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Care Management ~ Eldercare Advocacy ~ Dementia Care

Serving families in Palm Beach, Martin and Port St. Lucie counties

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The best approach to a parent who refuses help is to back off and look at the situation from a different perspective. Take a moment and try to figure out why your mother might not want your help. Be sure you’re thinking about the situation from her point of view, not yours. It’s hard to do, but take a few minutes alone, in a quiet room, and imagine yourself in her shoes.

Begin with the premise that, like you, your mother treasures her independence and wants to make her own decisions. She realistically assumes that if she tells you something is wrong, you will want to help her and do something about the problem. If she is ill, she knows that in order for you to help her effectively, you must involve yourself in her private life, and that may jeopardize her independence. The result of your actions may mean the loss of her driving privileges or a move to an assisted living community or a nursing home. It may force her to admit she can no longer take care of herself and that she may have begun an irreversible slide into dependency. She senses that from the moment you begin to help her, nothing in her life or your relationship will ever be the same. She is absolutely right. Do it anyway.

You will find ways to comfort your mother through the necessary changes, but for now, your assistance may be the only way to help assure her health and safety. Your mother might not be sure which of her changing needs are natural with advancing age and which might signal a treatable problem. Rather than “pester” the doctor, she may decide to “wait,” believing or hoping the problem will take care of itself or that there is nothing that can be done. “After all, dear, I am eighty-four.”

Our parents rarely deceive us out of malice or harm, or to cause us more anxiety or pain. Most of our parents learned self-reliance as children and have practiced it their entire lives. Many come from a family tradition of not consulting doctors for seemingly ordinary occurrences like a cough, the flu, a pain, or even a broken toe. Their parents (your grandparents) had to be self-sufficient to survive. The nearest doctor may have been so far away, or so expensive, that treatment for less-than-life-threatening problems wasn’t feasible.

For situations that involve memory loss, you may hear, “At my age, I’m entitled to forget a few things.” You may be tempted to accept your mother’s explanation; after all, don’t we all occasionally forget where we put our car keys, the name of an acquaintance, or even our own telephone numbers? Yes, we do forget those things, but our memory lapses are usually temporary: we eventually find our car keys, remember the person’s name, and recall our own telephone number. Before you let your mother convince you she’s fine, try to determine whether her lack of recall is sporadic and temporary, or recurring with growing confusion. If it’s the latter, intervene quickly and see a board-certified geriatric physician.

To some of our parents, aging may be a metaphor for loss of independence, relinquishing the role as head of the family, and for becoming a burden to the family. For many, it can also mean a constant battle to maintain their privacy and control of their future. When we try to help, we have a tendency to “take over” and make immediate changes, regardless of the impact on our parents’ lives. Although changes may be necessary for their health and safety, to our parents these changes may seem disheartening, disorienting, humiliating, and unnecessary. You can help prevent those feelings, or diminish them, by following these three steps:

  • Take time to think your ideas through and plan them out thoroughly. For example, if you know that your father can’t drive safely and have removed his car, try to provide alternate transportation so your father can still run his errands, go to a movie, or to a restaurant for dinner. If you think your mother would be better off moving into an assisted living facility, work out the logistics with your mother and your family before making the final decision, rather than making her feel like a burden to you by arguing about them in front of her during and after her move.
  • Talk with your parent before you make any changes. If she is capable, develop a continuing strategy of working at trying to persuade her to do the right thing for her health and safety. It may take more than one meeting, but it’s worth it. Don’t expect an automatic or even a quick agreement to your recommendations. You may be asking your parent to change decades-old habits, a well-established routine, or even a total lifestyle. Unless we ask for help, very few of us want other family members meddling in our business and telling us what’s best for us. Instead of forcing the issue, set a goal of trying to convince your mother to take care of her needs. When you talk to your mother about the benefits of following your suggestions, be sure to put yourself in her position. Forget about what you want. Try to figure out and stay focused on how your plan will help her achieve what she wants.
  • Present your parent with choices so that she can continue to maintain some control and autonomy. This approach is practical only if your parent is realistically able to make the decision. Don’t attempt to make an agreement for a future date with a parent who exhibits medium to advanced dementia symptoms. Your parent won’t remember the discussion or the date, and constantly re¬mind¬ing her will only cause her more anxiety and confusion. For instance, if you are helping your mother move, identify several dates that work for you, and then give her the responsibility for choosing which date she wants to move. If you are hiring a homecare worker, interview several candidates and choose two or three that you feel are a match for your mother’s healthcare needs and personality. Then let your mother interview your choices and choose the homecare worker she likes the best. You will still have the worker of your choice, and your mother will have had the final say in the decision. This approach will increase her control, which usually helps assure more cooperation. You will receive fewer complaints from your mother and the worker, and you will have to replace fewer workers 

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