{"id":7395,"date":"2023-08-28T14:35:05","date_gmt":"2023-08-28T18:35:05","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=7395"},"modified":"2023-08-28T14:35:05","modified_gmt":"2023-08-28T18:35:05","slug":"what-to-do-when-your-older-parents-resist-help-or-advice","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2023\/08\/what-to-do-when-your-older-parents-resist-help-or-advice\/","title":{"rendered":"What to Do When Your Older Parents Resist Help or Advice"},"content":{"rendered":"

A kind of role reversal can happen when your parents take risks or jeopardize their health, and you worry and insist they do what you think they should do. That often gets you nowhere. In this article, Judith Graham, a columnist for <\/span><\/i>KFF Health News<\/span><\/a>, <\/span>consults experts for tips on how to handle such situations. Her piece was posted on the <\/span><\/i>KFF Health News<\/span> website on May 19, 2023. It also ran on <\/span><\/i>CNN<\/span><\/i><\/a>. Funding from the Silver Century Foundation helps <\/span><\/i>KFF Health News<\/span> develop articles (like this one) on longevity and related health and social issues. <\/span><\/i><\/p>\n

It was a regrettable mistake. But Kim Sylvester thought she was doing the right thing at the time.<\/span><\/p>\n

Her 80-year-old mother, Harriet Burkel, had fallen at her home in Raleigh, NC, fractured her pelvis and gone to a rehabilitation center to recover. It was only days after the death of Burkel\u2019s 82-year-old husband, who\u2019d moved into a memory care facility three years before.<\/span><\/p>\n

With growing distress, Sylvester had watched her mother, who had emphysema and peripheral artery disease, become increasingly frail and isolated. \u201cI would say, \u2018Can I help you?\u2019 And my mother would say, \u2018No, I can do this myself. I don\u2019t need anything. I can handle it,\u2019\u201d Sylvester told me.<\/span><\/p>\n

Now, Sylvester had a chance to get some more information. She let herself into her mother\u2019s home and went through all the paper work she could find. \u201cIt was a shambles\u2014completely disorganized, bills everywhere,\u201d she said. \u201cIt was clear things were out of control.\u201d<\/span><\/p>\n

Sylvester sprang into action, terminating her mother\u2019s orders for anti-aging supplements, canceling two car warranty insurance policies (Burkel wasn\u2019t driving at that point), ending a yearlong contract for knee injections with a chiropractor and throwing out donation requests from dozens of organizations. When her mother found out, she was furious.<\/span><\/p>\n

\u201cI was trying to save my mother, but I became someone she couldn\u2019t trust\u2014the enemy. I really messed up,\u201d Sylvester said.<\/span><\/p>\n

Dealing with an older parent who stubbornly resists offers of help isn\u2019t easy. But the solution isn\u2019t to make an older person feel like you\u2019re steamrolling them and taking over their affairs. What\u2019s needed instead are respect, empathy and appreciation of the older person\u2019s autonomy.<\/span><\/p>\n

Before interfering, try asking yourself whether what your loved one is doing really matters to their health or safety.<\/b><\/p><\/blockquote>\n

\u201cIt\u2019s hard when you see an older person making poor choices and decisions. But if that person is cognitively intact, you can\u2019t force them to do what you think they should do,\u201d said Anne Sansevero, RN, president of the board of directors of the Aging Life Care Association, a national organization of care managers who work with older adults and their families. \u201cThey have a right to make choices for themselves.\u201d<\/span><\/p>\n

That doesn\u2019t mean adult children concerned about an older parent should step aside or agree to everything the parent proposes. Rather, a different set of skills is needed.<\/span><\/p>\n

Cheryl Woodson, MD, an author and retired physician based in the Chicago area, learned this firsthand when her mother\u2014whom Woodson described as a \u201cvery powerful\u201d woman\u2014developed mild cognitive impairment. She started getting lost while driving and would buy things she didn\u2019t need, then give them away.<\/span><\/p>\n

Chastising her mother wasn\u2019t going to work. \u201cYou can\u2019t push people like my mother or try to take control,\u201d Woodson told me. \u201cYou don\u2019t tell them, \u2018No, you\u2019re wrong,\u2019 because they changed your diapers and they\u2019ll always be your mom.\u201d<\/span><\/p>\n

Instead, Woodson learned to appeal to her mother\u2019s pride in being the family matriarch. \u201cWhenever she got upset, I\u2019d ask her, \u2018Mother, what year was it that Aunt Terri got married?\u2019 or \u2018Mother, I don\u2019t remember how to make macaroni. How much cheese do you put in?\u2019 And she\u2019d forget what she was worked up about and we\u2019d just go on from there.\u201d<\/span><\/p>\n

Woodson, author of <\/span>To Survive Caregiving: A Daughter\u2019s Experience, a Doctor\u2019s Advice<\/a>,<\/span><\/i> also learned to apply a \u201cdoes it really matter to safety or health?\u201d standard to her mother\u2019s behavior. It helped Woodson let go of her sometimes unreasonable expectations. One example she related: \u201cMy mother used to shake hot sauce on pancakes. It would drive my brother nuts, but she was eating, and that was good.\u201d<\/span><\/p>\n

