4 Key Questions to Ask if a Senior Family Member Refuses Care

CaregiverStress.com has a lot of good articles on the topic of family communication. Here’s one of interest to adult children.

Robin

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www.caregiverstress.com/family-communication/caring-elderly-parents/4-key-questions-to-ask-if-a-senior-family-member-refuses-care/

4 Key Questions to Ask if a Senior Family Member Refuses Care
CaregiverStress.com
February 6, 2017

It’s not uncommon for a senior to resist the idea of receiving care, especially from an outside source. Most seniors strongly desire to maintain their independence, and that doesn’t just mean living in their own home.

Elaine discovered this truth when she tried to hire a caregiver for her husband, who is in the early stages of Alzheimer’s disease.

“I thought it seemed perfectly logical to get a professional caregiver for Roger after he left the stove on while I was at work one day,” Elaine said, “but he got very upset when I brought the subject up. He said he was getting along just fine on his own, even though he agreed he didn’t always remember to turn off the stove or keep the front door locked.”

Even in the face of overwhelming evidence that caregiving support is needed, seniors may be resistant to the idea. But don’t think they’re just being stubborn. Many seniors have valid reasons for refusing care. You can find out the real reason they’re resistant by asking these four questions.

1. Are you concerned about the financial impact of caregiving?

Many seniors live on a tight budget, and professional caregiving services are not free. However, some seniors may overestimate the cost of caregiving, or they may underestimate their own financial position.

If a senior relative cites financial concerns as a reason for refusing care, you can:

* Take an honest financial inventory that examines monthly income and expenses, as well as cash reserves and investments
* Produce an accurate financial picture to ensure everyone is dealing with the facts
* Look for untapped resources, such as a mortgage-free home or veterans’ benefits, that could be used to fund caregiving
* Enlist a trusted financial advisor to create an unbiased budget that meets the senior’s needs
* Apply for a home care grant

2. Are you worried about losing your privacy?

Privacy takes many forms. It is not just about being concerned someone will rummage through your personal belongings. When a senior engages a professional caregiver, the senior’s habits and lifestyle suddenly become open to “public” view, which may make them feel scrutinized or judged. And if a senior requires assistance with personal care tasks like bathing, their privacy is further eroded.

If a senior loved one is refusing care due to privacy concerns, you can:

* Pledge to start slowly, by hiring a caregiver for just a couple of hours a week, on a trial basis. This allows time for the senior and caregiver to develop a trusting relationship that reduces feelings of invasion of privacy.
* Ask if the senior would rather have a family member provide bathing or toileting assistance. The senior may not want to burden a family member and may prefer a professionally trained caregiver help them with these tasks.
* If the senior is concerned about theft or other unscrupulous behavior by a professional caregiver, research professional caregivers that are background-checked and bonded, such as those from Home Instead Senior Care .

3. Under what circumstances can you see yourself getting caregiving help?

Many seniors refuse professional care out of a sense of pride. They have always taken care of themselves, and they imagine they always will. Of course, that is a rather rose-colored view of the future.

By phrasing the question of caregiving as an expected future development instead of a “now or never” proposition, you give the senior a sense of control over his own life and allow him to set some criteria under which he will consider professional caregiving.

If the senior refuses to engage in speculation, try to gently lead the conversation yourself by exploring various situations to narrow down the criteria that would warrant getting a caregiver. For example, you could ask:

* I know you like to plan ahead for unexpected events, so how would you like to handle your home care if something happens to you medically, like a debilitating stroke?
* How should we proceed if, say, you start forgetting to pay the utility bills?
* If you reach a point where you can’t keep up with the housework or laundry anymore, what would you like to do?

Be compassionate, not confrontational, when asking these questions. Remember, the point of this exercise is to obtain information, not to badger your loved one.

4. What advice would you give a friend in these circumstances?

Sometimes, due to dementia or simple human frailty, a senior just doesn’t recognize that he or she needs caregiving help. But it’s often easy for them to see when others need help. You can leverage this situation by creating a scenario in which they think they’re advising a friend instead of looking at their own circumstances.

