When older parents resist help or advice, use these tips to cope

By Judith Graham

It was a regrettable mistake. But Kim Sylvester thought she was doing the right thing at the time.

His 80-year-old mother, Harriet Burkel, fell at her home in Raleigh, North Carolina, broke her pelvis, and went to a rehabilitation center to recover. It was only days after the death of Burkel\’s 82-year-old husband, who had moved into a memory facility three years before her.

With growing anguish, Sylvester had watched his mother, who suffered from emphysema and peripheral artery disease, become increasingly frail and isolated. I would say, can I help you? And my mother said: No, I can do it myself. I do not need anything. I can handle it, Sylvester told me.

Now, Sylvester had a chance to get some more information. She broke into her mother\’s house and went through all the paperwork she could find. It was a completely disorganized mess, bills everywhere, she said. It was clear that things were out of control.

Sylvester took action, rescinding his mother\’s orders for anti-aging supplements, canceling two car warranty insurance policies (Burkel wasn\’t driving at that point), rescinding a one-year contract for knee injections with a chiropractor, and pushing back donation requests from dozens of organizations. . When her mother found out, she flew into a rage at her.

I was trying to save my mother, but I became someone who could not be trusted by the enemy. I really screwed up, Sylvester said.

Dealing with an aging parent who stubbornly resists offers of help is not easy. But the solution isn\’t to make an older person feel like you\’re squashing them and taking over their affairs. Instead, respect, empathy and appreciation of the autonomy of the elderly are needed.

It\’s hard when you see an older person making bad choices and decisions. But if that person is cognitively intact, you can\’t force them to do what you think they should be doing, said Anne Sansevero, chair of the board of directors of the Aging Life Care Association, a national organization of care managers who work with the elderly and their families. They have the right to make choices for themselves.

This does not mean that adult children who are concerned about an older parent should step aside or accept everything the parent proposes. Rather, a different set of skills is needed.

Cheryl Woodson, an author and retired physician based in the Chicago area, learned this firsthand when her mother, whom Woodson described as a very powerful woman, developed mild cognitive impairment. She started getting lost while driving and buying things she didn\’t need and then giving them away.

Punishing his mother wasn\’t going to work. You can\’t push people like my mom or try to take control, Woodson told me. Don\’t tell them, No, you\’re wrong, because they changed your diapers and will always be your mother.

Instead, Woodson learned to appeal to her mother\’s pride in being the family matriarch. Whenever she got angry, I asked her: Mom, what year was Aunt Terri married? Oh mom, I don\’t remember how macaroni is made. How much cheese do you put in? And she would forget what she was worried about and we would go from there.

Has Woodson, author of To Survive Caregiving: A Daughters Experience, a Doctors Advice, also learned to apply a safety or health issue? standard for her mother\’s behavior. She helped Woodson let go of her sometimes unreasonable expectations. An example she recounted: My mom used to churn hot sauce onto pancakes. She would have driven my brother crazy, but she was eating, and that was good.

You don\’t want to rub your nose at their inability, said Woodson, whose mother died in 2003.

Barry Jacobs, a clinical psychologist and family therapist, used similar themes in describing a nearly 70-year-old psychiatrist who didn\’t like bowing to authority. After his wife died, the older man stopped shaving and changed regularly. Although he had diabetes, he didn\’t want to see a doctor and instead prescribed himself medication. Even after several blows damaged his vision, he insisted on driving.

Jacobs takes: You don\’t want to toe to toe with someone like this, because you\’re going to lose. They are almost daring you to tell them what to do so they can prove to you that they won\’t follow your advice.

What\’s the alternative? I would use empathy and appeal to this person\’s pride as a basis for handling adversity or change, Jacobs said. I might say something like, I know you don\’t want to stop driving and that this is going to be very painful for you. But I know you have gone through difficult and painful changes before and you will find your way through this.

You\’re appealing to their ideal self rather than treating them like they no longer have the right to make their own decisions, she explained. In the case of the older psychiatrist, conflict with his four children was constant, but he eventually gave up driving.

Another strategy that can be helpful: Be seen, but do it in a face-saving way, Jacobs said. Instead of asking your dad if you can control him, go to his house and tell him: The boys really wanted to see you. I hope you do not mind. Or, we made too much food. I hope you don\’t mind if I bring it to you. Or I wanted to stop. I hope you can give me some advice on this problem that I have in mind.

This psychiatrist had no cognitive problems, although he wasn\’t as sharp as he used to be. But pervasive cognitive impairment often colors difficult family interactions.

If you think this might be a factor with your parents, instead of trying to get them to accept more help at home, try getting them medically evaluated, said Leslie Kernisan, author of When Your Aging Parent Needs Care. help: a step-by-step geriatrician -Guide to memory loss, stamina, safety concerns, and more.

Decreased brain function can affect an older adult\’s intuition, judgment, and ability to understand the risks of certain actions or situations, while also making people suspicious and defensive, she noted.

However, that doesn\’t mean you should give up talking to an aging parent with mild cognitive impairment or early-stage dementia. You always want to give the older adult a chance to evaluate and talk about what\’s important to them and their feelings and concerns, Kernisan said.

If you frame your suggestions as a way to help your parents achieve a goal they\’ve deemed important, they tend to be much more receptive to it, she said.

A turning point for Sylvester and his mother came when the elderly woman, who developed dementia, went to a nursing home in late 2021. Her mother, who at first didn\’t realize the move was definitively, she was furious and Sylvester waited two months. before the visit. When she finally entered Burkel\’s room, carrying a Valentine wreath, Burkel hugged her and said, \”I\’m so glad to see you,\” before walking away from her. But I\’m so mad at my other daughter.

Sylvester, who doesn\’t have a sister, replied, I know, mom. He had good intentions, but he didn\’t handle things right. She learned the value of what she calls a therapeutic fiblet from Kernisan, who ran a family caregivers group that Sylvester attended between 2019 and 2021.

After that visit, Sylvester saw his mother often and all was well between the two women until Burkel\’s death. If something was bothering my mom, I\’d just say, \”Interesting\” or \”That\’s a thought.\” You have to give yourself the time to remember that this is not the person you used to know and create the person you need to be your parent, who has changed so much.

We\’re eager to hear from readers questions you\’d like answered, problems you\’ve had with your care, and advice you need for dealing with the health care system. Visit kffhealthnews.org/columnist to submit your requests or suggestions.

KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of the core operating programs of KFF, an independent source of research, survey and health policy journalism. Find out more about KFF.

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This post was previously published on KFF Health News.

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