Caregivers Should Aim for Middle Ground When Family Members Resist Care

Sherry sees all the signs that her mother needs more care if she wants to continue living independently. An unkempt house, missed bill payments, and mixed-up medications are just a few of the indicators pointing to a necessary and painful intervention. Whenever Sherry brings up the possibility of bringing in some help, her mother adamantly refuses. It’s putting a strain on their relationship, and Sherry is at a loss as to how to proceed.

Sound familiar? Resistance is all too common among older adults who have been living independently but who now need some help due to illness or disability. As a caregiver, you do your best to try to convince your loved one to accept some help. Unfortunately, the less-than-enthusiastic reaction makes you end up feeling like the enemy.

(c) Ambro at

(c) Ambro at

I recently attended a fascinating webinar offered by LivHOME, a professional home care company, that dealt with this very topic. The presenter, Steven Barlam, did a fantastic job of delineating the many possible reasons that an older person might meet the suggestion of home care with such resistance. The reasons that resonated with me included:

  • A desire to maintain control over one’s life
  • A lack of trust in “the system”
  • A lack of capacity to understand the need for extra help
  • Fear of having a stranger in the house providing care
  • Denial that any kind of help is really needed
  • Skepticism about whether an outside service can actually help

If you put yourself in your family member’s shoes, perhaps you can identify with some of these notions. I sure can. We’ve all needed to reach out for help at one time or another but in our culture of rugged individualism, we’ve thought, “To hell with that, I can do this myself.” We might not think we are afraid or distrustful or in denial, but in hindsight, we can surely see these psychological instruments at play.

So, what is a caregiver to do? Barlam offered some great advice. He pointed out that bullying the person into receiving care is never good, but neither is giving up or giving in. Instead, aim to reach some middle ground with your family member. The way to do that is to build trust with the person. Here are some suggestions for doing just that:

  • Acknowledge the person’s reservations about accepting help.
  • Try to pinpoint and verbalize what’s important for the person, whether it be some degree of control over the daily schedule or maintaining dignity and privacy.
  • Normalize the situation by providing examples of other families you both know who have accepted help (Hint: Don’t make up these stories – find real examples, because they are there.).
  • Position yourself as the person’s ally and co-pilot on this journey.
  • Choose your battles wisely. You may not be able to convince your loved one to accept all of the help you think he or she needs, but the acceptance of even one piece of the puzzle is a victory.

I appreciated the opportunity to attend this webinar and have these principles illuminated to me so I could pass them along to you. If you’ve successfully employed other strategies to deal with resistance, please share them here! We can all learn from each other on this caregiving journey.

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