Simply use the tried-and-true “asking for a friend” angle. Construct a fictitious “friend” who needs help, based upon details from the senior’s actual life. Present the scenario to the senior loved one to get his “take” on what the friend should do. If the senior advocates for caregiving, you can later revisit the conversation and gently suggest that your loved one should take his own advice.

And if the senior does not end up seeing professional caregiving as a solution to the scenario you presented, then you’ve gained valuable insight into why the senior is not ready to receive care yet.

Navigating the complexities of interpersonal relationships (and, sometimes, family politics) can lead to power struggles over deciding whether or not a senior relative needs caregiving. However, by asking a few key questions you may be able to identify why a senior is refusing care and then gently persuade him or her to reconsider.

“How to ask for the help you need”

Someone turned me on to The Caregiver Space blog site, thecaregiverspace.org. It has a lot of interesting blog posts on caregiving, obviously. Here’s a recent one about asking for the help you need.

One suggestion given is that you should first ask yourself these three questions:
* Do you want help or someone to listen?
* Do you want an expert or someone who’s been through it?
* What am I asking for?

The author mentions apps like Tyze (tyze.com) and Caring Bridge (caringbridge.org) as ways to organize your thoughts into exactly what help is needed and when.

Robin

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thecaregiverspace.org/ask-help-need/

How to ask for the help you need
by Michelle Daly
The Caregiver Space
February 15, 2017 at 10:00 am

So many caregivers find their requests for help fall on deaf ears. So many people say they’re willing to help, but then they never seem to be around when you need them. Why does this happen?

Friends and family

It can be uncomfortable to do, but letting people know you could really use their help is important. Ask a neighbor if they could pick a few things up for you while they’re out. Let your community organizations know you could use a volunteer for a few hours to clear up your yard or keep your mom company. See if your friend would come cook dinner and eat with your family once a week. The more specific you are, the better your chances.

It can be a real challenge to break up tasks into pieces that strangers can help you with, so start small. Hopefully soon certain asks will be taken off your plate without you having to do anything about it — the neighbor who mows your lawn when he does his and the friend who’ll take your dad to the doctor every week.

People will say no and let you down, but people will also help.

Many people want to help, they just don’t know what you need. It’s like that friend you keep meaning to see, but never make real plans with — get specific and it’ll actually happen. People feel good about helping. Think of all the times people have helped you in the past — they’ll be there for you again.

Insincere offers

Sometimes people offer to help just like they ask you how you’re doing today or comment on the weather — it’s just a reflex. They’ll be surprised to hear from you if you call them up and ask them to follow through.

Genuine offers

Other people really mean it when they say they’d like to help, but they don’t know what to do. Often times they’ll come through if you ask them to do a specific task.

It can be frustrating to ask people for help multiple times and have them turn you down. Everyone’s busy, not just caregivers, but there are ways around feeling like coordinating help is more effort than it’s worth.

Apps like Tyze and Caring Bridge help you by saying what you need and when you need it and allowing people to step in when they’re available. When people offer to help, add them to your network of supporters on the app. Make a list of the things you need help with. Ask them in person or over the phone, too.

Professionals

Medical professionals often have to put their guard up against getting too involved with patients, so they may cut you off or seem cold when you tell them how much you struggle. They may also not take the time to figure out what, exactly, it is you’re asking for.

If you ask direct questions — can I get help with this bill? can I get medication delivered? is there home care help available? — you may have better luck.

Ask yourself this

Do you want help or someone to listen?

If you’re frustrated with someone’s attempts at giving you advice, ask yourself what you’re looking for from the conversation. Do you want advice? Offers of actual help? Or do you just want someone to listen and encourage? Let them know what you want.

Do you want an expert or someone who’s been through it?

There’s a time when you want specific advice and a time when you’d like to commiserate and hear about someone else’s experiences. Remember that an expert may have never actually had to apply his or her advice. Each person’s experiences are unique, so what helped one person may not help you.

What am I asking for?

How much of the background information does someone need to know to understand how they can help you? So many times in life a brief question is more likely to get attention than a long story.

Who to ask

Your doctor likely has no idea how much things cost or what programs are available to help. Doctors also rarely have the time to listen. What you can do is ask your doctor or nurse to refer you to a social worker.

