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Talking to a parent about arranging for in-home care.

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You may have been unsuccessful in your attempts to convince a parent to make a move to retirement or assisted living community, or perhaps you've already broached the subject, and your parent has said "I'm just fine on my own. I don't want a stranger in my house!" Or, perhaps you are involved in supporting your parents by doing or arranging yard work, housecleaning and grocery shopping.

Some people are faced with an uncomfortable situation of convincing a parent to become accepting of help from a paid caregiver. Particularly if your own personal balance in life is askew, you may be highly encouraged to elicit change.

It's difficult to have a single in depth conversation and expect a parent to change their mind and become suddenly accepting of care. It is better to have multiple, shorter discussions over time. This allows your parent to have time to contemplate the idea and to become more familiar with the concept of needing care. If you attempt to obtain agreement in one single discussion, you may be faced with resistance and unwillingness to discuss the options.

It is important to be honest and clear with your parent. Depending upon how urgent their situation, you may need to schedule multiple visits within the same week to talk about these topics. If you are fortunate, and your parent is not unsafe in their home, then it is wise to stretch the conversation over a period of weeks or even months.

To increase the likelihood of obtaining consent, follow this pattern for discussing your concern:

Consider giving your parent an agenda. Place three or four concepts on a piece of paper, and stick to the topics listed. If your parent feels you are being too controlling by having a written agenda, tell them that you wrote it down to help yourself. Tell them that this is a very difficult subject, to discuss, and so to say what you know needs to be said, you've put some ideas down in writing.

Remember to keep your discussions to a maximum of three concepts to avoid being perceived as "pushy" by your parents. The goal is to get your parents to view their situation objectively and to make decisions on their own, if possible. And if they are unable to make decisions on their own, they need to feel as if they are participating in the decision-making process. If they are able to recognize and state out loud that they need help, they are more likely to be accepting of care.

Here are some sample topics you may wish to include:

I'm not sure what you would want if you were to need care but you were unable to talk. Can you help me understand your preferences?

I think the time has come for you to communicate how your family can best be of support to you as you grow older. Do you want us to be of help to you, or do you prefer having someone else help you?

I don't like to think about how things change, but realistically they always do. I would be grateful to talk to you about how I can be of support to you in getting help around the house now and then.

If you are faced with a crisis situation and are told by a doctor or discharge planner at a hospital that your parent can no longer live safely in an independent situation, you likely don't have the luxury of asking open-ended, probing questions to gather your parents input regarding their care. Instead, you may find that you need to use language to make it clear that: Your parents need to choose between option A, B, or C, orů

You will have to make the decision and arrange for services and have an on-going discussion to hammer out a more specific plan.

In all cases, it's advantageous to talk about the options. Give your parent an understanding that any service that is arranged can be changed at any point in time. Ask that they be supportive and accepting of this change for a period of time. Most people can tolerate change if they know that they have an "out," and if they know that another discussion will be held in 30 to 60 days.

The three primary reasons why a parent may be unwilling to accept care;

1. Cost

Good care is not inexpensive. Your parent may be unaccustomed to paying for services. If you can financially afford to pay for a month of expenses out of your own pocket, you may find that your parent is more receptive to accepting care. Then again, perhaps not. Many older adults are very conservative about spending money on what they may consider a luxury service, and they may resent the fact that you are paying for something that they consider to be their own responsibility. Most parents continue to feel like the "parent," so accepting that their child has paid for services for them may not be feasible. Each family has their own dynamic regarding this topic.

Speak to your parent about the benefits of staying in their own home. If they need little help, then point out the cost savings of having help come in versus the cost of moving. Let them know that a future move may become necessary, but for now "it's not as expensive as moving, and it's not nearly as disruptive to your life right now."

Always give your parent the option to move, if this is financially feasible for them.

Although in-home care can serve people their entire lifetime, at some point socialization, finances, or services may warrant a move.

If your parent is accustomed to paying for services, or if your parent tends not to listen to your ideas and suggestions, consider hiring a professional care or case manager to help communicate with your parent and to manage services.

Geriatric Assessments - Counseling, Care - Case Management

2. Denial

It's difficult for us to view ourselves as old. Because the process of aging is gradual, it's easy for a person to be unaware that they are no longer capable of managing their own affairs without assistance. Pointing out to a person that they are old and frail is not helpful to the situation. It is better to focus on your concerns - give an example to clarify, and ask for feedback or a decision.

For instance:

"Mom, I feel it would be helpful to you to get a little help around the home now and then. I'm concerned about you cleaning your bathroom floors. What if you lost your balance? Can I help you arrange some support or should we look into getting you an emergency pendant or bracelet so that if you do fall, you could call for help?"

3. They are afraid of the unknown

This is simply human nature. We don't realize how good things could be because we worry about the "what ifs" and about things that will likely never happen.

Give recognition to the fact that arranging for services does feel strange to you as well, and then help them refocus by thinking of the benefit to them.

"The good thing about arranging to have this person come in to help you is that you'll get to know someone else you might call on to help you with other things over time, and we can always make a change if it doesn't work out."

4. They may be hiding the fact they are becoming forgetful

50% of people age 80 or older suffer from some type of memory loss. By keeping things as they are, they can better mask their forgetfulness. To address this issue, you may consider humor rather than brutal honesty. Making light of the situation may help your cause:

"Dad, it would be nice to have a part-time person to be of help to you - you mentioned that you forget to take your medication, or you forget other things from time to time. Maybe with someone to help you part-time, you can let them be the one who worries about things rather than you."

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Last update: 2013-02-19 22:00
Author: Tech Support
Revision: 1.2

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