6 Steps to Take When Aging Parents Need Help Even if Theyre Resisting - Better Health While Aging

Have you noticed worrisome changes in your aging parent?Maybe theyve been mostly okay but now youre seeing problems with memory, such as forgetfulness or asking the same questions repeatedly.Or maybe youve noticed trouble with driving, keeping up the house, managing stairs, or paying bills.Some aging parents simply begin to seem more withdrawn.Others start leveling accusations at others, claiming someone took or moved something, or acting paranoid.For many adult children, these changes lead to mounting questions.

Whats wrong? Whats happening? Is it safe for Mom to keep driving? Should Dad live alone much longer?I think of this as the uh-oh stage.Its a transition no one looks forward to, and most havent prepared for: the time when you might have to start helping your aging parent.And for many, it comes with an added challenge: Most aging parents dont welcome much help from their adult children.They may see it as interference, or an invasion of privacy.Some parents might even refuse to accept that theyre having difficulties, despite issues that feel glaringly obviousand concerningto you.By the time youre noticing changes and have safety concerns, its quite possible that youre right: that your parent does need help of some kind.

So how should you best get involved, especially if your attempts to do so have gone poorly in the past?Well, its certainly not easy.These situations are complicated from a medical and eldercare perspective, plus they tend to bring up difficult emotions for older parents and adult children alike.But I do believe that its crucial for families to get involved.Its not likely to be easy.

But it can be easier, if youre able to learn the better ways to do soand also what to stop doing.The very best way to learn this is to work closely with professionals trained to assist aging adults, such as geriatricians and geriatric care managers (who are also known as aging life care experts).That said, geriatricians are in short supply and can be hard to find, and geriatric care managers must be paid out of pocket (although its often a worthwhile investment).And although local Area on Aging Agencies do exist and can be great resources, theyre also often short-staffed and underfunded.Thats why Ive created this article for you, explaining a step-by-step process that anyone in this situation can follow.Its based on what I help families do, when I advise them on how to step in and assist an aging parent.Heres an overview of the steps:Collect the facts on the situation, by checking for specific signs an aging parent needs help or is unsafe, and by respectfully gathering information from others.Get your parents perspective, so you can understand how they see the situation and whats important to them, before you make any more attempts to get them to make changes.

(Dont even think about getting them to understand, agree, or accept whats going on during these initial conversations.)Find out what an ideal medical and eldercare intervention looks like, to guide plans if there really are signs of memory problems, safety issues, or declines in independence.Learn some legal fundamentals about signs that mental incompetence or incapacity might be an issue, and about legal documents, such as powers of attorney, that can better enable you to assist your aging parent.Create an actionable plan that addresses whats most important, based on what youve learned about your parents situation and priorities so far.Every family is different, but usually whats most important might involve:Working on getting a medical evaluation, and hopefully a diagnosisAddressing the most important safety and care issuesConnecting with your parent and persuading them to accept at least some changesImplement your plan.Be prepared to make several attempts, because thats usually what it takes.(Want a much more detailed version with checklists, sample dialogue to say, workarounds for common obstacles, and what this looks like examples? Thats all in my new book When Your Aging Parent Needs Help, and you can learn more about it here.)Let me now explain these six steps in a little more detail:1.

Get the facts: Checking for signs your aging parent needs helpYou might think you know whats going on but surprisingly, our starting assumptions can be wrong or incomplete.Thats why its important, before you do anything else, to try to gather information that will help you confirm that your worries are justified.I recommend checking on these particular things:Signs of problems with memory and thinkingSigns of problems with life tasks and safetyWhat other family members and key people in your parents life are noticingAny bright red flags that indicate you probably should step in sooner, rather than laterTo help people check for worrisome signs, I created a free downloadable guide a few years ago, with easy-to-use checklists.

