When mom or dad won’t accept help

Scientists have found that humans age dramatically in two bursts — at around age 44, then at around 60. As people get beyond middle age, a fairly significant number don’t want to admit to themselves that they are getting older because of a variety of factors:

• Society portrays aging negatively. (At least we have Kathy Bates as “Matlock” showing us a 70-something smart cookie.)

• Psychologically, people associate aging with decline and loss of abilities, so they avoid thinking about it.

• Ageism, the last acceptable form of discrimination, is still present in workplaces.

• Preserving a younger self-image is a boost to the ego.

This denial manifests itself in many ways — for example, buying a three-story house or getting a 50-pound dog when you’re in your 60s or 70s. And I think it’s at the root of why, when our parents are getting older, they resist accepting help from their children and their caregivers.

It’s a process

We may age more quickly at certain times, but getting older is a process, and processes take time. Which is why the first time you ask Mom or Dad, “Do you want someone to come in a few days a week to help you out?” the answer may very well be, “I’m fine” or “Heck no,” or words to that effect.

So you have to keep at it and not give up at the first sign of resistance, especially if you can see their capacity to perform the activities of daily living (ADLs) is becoming diminished.

What are the activities of daily living?

Activities of daily living are an indicator of a person’s ability to function independently. They include eating, bathing, toileting — tasks needed to keep a body healthy and safe. ADLs can also include more complex tasks like managing money, managing medications, cooking and doing laundry, which are important for independent living.

If a parent has difficulty performing one or more ADLs, they may end up living in unsafe conditions and have a poor quality of life unless they receive assistance.

ADLs can be empirically observed and measured, which takes emotions and assumptions out of the equation. You can also report to Mom’s or Dad’s doctor if you observe difficulty with ADLs, so the doctor can have that conversation with them.

Most importantly, you want to keep an eye on ADLs before there’s an accident, injury or financial mishap: a stove or oven left on, a fall in the bathroom, or bills going unpaid.

How to approach ‘the talk’

Getting a senior to accept help is sometimes not easy, but it’s good to point out to them that they’re in control now. There may come a time when the decision to accept help is no longer in their hands.

Some general guidelines:

• Involve others, such as their doctor. What may be difficult to hear coming from a child may be more acceptable from a third party.

• Listen to their concerns and feelings. Show that you understand their thoughts about the perception of aging.

• Hear them out about their wishes and focus on the options they seem interested in. “If you could wave a magic wand, how would you make your life better?”

• Then ask questions: Find out why they might be reluctant to accept help, such as fears about the loss of independence or the cost.

• Give them choices: Allow them to help make decisions about the type of help they would be most comfortable with, and from whom. Would they be OK with a family member helping out but not someone from a care agency? How would they feel about having meals delivered a few times a week?

• Point out how today’s technological solutions can maintain independence. Have DoorDash deliver the groceries and a rideshare take you to the doctor.

• Reframe the meaning of independence: Remind them that asking for help doesn't mean they're becoming less independent, but rather embracing interdependence.

As much as you can, let Mom or Dad control the decision-making. But the fact is that at some point, children and caregivers may have to assume control. It’s important to have in place powers of attorney for health care and financial matters.

Finally, keep in mind that you’ll be next in line for this conversation with your children or caregivers. How would you want someone to speak to you, and how accepting will you be when someone says, “I think you need help?”

• Teri (Dreher) Frykenberg, a registered nurse and board-certified patient advocate, is the founder of Northshore Patient Advocates LLC (NShore). She is also founder and CEO of Nurse Advocate Entrepreneur, which trains medical professionals to become successful private patient advocates. Teri offers a free phone consultation to newspaper readers as well as to nurses interested in becoming advocates. Reach her at Teri@NurseAdvocateEntrepreneur.com.