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When you disagree over the level of care needed

6/9/2015

27 Comments

 
Aging, to begin with, isn't easy for everyone. It can sometimes seem like an endless series of adjustments to new circumstances- none which were asked for, and many of which are unexpected. Changes in physical health, social circles, functional abilities, new medicines, new living situations, loss of independence: These are things that can come out of nowhere, throwing your world upside down.

The difficulties adjusting to these changes throw another wrinkle into the equation. For example, as a geriatric care manager and aging lifecare consultant, I've worked with many clients who have been in denial of their need to accept changes to the way they do things. Specifically, some life changes warrant new interventions and forms of help, e.g. home health aides, medicine, walkers.

So often I've seen that the people with the best eventual outcomes are the ones who are open to accepting help from others- be it family or hired professionals. When a client and their family are on the same page, safety can be more-easily assured.

But what should families do when an elder is help rejecting? Here's some advice:
  1. If you know in advance of your loved one's actually needing help that they are likely to reject help later, start the conversation with them about their wishes now. That way, you leave them the opportunity to handle things on their own terms.
  2. If you've reached the point at which help is needed, but your loved one is help rejecting, it helps to sometimes involve a third party to help mediate. Geriatric care managers, in particular, are often able to be the person who says some sort of intervention is needed, while you can concentrate instead on providing the emotional support that your loved one would probably prefer from you instead of doting, demands, or ultimatums.
  3. Change tacks. Concentrate less on your loved one's deficits and more on their abilities, hobbies, and talents. Ask them what specific things you can do to help them continue to do the things that remain important to them.
  4. In cases where someone has lost the capacity to agree or not agree to accept help (through dementia or other illnesses), certain legal options are available to help ensure the safety of their loved one. Feel free to contact Scott to learn more about some of these options.

A final note: Above all, it's important that family members of help-rejecting people in need of help try to accept the fact that there may be limitations to their ability to set up care. Clearly, this is far from an ideal option. Nonetheless, it remains a major part of many of the cases I see every day. Setting reasonable expectations is perhaps the most crucial element of this process, and should not be overlooked.
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    Scott Dershowitz

    Founder of The Care Connector.

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