her to accept help on his/her terms.

​​Written by T.J. Foderaro