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My Mom Needs Caregiving Help but Won’t Accept Any. It’s Stressing Me Out
Expert advice for reducing conflict and encouraging safer decisions
Vidhya Nagarajan
Key takeaways
- Building trust and respecting an aging parent’s perspective may be more effective than repeatedly urging them to accept help.
- Look for natural openings to discuss challenges; this can help older adults consider changes without feeling pressured.
- Offering choices and support can help preserve independence and dignity as new limitations emerge.
Editors asked AARP Family Caregivers Discussion Group members and other caregivers to submit pressing questions they’d like family therapist and clinical psychologist Barry Jacobs to tackle in this column. Jacobs took on this hot-button topic.
Question: My mother doesn’t accept caregiving help, even though she greatly needs it, even to the most casual observer. She won’t let me attend her medical appointments with her (I am starting to suspect she’s hiding a potential diagnosis of early dementia), refuses any conversation about planning for what comes next as she ages, and won’t let me make the smallest of updates to her home to make it safer and more comfortable to age in place. It’s creating a lot of stress for me and my siblings to have to sit back and watch things get worse. What can we do?
—C.W., Chicago, IL
(This letter was edited for length and clarity.)
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Jacobs: What you describe is every adult child’s nightmare: Your mom is slowly failing. She may no longer have the thinking skills to realize it. Your efforts to protect her are continually rebuffed. If you pressure her, she may dig in her heels or withdraw from you and your siblings. If you sit back and allow her to do as she will, you may feel irresponsible and guilty if she has a bad fall, is in a car accident or is conned by a scammer.
What you describe may also be every aging parent’s nightmare: Her kids doubt her. They may not understand her well enough to appreciate what she can still do. Their efforts to protect her feel continually overbearing. If she tries to ward them off, they may push harder to take over her life. If she sits back and allows them to do as they will, she may feel she has lost her independence and, with it, her dignity and self-worth.
These two viewpoints are hardly reconcilable. You may be right, your mother may be right or the truth may lie somewhere in the middle. It would take a comprehensive evaluation of her overall physical, sensory and cognitive functioning by a geriatrician, physical therapist and/or occupational therapist to give you and her a more objective assessment — but it’s doubtful your mother would even consider undergoing this.
For the purposes of this column, let’s assume that you and those casual observers are 100 percent correct and your mom is in total denial that she needs help. There are three possible pathways forward then:
- You could continue trying to persuade her that accepting some assistance is essential to her well-being. Unfortunately, it sounds like she won’t give an inch for fear you’ll take a yard. If her need to maintain control has led her to reject all your reasonable suggestions thus far, then it is unlikely she is suddenly going to begin agreeing with you.
- You could do what many adult children in your position do: adopt a “watchful waiting” stance in which you stand back and expect that something bad will happen, such as a fall or car accident, which will make evident to everyone — your mother included — that she isn’t as capable as she was. You and your siblings would then have an opening to swoop in and implement the changes your mother has been resisting. The problem here, obviously, is that “something bad” could be very bad, even catastrophic. You don’t want to see her or anyone else get hurt.
- This path is the hardest: You could build greater trust with her and help her come to the conclusion that it would be wiser for her to take some precautions. This will only work if your mom has the cognitive capacity to make her own reasonable decisions.
Because your mother is already in a defensive posture, the third path will require a great deal of compassion, patience and creative diplomacy on your part — and still may not be enough to assure her that you are her trustworthy ally. Yet, in my opinion, this is your most promising option for getting past the current stalemate. Here are some ideas for becoming her partner to help her age in place:
Meet your mother where she is
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This boils down to making a show of respecting her perspective rather than trying to convince her of yours. Compliment her on any sign of her remaining strengths — such as a well-cooked meal or well-groomed appearance — instead of confronting her with her growing deficits. Encourage her independence, not dependence on you or others. In other words, do everything you can to demonstrate that you understand and support the lifestyle and sense of identity she is trying so hard to preserve.
Does this mean you are endorsing what may seem like her self-delusions? No, you can still firmly believe she needs lots of help. Repeating that to her at every opportunity, however, is not an effective way of joining with her. To the contrary, it makes you look like a nag and leads to greater emotional distance between the two of you.
Does this approach seem patronizing, dishonest or harmful? Think of it as a tactic to strengthen your relationship with her. The hope then is that she will be more likely to share the particulars of her day-to-day life with you and ultimately allow you greater latitude to express any worries you have.
Seek openings to discuss challenges
Preserving a lifestyle and identity takes maintenance. That’s especially true for older adults who are on the downward slope, slowly losing strength, balance and speed of thought. Look for ways to talk with her about that preservation effort and the challenges it usually faces.
For example, if your mother mentions that her knee has been hurting when she climbs stairs, don’t jump on this as a chance to tell her to move out of her house. Instead, express empathy for how she’s feeling and wonder aloud with her about what might relieve her pain. Should she take ibuprofen, use an Ace bandage or ice her knee? Should she make an appointment with her doctor? Wouldn’t it be great if she had some sort of contraption that could whisk her from one floor to the other, like a chairlift?
More from Barry Jacobs
‘Being a Caregiver Ruined My Sleep’
My Dad Won’t Listen to Me About Paying for Mom’s Care. How Can We Agree?
My Mom Wants Me to Be Her Caregiver, but She Won’t Move Near Me to Make It Easier
Our Long-Distance Sister Questions How We Care for Aging Parents
I’m a Sole Family Caregiver. What Will My Husband Do If Something Bad Happens to Me?
You aren’t telling her what to do; you are brainstorming possible solutions with her to help her live as she wants: pain-free in her home. That’s not being critical or trying to take over; it’s being supportive. Your mother, meanwhile, will be weighing whether to make changes, even temporary ones, so she can feel better. Some of those changes may involve accepting help, such as medical advice or home modifications. Consider that progress for someone who has been otherwise help-resistant.
Here’s another example: Let’s say one of your relatives has a stroke, which has forced her to move out of her home. Although this isn’t a direct challenge to your mother, it presents a hypothetical scenario for her to ponder. Tell your mom that you hope nothing like that ever happens to her, but also ask her what she thinks she would do if it did. Would she agree to move or fight to stay? Hire aides to be there with her? Or maybe allow one or more of her kids to live with her? Again, you’re posing questions to help her consider making necessary changes. That’s the first step toward becoming more adaptive.
Harsh reality and available choices
What I’ve described is a slow process. You or her doctors (preferably her doctors — let them play the bad guys) may need to help her face the harsh reality of losing some of her independence. This should be done with as much empathy and sensitivity as possible to help your mother grieve these losses rather than turn her grief into anger at you.
It is also a good idea to provide her with as many choices as possible over what will happen. For example, let her pick the personal care aides whom she may have to put up with. If she is no longer able to drive, let her decide which alternative transportation (church volunteers, rideshare services) she will have to learn to use. Be the supportive daughter who is still trying to help her preserve the self-reliant person she has been, even as she is overtaken by unwanted and dreaded change.
The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.
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