Convincing Elderly Loved Ones to Accept Help
Posted November 22, 2005 11:00 AM
Author Elder Rage www.ElderRage.com
Host Coping With Caregiving Radio Show www.wsRadio.com/CopingWithCaregiving
Listen to an overview of one of Jacqueline’s seminars:
http://boss.streamos.com/wmedia/wsradio/elder/121705/segment4.asx
WELCOME BACK ALL MY CAREGIVERS—Tell us your story!
Ohhh yeah, my father was the absolute worst! For eleven years he took very good care of my sweet mother after her heart attack, refusing all help, yet calling me long-distance every single day saying how hard it was. I'd fly to San Francisco, get caregivers in place, and within a few days I'd get the familiar call. "Jacqueline, I just can't work with your father--his temper is impossible to handle. I don't' think you'll be able to get him to accept help until he's on his knees himself."
When my mother nearly died from his inability to care for her, I had to step in despite his loud protests. I left my southern California life for what I thought would be a month or so. Instead, I was trapped at my parents' home for nearly a year of hell and heartache, without a day off, going through 40 caregivers as he'd swear, call them nasty names and throw them out of the house. One of his big excuses was that he just couldn't afford a caregiver, even though I offered to help pay. If I had to do it all again--here's what I'd do!
First and foremost, I would have bought Long-Term Care Insurance while my parents were still healthy--and started the conversation and plans for their old age much sooner. Had I done that, I could have saved a small fortune--not to mention my sanity. What I didn't understand, and most people don't either, is that Medicare and regular health insurance does not cover caregivers to come into the home, nor do they cover the cost of assisted living or nursing homes. Once a patient has stopped improving and is released from the hospital, you're on your own to pay for their care. This is a huge expense. Long-Term Care Insurance would have covered caregivers in my parents' home as soon as my mother came home from the hospital.
And if I had to place my parents in assisted living or a nursing home, the LTCi would have covered it. The alternative is your loved one has to literally become destitute before the government's Medicaid program will help with financial aid--but in most states, primarily only if they go into a nursing home. You're on your own to pay for custodial care to keep them at home. (More on LTCi http://blog.thirdage.com/?p=133)
I'd also call Adult Protective Services as soon as I arrived and discovered my parents' home in such a deplorable condition. By being on record with them from the outset, I'd have been able to prove my father's inability to care for Mom right away. I'd have them tell him that the house had to be cleaned and that he had to have a caregiver, or she'd never be able to come home from the hospital. I wouldn't have to be the bad guy--they would.
I'd also get ALL the healthcare professionals my parents went to on the bandwagon of promoting the caregiver idea and even rave about the caregiver I hired. Then, I'd just be the devoted daughter that helped find the ideal person.
I'd also understand that a person does not go from normal to demented overnight, that it's a looong process, and that my father's judgment was being compromised at times because he was at the beginning of it. Sometimes he was capable of normal thinking, but when the dementia surfaced, he wasn't. My compassion would return because I'd understand that dementia is intermittent, it comes and goes. If what he said or did seemed illogical or irrational, big flag--IT WAS! Ohhh, the dementia's back again--don't get upset by what he's doing. He's terribly frustrated and he's grasping at anything he can to hold onto control--let it go, let it go.
I'd realize that life had become so frightening and confusing for him, that he would pull out everything he had, from a lifetime of tried and true manipulative behaviors, to try to hold on to control--and that meant being alone with Mom. By understanding that sometimes he just wasn't capable of rational thinking, I'd reinforce my own better judgment of what needed to be done. My frustration level would be reduced, because I'd know to stop trying to use logic and reason to win my arguments--and I'd know to use distraction and redirection instead. My perception of the crisis would shift from being overwhelmed, to meeting a complex medical challenge, which would help me to not be so emotionally drained.
I'd also hire an elder law attorney and get a legal conservatorship / guardianship process going, so I'd be ready if it got to that point. I'd also find a caregiver support group, which would help me feel less alone. By hearing how others were handling their eldercare problems and frustrations, I'd gain more insight, ideas and strength.
Then, as soon as my mother was strong enough, I'd gradually introduce them to Adult Day Health Care to give them a life outside of lying in bed all day, day after day, just waiting to die. I'd realize that keeping them busy at day care would be the best thing for them, and would reduce the hours that we needed a caregiver. More on Adult Day Care: http://blog.thirdage.com/?p=149
Bottom line: I'd resolve to get them the help they so desperately needed, no matter how much my father protested.
Ahhh hindsight, it's always 20/20!
Jacqueline Marcell
Author Elder Rage www.ElderRage.com
Host Coping With Caregiving Radio Show www.wsRadio.com/CopingWithCaregiving
Tell us your story!
Thanks for the great postings, Cindy, Deborah, and Harriet! I am also having trouble convincing my Mom that she needs help. She is 77, and is showing signs of (hopefully) early Alzheimer's. She is also hard of hearing, and she qualifies for a free hearing aid from a state Telecommunications program. But she doesn't think she needs one. I moved in with her several months ago, and now after being on-hand to evaluate the situation first-hand, I know without a doubt that she needs one if she is to continue enjoying a good quality of life. The rest of the family agrees that she would benefit from a hearing aid. But she is paranoid, and doesn't want to disclose her financial info the forms require. Isn't paranoia a sign of Alzheimer's? She hasn't been diagnosed, and I would have a REALLY hard time getting her to complete an Alheimer's test at the doctor's office! I called and asked what kinds of tests they would use, but haven't gotten an appointment for a screening. Any suggestions on how to convince her to get the free hearing aid and get tested for Alzheimer's??
