Newsletter Articles

Is Your Aging Parent Refusing Help, Even When It's Obviously Needed?

By: Carolyn Rosenblatt

Elder Law Associates Newsletter dated September 17, 2018

This issue comes up so often at AgingParents.com, that it's worthy of discussion. The adult children notice that Mom or Dad is "slipping" mentally, and getting more frail. They mention maybe it's time to get someone in to help out. The kind suggestion is met with flat refusal and sometimes anger. "I'm fine!" the parent says emphatically. Or the well meaning adult children are told to mind their own business, or worse. If the parent has a mean streak, this may bring it out fast. Yet those family members have reason to worry. The parent has physical problems and perhaps cognitive decline to go with them, making the family nervous. It seems that the families with these concerns often have a widowed aging parent who lives alone. What can they do? Can you force someone to get help, they ask?

The answer to the last question is "no", you can't force help on a competent person who remains capable of making one's own decisions. If the parent is what courts call "gravely disabled" and incapable of caring for one's self and is therefore a danger to one's self, the court can intervene and place the person under guardianship (called conservatorship in CA). Under that circumstance, the guardian can indeed force help or placement in a care facility on someone. But that's a last resort and is an unpleasant, expensive path for any family to take.  Most people can age for quite a while with the legal capacity to decide about things such as having help at home, even if they need it but won't accept it. It may be their right to refuse help. Imagine an elder who is eating poorly but eating something, living in dirty conditions but not with dangerous vermin infestation, and wobbly when walking but still able to get around. I have heard client stories describing exactly that or even worse when it came to mobility. The adult kids lived in daily fear of the parent falling, losing weight, not cleaning up at all, and just generally sliding downhill slowly. The parent could rightfully refuse help until things got a lot worse. In other words, elders have the right to be unsafe, messy, underfed and other things they choose, for a time, anyway.

We live in a society that values self-determination. Our laws are generally set up to ensure that we get to decide how to live our lives, as long as we are not harming anyone else. Concerned adult children who have to witness forms of an elder's self-neglect are stuck in many ways, other than persisting in trying to offer a parent assistance or repeating the message of concern they have. One tack that has been effective in some cases is to let the aging parent know that YOU are the one with the problem of "worrying too much" and that this is a burden. Most parents do not want to burden their children so this can be persuasive. In order to relieve the burden on the adult child, the parent can be asked to just try out some in-home help a couple of days a week, perhaps.

The low key approach can be more useful than pointing out all that's wrong with the parent and expecting the parent to respond logically. Logic doesn't work here. The refusal of the aging parent to accept help is typically based in fear: no one want to lose control over one's life and a helper is the beginning of loss of control. You can't get at that fear with reasonable explanations of why your loved one should accept help with cleaning, grocery shopping, meal preparation or whatever the need may be. Fear underlies the snarky responses and rejection of well intentioned suggestions from family. Yet just about every adult child tries to use logical means to get an aging parent to change. Forget it. It is not likely to work unless there is a crisis. A serious fall, hospitalization or loss of ability to do basic things can change the picture in the parent's mind. But it's not a good idea to wait around for a crisis unless there is no other choice. Try the approach of asking the parent not to burden you when this is feasible.

As much as we disagree with a parent and get uncomfortable, adult children sometimes have to just accept the situation. Families can continue to offer to help and make it easy to find assistance the moment a parent shows willingness to relent and allow it. In our family, it took three years for our isolated elder to finally give in and give up living alone. Her decision was not driven by a crisis, either. She said she decided to move because she didn't want to be a burden to her children. We let her think that was her idea, though we'd been saying it for some time.

 Article Source: Forbes