A social worker can:

* provide counseling for you and your family
* connect you to support groups and other families
* help you find financial support
* help you communicate with the medical team

Many people struggle when a family member is seriously ill or disabled. Social workers can help you cope with the financial, emotional, and practical problems you’re facing.

Some resources recommended by “Care to Plan” tool

“Care to Plan” (mcicc-connect.org) is an online tool developed by the University of Minnesota for caregivers to those with memory loss.  Supposedly this “tool can help find support that is right for you.”

Four resources suggested by the tool (with some supplemental info provided by me) include:

#1 – Savvy Caregiver Course
* designed for caregivers of those with memory loss or dementia
* taught in person at many Alzheimer’s Association offices (alz.org)
* available via DVD from HealthCare Interactive (hcinteractive.com/savvycaregiver)

#2 – Powerful Tools for Caregivers Course
* 6-week course designed for family caregivers
* taught in person at many local area agencies on aging (find an agency near you via n4a.org)
* book available in English or Spanish via publisher (powerfultoolsforcaregivers.org)

#3 – Family Caregiver Alliance
* lots of publications on their website (caregiver.org)

#4 – Hire a geriatric care manager
* find one via their national association, Aging Life Care (aginglifecare.org)

Based on a review I read of the website by a Brain Support Network volunteer, those resources seem to be the full value of the tool.

The reviewer said:  “This online tool purports to determine your most immediate problem with a few simple questions, and direct you to a few appropriate resources to address it.  In reality, every outcome seems to direct you to the Alzheimer’s Association and their Savvy Caregiver course, your local Area Agency on Aging and their Powerful Tools for Caregivers course, and the Family Caregiver Alliance for all kinds of programs near you.  Excellent resources, to be sure, but certainly not individualized.”

By the way, Family Caregiver Alliance only has programs in the San Francisco Bay Area though it’s website has terrific publications.

I also noticed that one of the developers of this tool is a paid consultant of HealthCare Interactive.

So, I agree that the tool isn’t worth checking out….

Robin

 

How to have hope? (some ideas from those with PSP)

A few months ago, I helped a local person with PSP participate in the CurePSP monthly webinars for those with PSP. I asked on the call how others with PSP find hope. Here were some of their answers:

* walk on the bright side
* attend a support group meeting (or a CurePSP webinar)
* listen to uplifting music
* engage in something unrelated to the disorder
* read stories of encouragement
* don’t read too much about the details of PSP — the things that MIGHT happen
* exercise
* take a day at a time
* find something to look forward to
* spend time with family
* be with others who are worse off

What answer would you give?

By the way, if you have PSP, CBD, or MSA, or are caring for someone with PSP, CBD, or MSA, see the list of monthly CurePSP webinars here:

www.brainsupportnetwork.org/support-group/other-support-groups/

Robin

Interview with Ambiguous Loss Expert Pauline Boss

On Being (onbeing.org) is a public radio show that “opens up the animating questions at the center of human life.” The host is Krista Tippett. Last summer, Ms. Tippett interviewed family therapist Pauline Boss. The “animating question” must’ve been about ambiguous loss or grief. Dr. Boss is an expert is “ambiguous loss.” Her books include “Loss, Trauma, and Resilience,” “Loving Someone Who Has Dementia,” and “Ambiguous Loss.”

Here’s a description of the interview:

“There is no such thing as closure. Family therapist Pauline Boss says that the idea of closure in fact leads us astray — it’s a myth we need to put aside, like the idea we’ve accepted that grief has five linear stages and we come out the other side done with it. She coined the term ‘ambiguous loss,’ creating a new field in family therapy and psychology. And she has wisdom for the complicated griefs and losses in all of our lives and in how we best approach the losses of others — including those very much in our public midst right now.”

You can listen to the 50-minute conversation here:

The Myth of Closure: Interview with Pauline Boss
On Being
by Krista Tippet, host
June 23, 2016


www.onbeing.org/programs/pauline-boss-the-myth-of-closure/

Brain Support Network volunteer Denise Dagan listened to the full recording and said this:

“This is a really lovely 50-minute interview with Dr. Pauline Boss, Professor Emeritus at the University of Minnesota. It is apropos for everyone, but particularly for those of us living with long-term-illness, especially when dementia is a factor.”

For those who would like a faster approach, the transcript is at the link above.

Robin