Helping Seniors Accept In-Home Care

What can you do when seniors refuse to accept the care they need? These tips empower you to understand their fears and help them take action to avoid resistance.

Your elderly client has been caring for her husband with Alzheimer’s round the clock. She’s physically exhausted and emotionally drained. Yet time and again she refuses your advice to consider in-home care. Even on the cusp of burning out, she just won’t budge.

The same scenario plays out with the retired executive for whom you’ve proposed a fail-proof financial plan, and the wheelchair-bound woman to whom you’ve recommended an Aging Life Care Professional who can help address her issues affecting her well-being.

What’s the rub?

It’s common for seniors to resist support and insist on remaining independent even when this is no longer a safe option. This is understandable: the need for help represents a loss. The aging process is filled with losses large and small, and each loss hurts. Moreover, decisions around long-term care, health and well-being are significant. Their impact can alter the course of people’s lives. When facing such decisions, seniors often get overwhelmed and shut down.

A senior’s resistance to care can be frustrating for all involved and extremely challenging to overcome. The issues that need unpacking are highly complex, and no two situations are alike. Each will respond according to his or her life experience, values, preferences and needs.

But the good news is, there are a few simple strategies that can help you understand your elderly clients’ perspective and gain insight into what might be holding them back. Through better understanding your clients’ perceived experience, you’ll be better equipped to help them take action.

Doing so will also help you build a stronger, more productive and gratifying relationship with the seniors you serve and ultimately, improve your bottom line.

Recognize What Seniors Fear Most

The first step is to recognize that there is one common, underlying reason most elderly individuals get stuck when facing a life-changing decision:

Fear.

Just as no two situations or individuals are alike, fear-based resistance to care or help comes in many shapes and sizes:

Fear of being less-than-capable (or being perceived that way).

Your client may be thinking “If I admit to needing some help, I may be perceived as weak or useless.” This is when those tricky words “I’m fine” might come into play. As I’ve mentioned before, “fine” does not necessarily mean “good”.

Fear of impoverishment.

It’s no secret that aging is expensive. A move to a senior community can cost upward of $7,000/month. Your client may feel worried about burning through her resources, which could prevent her from even wanting to think about the complex issues aging brings. Instead, she’ll just defer deciding until another day.

Fear of change, or of the unknown.

“I know what I have and how I live, and while that may not be terrific, it is known.” Sound like your client? Moving, or accepting care from a stranger is a vast unknown. Even if the current situation has serious flaws, sticking with it is bound to feel like a less frightening prospect than change.

Fear of losing control.

Giving up the keys, the checkbook or financial control can feel incredibly disempowering. To many seniors, relinquishing these small things can feel as daunting as giving up control of…everything.

Fear of failure or rejection.

Your client may be ruminating about the plan’s potential flaws and dangers, wondering, for example, “What if it doesn’t work? Where will I be left then?” Coupled with a fear of the unknown, a fear of failure can drive clients to stall on decision-making for as long as possible.

Fear of losing a loved one’s attention.

If your client gains something by staying stuck — say he enjoys his wife’s doting care or his children’s solicitude– he may not be motivated to change the situation for the better. Sometimes staying stuck provides people with the attention they crave.

Some seniors may fear just one of these scenarios, while others may fear several of them — or all.

Understand the Cause of Resistance

The first step is to identify the cause of the resistance. Asking yourself the following questions can help you to understand better where the senior resistance may be coming from:

• What words is the client using when declining your offer to take action?
• If the client uses language relating to money or costs, this indicates a fear of impoverishment is at play.
• Language such as “choice,” “options,” “control,” “stuck,” or “all alone,” suggests a fear of losing control.
• Phrases such as “negative outcomes,” or “it’ll never work” point to a fear of rejection and failure.
• Historically, how has your client adapted to change?
• What aspects of the current situation are working for the client? Are there patterns suggesting that your client doesn’t like change? If so, your client may be grappling with a fear of change.

Once you’ve identified which fear or fears may be causing your client to defer taking action, you can choose an intervention tailored to the situation.

Find Meaningful Solutions

No matter what the specific fear or obstacle is, these four steps can help you move your client toward meaningful solutions:

1. Acknowledge what your client is going through and put yourself in her shoes so you can imagine how she feels. With that in mind, consider what would bring you peace if you were in the same predicament.
2. Reassure your client that he is not in this alone. Remind him that change is inevitable, that you are here to provide help and support throughout the process and that his loved ones will do the same.
3. Normalize the experience. Your client isn’t the first senior to go through a painful adjustment. Meet him with empathy, but make sure to frame his struggle within a broader narrative. Aging can be hard!
4. Provide authentic reassurance in response to each specific fear at play, talking about what he stands to gain by taking action. Sometimes the best reassurance comes in the form of positives about what’s to come.

And remember, if your client’s inability to move forward is in any way jeopardizing her health or safety, she stands to benefit from working with a professional who can facilitate conversations with her loved ones and move past the blockage. An Aging Life Care Professional or a geriatric care manager can offer her support and guidance while serving as an impartial, trusted advocate for her needs.

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