You can get it here: Quick Start Guide to Checking for Health & Safety Problems.Making a systematic effort to gather this information will help your family have a clearer picture of the problems and concerns.Doctors and eldercare experts will also need details about whats going on, whether to help them make a diagnosis or just figure out what kind of support and safety measures will be needed.2.Get your parents perspective: How to learn what matters to them and how theyre seeing thingsEven if youve already tried talking to your parent(s)and if youre like many of the families who write to me, you havechances are good that you havent yet used the most effective approaches.Families often talk to a declining older person with the intention of getting them to understand, or accept, that problems have arisen and that certain steps should be taken to keep them safe and well.This is well-intentioned and understandable.

Unfortunately, it tends to be counter-productive and often leads to frustration and conflict.So youll want to take a different approach to these talks.Which is to talk with the intention of listening, and helping your parent feel heard.This is the way a geriatrician approaches a patient, especially one who is reluctant or resistant.You want to listen intently, to learn more about what theyre thinking, feeling, and preferring.At the same time, youll want to avoid arguing, correcting, or attempting any convincing.

(Now is not the time.)When you learn more about how your parent sees a certain situation, and what matters the most to him or her, youll end up in a stronger position to invite them to try a change you think will help them.Taking this important step can help soften resistance and improve the odds of practical success.Many families are relieved to find it also builds relationship capitalgoodwill youll need for the challenging future.For more on how to talk to a resistant older parent, try this podcast: 028 When Older Parents Resist Help: 4 Tips for Better Talks.3.Get informed: What an ideal medical and eldercare assessment and intervention looks likeLets face it, whats ideal doesnt always happen.

Still, its super useful to know what experts advise should happen, in a perfect world where you could control everything, because this gives you a guide for where to aim your best efforts.That can save you time and trouble later.Key is getting a medical evaluation.This is because most worrisome life problems families notice in an aging parent are actually being caused or worsened by an underlying medical issue.

You want to get answers to questions like: What might be causing the symptoms were concerned about? Could medications be an issue? (They often are.) Whats the plan for follow-up and what happens next?If youve been worried about memory or other thinking skills, the doctor (and starting with your parents primary-care provider is fine) should look for underlying causes of cognitive impairment.For more on what should be checked, see Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check.If your main concern is paranoia or false accusations, also see 6 Causes of Paranoia in Aging & What to Do.The ideal approach also involves taking steps to address immediate safety concerns and assist your parent with any daily life tasks theyre currently struggling with.Working with specially trained social workers or geriatric care managers can be very helpful to assess housing and care needs, and to come up with a plan to meet them.

These professionals also usually have ideas on how to manage common safety concerns, such as driving difficulties , or trouble managing finances.Or you can begin to look for resources in the area to help you.I suggest some excellent starting places in this article.

The Quick Start Guide also includes ideas on how to get help with any problems you notice.Last but not least, setting up certain lifestyle changes can help an aging parent maintain the best possible physical health, and can also slow cognitive decline, if any is present.For my top suggestions on maintaining a healthier brain, see here, and for my suggestions on maintaining physical health, see here.4.Learn about the potential legal angles: Signs of mental incompetence or incapacity and legal documents to check forIf youve noticed any problems with memory, judgment, or other thinking skills, then its a good idea to learn more about mental capacity and when an older person might be considered incapacitated or incompetent.This matters for several reasons.

One is that if your parent has ever completed a power of attorney for healthcare, or for legal affairs, it may only give you (or someone else) the ability to act if they are incapacitated.(This is sometimes called a springing power of attorney.)It also matters because if there are signs that an older person has lost the capacity to mentally understand the risks of a given situation, then it becomes more ethically and sometimes legally permissible for you to intervene.Now, just because your aging parent rebuffs your concerns, ignores safety issues, or refuses to accept help, that doesnt mean he or she has lost mental capacity.Still, it can be a good idea to learn more about capacity so youre clearer about whether to look into it more now, and in case the situation changes.Your understanding of your parents mental capacities can and should affect how you approach them when the time does come to take next steps, or try to convince them to make a change.You can learn more about capacity here: Incompetence & Losing Capacity: Answers to 7 FAQs.

