Resistance among care recipients is a natural phenomenon. The senior wants to retain as much independence and dignity as possible and perceives efforts to introduce lifestyle adaptations as unwarranted and offensive. The caregiver sometimes responds with impatience, annoyance and a lack of understanding about why someone would refuse clearly needed help and services.
In this two-way tango of resistance, the caregiver attempts to convince the senior to accept changes while the senior protests and seeks to defend the status quo. The dancers accomplish little more than stomping on each other's toes. This futile and frustrating interaction threatens both parties' well-being and good will.
It helps if you recognize resistance to change can indicate a healthy, fighting spirit. No one likes to admit they need someone else to do for them what they are used to doing themselves. You will need to tread gently and find ways to bolster the senior's sense of pride and self-reliance. Remember that the caregiver's role is to help seniors maintain as much control over their lives as possible under the circumstances, not take it away.
How can you overcome resistance?
These suggestions may help a senior learn to accept change:
Don't try talking care recipients out of their reality. It is frustrating and futile to attempt to change a person's firmly held beliefs. Instead, find as much as you can to agree with. This will disarm them and demonstrate your understanding of the difficult situation they face. For the moment, don't debate the facts of the dilemma but focus on their feelings. Let them know you empathize with their sadness.
Accept that they don't have to be happy about change. Sometimes happy is simply not an option. Your goal is to make sure they get the services they need. You cannot control how they feel about it. Do not try to convince seniors they are going to be much happier with the new home health aide or in the assisted living facility. Allowing them to grieve the losses associated with change facilitates letting go and moving on.
Find the common ground. Often caregivers and seniors approach caregiving as members of opposing teams. The senior's goal is to maintain the current lifestyle. The caregiver seeks to ensure the senior is as safe as possible. The best way out of the impasse is to find common ground and work together to achieve it. Compromise is often essential. Maybe the care recipient doesn't want full-time help but will accept meal deliveries, a part-time aide or installation of some assistive devices in the bathroom.
Involve the senior in making decisions. Perhaps it is no longer possible to put off hiring a home health aide. However, the senior can participate in choosing the person. Your approach to implementing services is as important as the services you implement. One of your most important roles as a caregiver is to help the other person retain as much control as possible.
Make it your issue. In some situations seniors may want the help you offer. However, to accept it would be a loss of face, an admission they are in need. Try positioning the request as a favor to you as the caregiver. Explain that taking this step will put you more at ease. By feeling they are helping you, they can maintain a sense of dignity and self-respect.
Be ready for windows of opportunity. Know about the resources available in the community before you need them. In some caregiving situations, a senior is willing to make needed changes only when a crisis occurs. The crisis — a fall or hospitalization, for example — creates an opportunity during which the senior will accept services. These windows close as quickly as they open. When you have the information you need before you need it, you will be able to implement the service before the senior can fully regroup and resist it.
Avoid emotional minefields. This is not the time to rehash old family issues and arguments. Keep the discussion focused on current practical realities. Avoid assigning blame for past decisions, actions and childhood traumas. When the discussion veers off-track, re-focus on the purpose of the meeting. If the subject continues to drift, let it go and bring it up another time.
Set limits. Seniors have the right to reject suggestions. However, caregivers have the right not to enable this situation by simply filling in gaps themselves. Care recipients can refuse to hire a homemaker to do the laundry, but you can refuse to perform this function. Setting limits may force them to accept needed services. If not, it's their choice. Unless you have legal authority over medical and personal care decisions, you cannot impose your will on them, even if you think it is in their best interest.
Choose your battles. You will obtain their agreement on some issues but not on others. Battle over the ones truly worth the fight — those directly related to their health, safety and well-being. And remember that caregiving is a marathon, not a sprint. You do not have to accomplish it all in one day. You must learn when to push and when to stop trying and accept the situation as it is.
