What to Do if Your Loved One is Resistant to Home Health Care

“It is so hard to admit, but, when I am honest with myself, I recognize that caring for my spouse is taking a toll on me. My adult children think I should hire an in-home aide to help me shower my spouse and give me time to slip away from our home for a few hours. It’s tempting - but neither of us want anyone in our home!”

How many of us have heard our older loved ones say something similar to this to justify why they refuse additional support – even when they know how much they could use it?  Currently, it is easy to use COVID as an excuse not to bring outside people into the home. But what happens when we are all vaccinated, or the needs of our loved ones are greater than the family can handle alone? 

Before we begin to introduce the idea of help in the home, remember that talking about difficult topics is actually a process; change doesn’t usually happen in one conversation. Here are some things we may wish to consider:

• Imagine if the roles were reversed.  How willing would we be to have someone come into our home and take charge? Accepting help may feel like admitting failure to manage or control our own life. It might even feel like an admission of aging, which many people do not want to accept. Ultimately, it is important to balance a loved one’s need for autonomy with our concern for their safety. 
• Not many people like to be told what to do.  Instead of talking, we can listen empathetically to what our parents or loved ones are saying. Are they feeling emotionally or physically overwhelmed? Are there specific tasks for which they will accept help?
• Ask open-ended questions. Asking questions not only demonstrates that we value a loved one’s opinion, but it may also help us gain additional insight into what matters most to them. 
• Never underestimate the commitments our older loved ones have made to each other. The promises made during the course of a lifetime can be just as impactful as vows made at a wedding. And these bonds exist not only within marriages, but also within families and friendships. 

So how do we have the conversation with family members or other loved ones when our perception of the need is far greater than their assessment of the situation?  Instead of taking an all or nothing approach, perhaps start with just one question: “If there is one job that you could take off your list, what would it be?” Maybe they would like help with meal planning/preparation. Or maybe they would like a handyman to fix the dripping faucet or take care of other repairs around the house. Ultimately, starting with a loved one’s concerns may allow us to address our concerns, as well.

After listening to their reasons for not wanting someone else in the home, it IS ok to offer practical support and identify some solutions:

• ”I cannot let a stranger into my home. My valuables will be stolen.”  
  • Make a list of those items a loved one identifies as valuable. Where can they be safely stored? In a safety deposit box? Outside the home? 
  • Contact their home insurance company to review their policy and help them to understand their coverage.
  • Contact the home health care agency to review their insurance, liability protection, and what they can do if a claim needs to be made.
  • Decide if installing security cameras helps them feel safer. 
• “My loved one will not accept help from a stranger.”  
  • Create a climate of acceptance by introducing the paid caregiver as a friend or known acquaintance. 
  • Allow the aide and person needing care to “visit” before moving directly to care, if possible.
• “I may be older, but I do not need help.” 
  • Not everyone wants to be on the receiving end of help.  We often want to be the person helping.  
  • Explain to a loved one that the home health aide and their family will benefit from having a paid position. The older loved one then becomes the one giving rather than receiving assistance. 
• “Outside people will bring COVID.”  
  • Request a copy of the health safeguards and procedures that all staff at the home health agency must follow and review it with loved ones.
  • Create an in-home safety station and procedures for everyone to follow.  Have a thermometer at the door as well as clean disposable masks and hand sanitizer.  
  • Place several additional hand sanitizers throughout the home especially in places where the older loved one and the aide will be interacting.  
  • Update the health care agency about in-home precautions.  

In the end, understand that the fear and uncertainty of chronic health conditions change and often upend family dynamics. Roles shift and issues of aging become more intense, oftentimes reinforcing our own vulnerability. Even as we juggle families and jobs, it is important for everyone’s well-being to see the value of interdependence as an extension of independence.