For more on powers of attorney, see here.5.Put it all together: Create a next-steps action plan customized for your familys situation and parents preferencesNow that youve laid the important foundation of observing, listening, and learning, its time to put it all together and take action.Obviously, theres no single right way to go about helping an aging parent; what you do will depend on whats going on with your parent, what matters to them, whats feasible, and more.Heres an A-B-C formula can help you create a plan that works for you:1.ASSESS: First, you want to review your assessment of the situation right now: your parents thinking skills, observed safety issues, life tasks theyre struggling with, and other key issues, as well as your parents/familys priorities.

Youll also want to review how much of the ideal next steps have taken place so far.2.BRAINSTORM: Youll then weigh your options for taking next steps.Youll need to consider things like:What seems most urgent/important to address?What seems most feasible?3.

CHOOSE AND PLAN: Based on what youve brainstormed, pick one to three issues youre going to focus on.(If you have siblings or other involved family members, its best to do this together and coordinate.) For each issue, plan some specific next action steps.These might include:Something to research (a health problem, a legal point, a service, an agency, experts, and so on).Something to do (make a call or appointment, tour a facility, review medication, hire someone, and so on).A conversation to have (with your parent or sometimes someone else, like a consultant, the doctor, a neutral third party, a sibling, your other parent, and so on).6.

Implement your action plan: Be prepared to persistNOW youre ready to effectively step in and try to do something to help your aging parent.Give it your best go, taking the next steps youve planned out.Be sure to use your best communication skills and consider capacity issues, if appropriate.

(They often are.) Failing to focus on good communication and the importance of capacity trip up many families.Based on how things go, youll reassess, adjust your approach, and likely try again.I like to tell people they should plan on experimenting, because families almost never get the progress theyre hoping for right away.In fact, its normal for this part to involve a lot of back-and-forth as you try to move past certain roadblocks or figure out the best tack to take with your parent (or with someone else whos involved, such as another family member or your parents doctors).Theres an art to learning to persist and try a few different approaches as you try to help your aging parent.

To get past the most common roadblocks, such as your parent refusing to go to the doctor, I recommend crowdsourcing ideas and advice from others in a support group; there are some good free ones online.I also have a whole chapter on getting past common roadblocks in my book, When Your Aging Parent Needs Help.No matter what happens next, consider it progressIf you follow the steps outlined above and persist, the odds are very good that youll get your parent more of what they need for their care and safetyand youll likely get them to come to better acceptance of the changes.Now, its definitely possible to do all the right things but still end up feeling stuck.Thats not unusual.There are, in fact, additional options to consider, if youve made multiple well-thought-out attempts to help yet feel your efforts are going nowhere.

For instance, it may be appropriate to consider watchful waiting, or even looking into last-resort measures such as petitioning for guardianship.(These are beyond the scope of this article; my new book includes a separate chapter on these scenarios.)Even if things stabilize, youll probably have a sense that something has changed since your initial uh-oh moments.And it has.

Your family has shifted to a new stage of life.The new normal might wind up feeling familiar (if seldom exactly the same as before), allowing you to step back awhile.Or you may be in active help mode for a long time.Thats pretty common.Whatever this ongoing journey through this stage of life is like for you and your parent, simply by approaching your aging parent using this thoughtful and caring process, you will be making a needed difference.Thats because what your parent needs most of all, during this time of change for them, is your presence and your connecting with them.

You wont be able to control everything and you probably wont be able to get all the safer outcomes you want for them.But thats ok.Youre showing up to help, youre learning to do it in better ways, and youll be doing the best you can to accompany them on their aging journey.And that will make a huge difference for your aging parent.I hope this article and my step-by-step process will be helpful to you.

If you have questions or comments, please post them below.You can also get a more detailed version of approach, with checklists, sample dialogue to say, workarounds for common obstacles, and what this looks like examples, in my book, When Your Aging Parent Needs Help: A geriatricians step-by-step guide to memory loss, resistance, safety worries, and more.