What to do when elderly parents refuse help

The relationship between children and their parents is one that is very complex and continues to evolve over time. While there can be bumps along the way, most family issues are usually resolved without lasting emotional trauma and can create even deeper bonds. However, even the strongest relationships can be put to the test when adult children are faced with confronting a parent who refuses any help they might need due to their age or physical condition.

It’s certainly not easy dealing with aging parents in denial and unwilling to speak about or admit their increasing need for assistance. If you’ve ever been stressed over this situation, you’re not alone. According to a Penn State University research study, a whopping 77% of adult children believe their parents are reluctant to take their advice or refuse help with daily tasks.

Here’s the good news – there are some simple things you can do that make having these types of discussions with a parent go more smoothly. But first, let’s review some of the more common signs that indicate your parents need help.

Signs your aging parents may not be able to live safely on their own

Living with chronic pain, the loss of close friends, financial issues and the simple act of getting older are factors that can contribute to your parents becoming more irritable, irrational or demanding. But there are some clear indicators that reveal if they may be jeopardizing their health and safety by living alone.

• Weight loss – Weight can drop dramatically when one is not eating well. Older adults are often more susceptible as they may have issues getting to the grocery store or simply don’t have the desire or energy to prep, cook and clean up – cooking for one can be very difficult, especially after the loss of a spouse. Such conditions can quickly lead to poor eating habits and malnutrition, which in turn weakens the immune system and increases the risk of developing other health concerns. Check their cupboards and refrigerator to see if they are stocked with nutritional food. If you notice a parent has lost significant weight, consider working with a nutritionist, helping your parent with grocery shopping and meal prep, or hiring a prepackaged meal delivery service.
• Poor hygiene – Forgetting to shower, neglecting grooming habits, wearing dirty clothes and avoiding other personal hygiene are often signs that a parent is struggling with cognitive decline, loneliness or depression. Checking in with daily calls, making a laundry schedule and planning events outside the home are all ways you can help. There are also homecare services that can help with daily grooming, toileting and light housekeeping.
• Messy home – A cluttered home poses safety risks and can even lead to health issues. Also check their mail – are there stacks of unpaid bills lying around? This could be a sign that cognitive decline is setting in. If this is a concern, elder-proof their home and consider hiring a cleaning service to check in on your parent and tidy up once a week.
• Vehicle damage – Give your parent’s car the once-over. If you notice new scratches or dents, this could be a sign of failing eyesight or delayed reflexes. It may be time to reassess if it’s safe for them to continue driving and, if it’s not, contact family and friends to make a weekly schedule based on who is able to help.
• Jokes about getting lost – We all have our “got lost” stories, but if your parent repeatedly says they’ve had trouble finding their car in a parking lot or get disoriented while walking along familiar routes, this might indicate something more serious. Their laughing off such incidents may be a defense mechanism or simply denial. Talk to your parent about being evaluated by a medical professional who can diagnose and treat cognitive health issues.
• Low energy – While most everyone slows down as they age, a sudden or severe lack of energy could be a warning sign. If your parent appears run down or frequently complains they are tired and have no energy to do things, consider scheduling a doctor’s visit. Loneliness, depression, not taking routine medications properly or a newly acquired physical malady can contribute to exhaustion.
• More frequent falls – More than one out of four older adults fall each year, and it’s the leading cause of decline in the senior population’s health. There are many factors that can contribute to falling including lower body weakness, vision problems and vitamin deficiencies. As a serious fall can quickly turn an independent lifestyle to one that is immobile and requires extensive medical treatment, it pays to do a risk assessment. Clear your parent’s house of any unneeded clutter, tack down or remove any loose rugs, and encourage them to go for walks, attend an exercise class, maintain a healthy diet and get a good night’s sleep.
• A messy medicine cabinet – Are your parent’s medications in order or do you see a lot of bottles with lapsed expiration dates? Not taking medications regularly can obviously be detrimental to your parent’s health and can create a domino effect that results in more adverse physical and mental issues. Help organize their meds and set them up with a medication reminder – like digital smartphone apps – to help keep them on track. Make a list of all medications they are taking along with the correct dosages and keep this information handy so you can discuss it with their doctor.

