Let’s say you’re in your forties, fifties, or sixties. Your parents, still alive and in their seventies or older, are ailing, either one or both, and you’re responsible for their care. What can you do when their safety is at stake and they refuse to follow your suggestions?
If you can manage, despite the great age difference between you, to understand where your parents are coming from, it will be easier to elicit their cooperation at least some of the time. This post aims to offer you a few useful ideas adaptable to the many possible problems in this area. For the sake of argument, I will use one simple scenario.
Your mom and dad, in their eighties, have been living in a three-story house, with bedrooms on the second floor. The stairs are increasingly hazardous for them, and a lift is not an option. You want them to move into a large room on the ground floor, which would be suitably furnished and arranged for their convenience. They angrily refuse and assert that it’s their house, not yours, and that you have no right to tell them how to live in it. Both parents are frail, and your dad’s dementia is worsening.
Apart from your love for the people who gave you life, you’re worried that harm will come to them, possibly when you’re not around, unless they do as you ask. What’s more, if harm does come to them, you might be held legally responsible—a matter of elder neglect, perhaps, or reckless endangerment by you, their legally responsible caretaker.
Must you take on this risk in addition to the work and worry you already experience while caring for them? How can you put yourself in the shoes of people more than a decade older than you, out on the perilous frontier of old age, about which your own knowledge is as yet very limited? And let’s not forget that the situation is emotionally charged for you because you too are aging, and the preview of coming attractions can be unappealing to say the least.
Empathy always helps. Assume that your parents, cognitively impaired or not, are struggling with massive amounts of anxiety. In this particular situation, the move downstairs reminds them that they are becoming older and weaker.
Old people cling to the same ways of doing things because these offer them (false) reassurance that they themselves are not changing. Fear makes them rigid. They feel:
• more lacking in power than ever before in their adult lives
• trapped, at the mercy of other adults
• physically weak, perhaps in pain
• uncertain and anxious about the future and about change
• frightened of death
• vulnerable, with anxiety that can resemble paranoia
- Repeat the gist of their objections, and ask them to confirm that you have understood them. (This is a good tactic in arguments with people of any age, since they can see that they have been heard.)
- Remind them of your love and concern. Ask them to acknowledge your role as backstop.
- Highlight the benefits for them of the proposed change. Focus on things you know they like, for example: the new digs will be closer to the kitchen and bathroom; the television will be closer to hand, as will the front door when mail is delivered and the dog needs walking.
- Draw their attention to hazards about which they worry. “What if the fire alarm sounds and you can’t get downstairs quickly?”
- Highlight the things that will stay the same, since your parents see change as the enemy here.
- Build on statements of what they have said they want. Seize opportunities to make them feel that you are noticing and respecting their preferences.
- Ask for a trial period, after which everyone can reevaluate the situation.
- Find ways to offer options. You relieve their anxiety when you make them feel more in control. Exercise patience as best you can.
- If two parents are involved, and one seems to be deferring to the other without feeling entirely the same way, approach the diffident parent in private. Ask for her advice and support in dealing with the resistant parent. Sometimes one spouse can persuade the other to give the new arrangement a try.
- Make room for a stubborn, frightened parent to change his mind and accommodate you without losing dignity. Create ways for him to get out of a corner he may have boxed himself into.
- Acknowledge that the other person doesn’t want the change you are proposing. Ask why not, show that you understand, then back off. This technique, which therapists call “going with the resistance,” is unbelievably powerful. Once the pressure is off, people will often start to yield immediately. They simply need to believe that they are acting on their own without any coercion.
If this tactic and others fail, you can say, “Well, if that’s how you feel, I guess we’re at a stalemate. I can’t keep doing [XYZ] without your help, but if you don’t feel able to give it, I guess I’m up the creek. I really wish you would reconsider, though. I don’t see how I can proceed unless you help me.”
In this way you effectively transfer the power. If your parent then agrees or yields somewhat, you can heap on the gratitude. People who feel powerless and at the mercy of others are constantly looking for ways to reassert control.
Approaches Likely Not to Succeed
It is pointless for you to expect your parents to sound rational. The sticking point has to do not with reasons but with feelings. Some tactics that you might feel tempted to use will almost certainly fail and may heighten their resistance to your proposal. These include:
- Reminding them of the bad spot they are putting you in
- Telling them to be reasonable
- Patronizing them
- Getting angry and yelling
- Threatening to leave them or send them to a nursing home
More General Remedies
In this area as in the helping professions generally, you must take care of yourself if you expect to be useful to anyone else. Nothing leads to burnout faster than relentless self-sacrifice.
- Look for help from other family members, and consider hiring help. The possibilities include but are not confined to geriatric care managers; nurses and home health aides; and elder day care.
- Take care of yourself. Make sure you have meaningful work in the world and a social life with people your own age. Plan activities that you enjoy. Work out. Take respite. Make sure that you have enough privacy and alone time.
- Observe good boundaries where your parents are concerned. Be able to distinguish between the important and the trivial and between your stuff and theirs. Recognize that you can only do your best and that you will not be able to control your parents in every way all of the time. You cannot protect them, either, from all of the consequences of their actions.
- Remember that you are not alone. Find support groups for caregivers at your church, at the local chapter of the National Alliance for the Mentally Ill, through the hospital and medical providers treating your parents, and through your town social worker, senior center, or community center.
People who have walked the same path are a wonderful source of ideas for overcoming obstacles. They will also be supportive in a way that no one else can, because they have had experience in a similar situation. Support groups can be a great source of new friends. Shared hardships promote bonds between people.