It’s not an uncommon scenario: as your mom, dad, aunt, uncle, or other friend or family member ages, they begin to struggle with everyday tasks. You might worry about their health and safety. Maybe they even have a fall or two, or you notice they’re forgetting important things and seem confused at times.
When this happens, there may be some disagreement between you and your loved one on the best choices to ensure their well-being. Older adults understandably want to maintain their independence as long as possible. Their family may have concerns that difficulties with daily living will get worse and lead to serious problems.
If you’ve come to the conclusion that the older adult in your life needs regular help with activities of daily living, but they are resistant to long-term care, how can you help them understand their options and have a meaningful conversation about planning for their safety and care?
Let’s take a look at helpful ways you can discuss long-term care with someone who is resistant to taking this big step in their life.
Step one: recognize autonomy
Autonomy is, simply put, the ability to act on one’s own interests and values. 1 This is important to people across all stages of life. For older adults, autonomy can often be threatened by multiple factors. Loss of income, decreased physical and mental abilities and other challenges with independence can slowly take away autonomy.
When an older adult moves to a long-term care facility, they often lose their autonomy and ability to make decisions for themselves. 2 Think about some ways that we normally have autonomy:
- Control over what, where, and when to eat
- The ability to choose when to go to bed, and when to wake up in the morning
- The choice of who sees our bodies without clothing
- Personal hygiene choices – even simple things like water temperature
- Freedom to move about, to drive, and to decide when and where to go places of our own choosing
- Choice of leisure activities and daily routines
Thinking about these ideas, it’s easy to understand why an older adult may be resistant to long-term care.
There are two ways you can incorporate an understanding of autonomy in your conversation about care needs. To start, it’s important to acknowledge fears about loss of autonomy. You can let your loved one know that you are aware of their potential concerns, and ask them to share what worries them the most.
Secondly, there may be ways you can offer to support their autonomy. Is in-home care an option? Are there any tasks you can help with, like driving them for weekly trips to go shopping? What is the least restrictive care option- could there be a choice other than a nursing home, for example, with private living quarters?
Allowing your loved one to express their concerns and participate in the decision-making process often goes a long way toward overcoming resistance. You may even be able to come to some compromises along the way- like opting for a temporary stay at a care facility to test it out, or finding ways to schedule regular visits to take them out for meals or other activities.
Don’t Navigate the Conversation Alone
Enlisting help from other trusted people in your loved one’s life is another key to discussing long-term care when someone is resistant.
It can be helpful to have a conversation with your siblings ahead of any discussion with the older adult in your life. The more you are all on the same page, the less conflicting opinions will be shared when it comes to big talks. This reduces confusion in making the best decision.
Sometimes you may find that others outside of your family circle share some of your concerns for the safety and well-being of your loved one. These people may include close family friends, or clergy if you’re part of a religious community. Asking them to join in a discussion can help add weight to the concerns being shared.
And finally, healthcare providers can be an excellent resource when contemplating long-term care. If you’re able to join your loved one at an appointment, you can bring up these concerns with a trusted physician or another healthcare provider. They can advise on medical concerns, memory issues, and physical limitations, and help explain why (and whether) long-term care is a good option.
Other key conversation tips
It’s easy to emphasize the worries you have about the difficulties your loved one may be having, especially if they are trying to brush them off. Instead of making the focus of the conversation all about their problems, keep these approaches in mind as well:
- Talk about your feelings- your experience counts too, and when things are left unsaid, it’s easy for the other person to misunderstand the situation. Are you having difficulty juggling childcare and helping your loved one at the same time? They may not have considered this angle. Maybe respite care is a good compromise.
- Don’t push- sometimes giving a person time to think about big life decisions is helpful. You may not agree after the first conversation you have, but simply saying “will you talk with me about this another time?” can leave the door open without the person feeling too pressured.
- Focus on positives- what are some of the benefits of long-term care for your loved one? Maybe they are lonely and having companionship would help. Is it hard for them to manage household tasks? What if someone else did it for them?
- Talk about the future- it can be easy to focus on the present, but sometimes that can leave older adults feeling like they’re about to be left out and left behind. Remind them about ways you’re looking forward to connecting, for example, plans for holiday gatherings and how they can participate.
Remember that solutions aren’t one-size-fits-all
Conversations with your loved one about long-term care can help you determine their unique needs and wishes. There are many options for care, and it’s also important to remember that needs can change over time.
The majority of older adults- as many as 90%- prefer to stay in their own homes as long as possible. 3 Because in-home care can be tailored to different needs, this may be an especially helpful way to give you peace of mind that your loved one is safe and cared for while allowing them the autonomy that staying in their own home brings.
If you’re not able to come to a decision and your loved one continues to resist the idea of long-term care, there’s another conversation worth having, if you haven’t already. If anything unexpected happens, who will make decisions on your loved ones’ behalf? Ensuring that at a minimum, advance directives have been created, can help plan for care needs in the future even if you’re not able to agree in the present.
The biggest takeaway? Ongoing, open communication is important, no matter what the outcome is. By keeping the conversation going, you’ll maintain a close relationship and you may have the opportunity to help the older adult in your life eventually make the leap from being unsure about long-term care to open to new possibilities.
If you would like to pursue in-home care as a solution, Caresify’s professional caregivers can work with you and your loved ones to create a plan of care that is tailored to their needs. You can learn more here, or call 888-799-5007.
Spanish 
English