\u201cYou don\u2019t want to rub their nose into their incapacity,\u201d said Woodson, whose mother died in 2003.<\/span><\/p>\n

Try to offer help in a way that\u2019s face-saving for the other person.<\/b><\/p><\/blockquote>\n

Barry Jacobs, PsyD, a clinical psychologist and family therapist, sounded similar themes in describing a psychiatrist in his late 70s who didn\u2019t like to bend to authority. After his wife died, the older man stopped shaving and changing his clothes regularly. Though he had diabetes, he didn\u2019t want to see a physician and instead prescribed medicine for himself. Even after several strokes compromised his vision, he insisted on driving.<\/span><\/p>\n

Jacobs\u2019 take: \u201cYou don\u2019t want to go toe-to-toe with someone like this, because you will lose. They\u2019re almost daring you to tell them what to do, so they can show you they won\u2019t follow your advice.\u201d<\/span><\/p>\n

What\u2019s the alternative? \u201cI would employ empathy and appeal to this person\u2019s pride as a basis for handling adversity or change,\u201d Jacobs said. \u201cI might say something along the lines of, \u2018I know you don\u2019t want to stop driving and that this will be very painful for you. But I know you have faced difficult, painful changes before, and you\u2019ll find your way through this.\u2019\u201d<\/span><\/p>\n

\u201cYou\u2019re appealing to their ideal self rather than treating them as if they don\u2019t have the right to make their own decisions anymore,\u201d he explained. In the older psychiatrist\u2019s case, conflict with his four children was constant, but he eventually stopped driving.<\/span><\/p>\n

Another strategy that can be useful: \u201cShow up, but do it in a way that\u2019s face-saving,\u201d Jacobs said. Instead of asking your father if you can check in on him, \u201cgo to his house and say, \u2018The kids really wanted to see you. I hope you don\u2019t mind.\u2019 Or, \u2018We made too much food. I hope you don\u2019t mind my bringing it over.\u2019 Or, \u2018I wanted to stop by. I hope you can give me some advice about this issue that\u2019s on my mind.\u2019\u201d<\/span><\/p>\n

This psychiatrist didn\u2019t have any cognitive problems, though he wasn\u2019t as sharp as he used to be. But encroaching cognitive impairment often colors difficult family interactions.<\/span><\/p>\n

If you think this might be a factor with your parent, instead of trying to persuade them to accept more help at home, try to get them medically evaluated, said Leslie Kernisan, MD, author of <\/span>When Your Aging Parent Needs Help: A Geriatrician\u2019s Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, & More.<\/span><\/i> <\/span><\/p>\n

You always want to give the older adult a chance to weigh in and talk about . . . their feelings and concerns.<\/b><\/p>\n

\u2014Leslie Kernisan, MD <\/b><\/p><\/blockquote>\n

\u201cDecreased brain function can affect an older adult\u2019s insight and judgment and ability to understand the risks of certain actions or situations, while also making people suspicious and defensive,\u201d she noted.<\/span><\/p>\n

This doesn\u2019t mean you should give up on talking to an older parent with mild cognitive impairment or early-stage dementia, however. \u201cYou always want to give the older adult a chance to weigh in and talk about what\u2019s important to them and their feelings and concerns,\u201d Kernisan said.<\/span><\/p>\n

\u201cIf you frame your suggestions as a way of helping your parent achieve a goal they\u2019ve said was important, they tend to be much more receptive to it,\u201d she said.<\/span><\/p>\n

A turning point for Sylvester and her mother came when the older woman, who developed dementia, went to a nursing home at the end of 2021. Her mother, who at first didn\u2019t realize the move was permanent, was furious, and Sylvester waited two months before visiting. When she finally walked into Burkel\u2019s room, bearing a Valentine\u2019s Day wreath, Burkel hugged her and said, \u201cI\u2019m so glad to see you,\u201d before pulling away. \u201cBut I\u2019m so mad at my other daughter.\u201d<\/span><\/p>\n

Sylvester, who doesn\u2019t have a sister, responded, \u201cI know, Mom. She meant well, but she didn\u2019t handle things properly.\u201d She learned the value of what she calls a <\/span>\u201ctherapeutic fiblet<\/a>\u201d<\/span> from Kernisan, who ran a family caregiver group Sylvester attended between 2019 and 2021.<\/span><\/p>\n

After that visit, Sylvester saw her mother often, and all was well between the two women up until Burkel\u2019s death. \u201cIf something was upsetting my mother, I would just go, \u2018Interesting,\u2019 or, \u2018That\u2019s a thought.\u2019 You have to give yourself time to remember this is not the person you used to know and create the person you need to be your parent, who\u2019s changed so much.\u201d<\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

It was a regrettable mistake. But Kim Sylvester thought she was doing the right thing at the time.<\/span><\/p>\n

Read more What to Do When Your Older Parents Resist Help or Advice<\/span> ›<\/span><\/a><\/div>\n

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