My Dad also has Alzheimer's and I guess luckily for us, he has a history of blackouts with unknown origins. Due to those blackouts, he was not allowed to drive. Being able to blame the doctor (as opposed to family member) made the driving problem a bit easier to handle.
What I don't understand with my Dad is how he can still think that nothing is wrong. He is hallucinating that he is supposed to be teaching again, sometimes he tries to tell my Mom that the doctor told him he can drive again. We can be as charming as possible, but when he doesn't feel confused, it's hard to convince him that he really is. On the one hand, maybe it's a blessing he doesn't realize how bad he is. On the other, it might make my Mom's job easier if he did ask for help once in awhile.
My Mom doesn't ask for help either. She is 79, healthy and taking care of my Dad. With her, we continue suggesting different options/solutions for his care, and hope over time she agrees to some of the help we are suggesting. She finally caved in and has a part-time caregiver. And she is close to caving in on sending Dad to a senior center one day a week as an outing. She still always has to say "no" to an idea about a dozen times before it starts sounding feasible to her. My latest idea she denied, was to get a life alert for her, in case she falls. She said no and is convinced my Dad would be able to call 911. I told her I wouldn't trust him to do that, but then she goes into the "we all have to go sometime" dissertation! I know if I keep mentioning it over the next few months, she will hopefully cave in and accept the idea (hopefully without an incident that would force it upon her).
My brother and I will keep working at it. We know we are doing the best we can given that we are both out of state. We can't force my Mom into accepting the ideas at this point, but we can continue listening and offering suggestions as best we can. It's not easy watching our parents become old and frail. My Dad was my rock growing up. I'm trying to be his ... if he'd only let me.
Happy Thanksgiving everyone!
Convincing my parents that there was a problem was very difficult. My father knew how to "cover" his memory lapses. He would call everyone "sweetie" or "pal" when he couldn't think of a name. He would play with the little ones in the family because they wouldn't notice his problems and the adults would have.
My father was diagnosed with Alzheimer's in 1999. He was already in stage 4. He was forgetting how the days of the week were arranged and his driving was becoming erratic. Only weeks after the diagnosis he began to hallucinate.
Convincing our mother that he was no longer able to drive safely was difficult. That was our first and perhaps biggest challenge.
As his illness progressed at an amazing pace he began to suffer falls. His depth perception and his gait were being affected by the disease. Both of my parents were elderly so as my father would start to fall and my mother would try to support him BOTH were in danger of injuring themselves.
As an adult child of an Alzheimer's patient you need to use all of your charm and your powers of effective communication to help them see that you have their best interests at heart. Try to imagine how frightening it must be as their independence is going away and their confusion grows. Let your heart lead the way but keep your brain envolved!
Remember, it is organic...not an attitude.
Deborah Uetz
author of Into the Mist, When Someone You Love Has Alzheimer's Disease
www.intothemist.us
Hey Harriet, so glad you finally were able to get him to use the walker! I had the same problem with Dad, refused forever, until he took a terrible fall too and fortunately wasn't hurt. Then he'd use it sometimes!
Here's the direct link to hear your interview: http://www.wsradio.com/internet-talk-radio.cfm/shows/Coping-with-Caregiv...
Convincing Elders to Accept Help
Convincing failing elders to accept help isn't easy. My father-in-law is 97 1/2 years old now, terribly hard of hearing, and increasingly forgetful. As if that isn't enough, he's also dizzy most of the time. He has had a long and exciting life but his body is wearing out now.
My husband and I are trying to give him the best quality of life we can as his life draws to a close. But we couldn't convince him to use a walker. Of course, he kept forgetting the idea. (Sometimes I think he was pretending to forget.)
Other family members tried to convince him to use a walker but Dad would always rejected the idea. Two weeks ago my father-in-law fell backwards into a open doorway and injured his head. He cut his head and blood flowed into his hair and dripped on his clothes. The fall scared him and the assisted living staff.
The time for the "soft sell" had passed and the time for the "hard sell" had come. "You need a walker," I said firmly. Actually, I shouted the sentence so he could hear it. Dad shook his head. No walker.
How could I get him to change his mind? I thought for a moment and said, "Your friend Bill uses a walker and he loves it. Bill says it gives him mobility and stability. Wouldn't you like to have mobility and stability?"
Apparently invoking his friend's name did the trick because he agreed to try a walker. He wouldn't have to keep the walker, my husband and I assured him, he could just try it. If he didn't like the walker we would take it back.
My brother and sister-in-law took Dad to a medical supply store and helped him choose a walker that met his needs. Dad choose a green one, with hand brakes, a basket on front, and a seat in case he needed to sit down. Now he's a commercial for walkers!
"It's just wonderful," he keeps saying.
When it comes to convincing our elders to accept help sometimes slow and steady does the job. In our case, it took all family members to convince my father-in-law to use a walker. More important, we worked as a team and coordinated our efforts. We'll tie a bow on Dad's walker for the holidays and tell him we love him.
Harriet Hodgson, Member
Association of Health Care Journalists
Author of "Smiling Through Your Tears: Anticipating Grief," Lois Krahn, MD, Co-Author
An Amazon book and available from www.amazon.com (five star review)
Website www.harriethodgson.com
To hear my interview with Jacqueline Marcell on "Coping With Caregiving" go to http://blog.thirdage.com/?author=12
Thanks for that Deborah, so sorry about your dad, and yes--the driving issue may be the toughest. For those who may have missed my previous post on that topic and the numerous interesting responses, see: http://blog.thirdage.com/?p=242
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