As the process of aging presents more and more challenges, many seniors become more resistive to help. Ironically, at the very time when a little more help would be useful, families are often faced with frustration and conflict when their older relatives say no to their suggestions for assistance. There are a variety of factors that contribute to this resistance. Here are some useful suggestions for having a conversation to address issues that cause resistance to help.
Psychosocial Barriers to Service Use
Despite an obvious need for assistance, sometimes the urge to remain independent is strong. According to a survey by Home Instead Senior Care, only one-quarter of seniors actually ask for help directly, so encountering resistance from the other 75% is very normal.
Here are some things to consider when trying to understand where the resistance is coming from:
- Desire to maintain an image of self-reliance and independence – for many seniors being dependent on others is undesirable. So presenting the perception that they can manage independently, even at the risk of injury from accident or fall, is the chance they are willing to take.
- Do not want to take “welfare” – asking for, or receiving, help feels like accepting welfare or a “handout’ which is counter to the values of today’s elderly population.
- Do not want to impose on others – you will hear a senior say, “you are busy and have your own lives, I don’t want to be a burden!” Being dependent is one thing, but “requiring” another’s help will foster resistance.
- Embarrassment or stigma – the stigma that many elderly feel when they ask for help far outweighs the benefits that assistance may provide. So they don’t reach out to others.
- Need for privacy – traditionally, today’s older generation has little or no experience with community services or in-home help. They like their privacy and resist including anyone in their day-to-day activities of living.
Factors That Can Lead to Resistance
Resistance to help can be influenced by many factors and being aware of the part each plays in the senior’s decision can be useful in managing the resistance.
- The help needed – sometimes managing the household is easier to accept than help for personal care.
- The helper – the gender, age, and/or ethnicity may contribute to the senior’s discomfort with accepting help.
- The recipient – men are much more opposed to help than women.
- The context – is the need for help new, increasing or long-term? If it is a new need or increasing need, resistance may be less than if the situation is long-standing and the senior is set in her ways about managing on her own.
- Cost of help – paying for help can be a deal breaker for most seniors. They rarely see that the benefits of paying for help outweigh the burden of the cost.
Approaches for Overcoming the Resistance
Getting seniors to even consider help requires a thoughtful approach. Here are a few suggestions for taking on the conversation:
- Use respect and empathy – talking “down to” a senior will end the conversation quickly.
- Allow the person to have input into the process of deciding what to do.
- Be proactive and discuss care options before the need arises – having a “what-if” conversation may provide insight into what they are thinking about the prospect of help.
- Emphasize that asking for help is a sign of strength, not weakness – making a wise decision instills the feeling of confidence and control in people.
- Remind them that recruiting appropriate help means maintaining their independence, not losing it.
- Emphasize the “value” of assistance and not the “cost.”