If you detect one or more of these issues with your parent, set aside time to calmly discuss your concerns. Unless their safety is in immediate peril, rather than suggest any immediate action, it sometimes helps to let them think about what you’ve told them. Giving them time to process the information so that exploring next steps – such as a doctor visit or advice from objective experts – goes more smoothly.

How to help your parents accept care

When you begin to notice that your parent’s actions and behavior are a serious risk to their health and safety, here are some tips to help reduce any resistance, resentment and anxiety that may arise when you express your concerns and offer ways to help them.

• Have empathy – Be aware that your parent may be struggling with the physical, mental and emotional aspects of aging. Taking a moment to understand their mindset and being mindful of their feelings can help you better communicate your concerns. Your tone of voice, body language and the words you use to express yourself can make all the difference in having them accept your help.
• Respect their sense of agency – Understanding that your parent’s independence is important to them can help you identify the root causes of their behavior and help you determine the best way to make positive changes.

Ask these questions about your parent’s behavior:

• Are they acting this way out of habit?
• Is this behavior change recent?
• Has some incident triggered this change?
• Are they worried about losing their independence?
• Are they suffering from depression or anxiety?
• Are they confused or do they have dementia?
• What are some things they may be fearing?

Remember that the goal is to help your parent receive the best care possible. Even though it may feel like the parent-child relationship has flip-flopped, avoid infantilizing your parent – dealing with a stubborn parent is not the same as dealing with a stubborn child. You’re more likely to get cooperation when you approach them as adults, whether it be something as routine as medication reminders or more involved issues, such as diabetes treatment.

• Accept the situation – Despite your best intentions, you have to accept that your parent is an adult and entitled to make decisions about their own life and how much assistance or care they are willing to receive. Doing so can help reduce your stress, manage your expectations and improve your relationship with your aging parent.
• Choose your battles – Even though your intentions are good, repeatedly asking a parent to change their behavior can be quickly misconstrued as nagging. To avoid this issue, focus on the most pressing issues, making those that affect their health and safety a top priority. If there are several serious concerns, focus on one or two at a time so the parent doesn’t feel overwhelmed. Consider having a medical professional bring up your concerns with your parent as they may be more receptive to accepting advice from someone who isn't their child.
• Explain how their behavior affects others – While it may be easy for your parent to disregard the consequences of their actions on themselves, they may be more sympathetic when you frame how they affect their loved ones. Gently explain the stress and anxieties that their refusing help causes you, or how an unhealthy habit, like smoking, poses the risk of second-hand smoke to their grandchildren.
• Don’t keep things bottled up – It’s easy to internalize all the stress that comes when dealing with an uncooperative parent, and the fear, frustration and anxiety can become overwhelming. Don't take it on by yourself. Rely on family members – such as your spouse or siblings – as an outlet for you to share your feelings and ask them to have these same conversations with your parent. Finding activities and people you can confide in will help release any pent-up negative emotions.
• Give them something to look forward to – Whether it’s an anniversary, graduation, wedding or simply a family game night, making your parent part of a future event may encourage them to take positive actions, like bathing, grooming and dressing up for the occasion. It may also motivate them to more willingly accept any needed care or assistance you suggest. Send them gentle reminders of the special date, talk about it frequently, put it on their calendar – anticipating an upcoming event can often brighten someone’s day as much as the event itself.

When you’ve tried everything, but your parent still refuses help

You’ve been proactive about creating a long-term care plan. You’ve patiently listened to your parent’s needs. You’ve sought the advice of family, friends and healthcare professionals. You’ve had open conversations that come from a place of love and caring. You’ve done all this, and your parent still refuses your help.

Sometimes even doing everything in your power may not be enough to convince your parent to take your advice and accept the care or help they may need. If your parent is unwilling to address the reality of their situation, accept that things are out of your hands and hope the seeds you’ve planted will sprout with a little more time. While this can feel like a huge setback, don’t give up hope. Keep communication open, keep expressing your love and concern, and stay open to any compromise your parent may suggest that puts them closer to the care they need.

Talking to others may also help ease your stress and explore different options. You may consider a support group, a senior living provider, talking to a director at a local senior living community or reading information that could make future discussions with your parent go more smoothly.