What To Do If Your Elderly Parent Refuses Assisted Living

grumpy-woman

You know it's time. You're haunted by worry, knowing that your parent or other loved one is no longer safe living in her home. And as a caregiver, you're overwhelmed -- her daily needs have simply become greater than you have the time and availability to meet. But unfortunately, knowing your parent needs to move into assisted living or another senior care community and persuading her to do so are two different things. Here's how to convince a reluctant or stubborn parent that moving to assisted living is the right choice for her now.

Scenario 1: Your Loved One Is Resistant, but Open to Discussing Assisted Living

For some older adults, assisted living is an option worth considering, but they need convincing that it's the right choice for them. If this is the case with your parent or other loved one, you're better off than many caregivers because you're in a position to have a reasonable discussion about the future and what it holds.

  • Keep the focus on her health and well-being.
    Help your loved one make a list of the pros and cons of staying and moving. As much as you can, focus on her safety, her physical and mental health, and her daily needs, as these issues are the hardest to get drawn into an argument about. (Your loved one can argue much more easily about whether she really needs art classes or help with transportation than she can about the fact that she keeps forgetting to turn the stove off and can no longer manage her medications safely.) Make sure to take stock of both how things are now and what's down the road. If your loved one has significant health issues or memory problems, it's important to talk about them honestly. Explain that moving now will allow her the largest number of options, since many assisted living communities won't accept new residents with serious health needs.

  • Offer a range of choices.
    Help your loved one think positively about a potential move by helping her make a "wish list" of the features and options she'd like in an assisted living community. Schedule visits to a variety of communities so she can get a sense of the wide array of choices. By selecting among numerous possibilities, she'll feel more in control of the decision and not as if she's being railroaded.

    SEE ALSO: Find Assisted Living Near You

  • Foster social connections to help overcome fears.
    It's uncomfortable to leave what you've always known for the unknown, and older adults have even more difficulty with change than the rest of us. Once you've narrowed your search, don't rush -- schedule visits for meals, join in activities, and attend events at the communities you're seriously considering. Help your parent get to know some of the other residents, and ask them what they like about living there. (If she already knows folks there, so much the better; enlist them in encouraging her to join the community. Let them help persuade her by describing their positive experiences.) Plan for future social events as well; is there a weekly card game she could join, or a series of outings she could go along on? Being able to visualize herself in this new life with her friends will help overcome her worries and anxieties.

Scenario 2: Your Loved One Absolutely Refuses to Discuss Moving to Assisted Living

In many families, "Don't put me in a nursing home" has become a sort of mantra, and adult children and other caregivers feel terribly guilty about insisting that a loved one move. But the truth is, assisted living facilities of today are very different from the nursing homes your loved one remembers from days gone by, and you know in your heart that moving is the best thing for her. So hang onto that conviction and stick to your guns.

  • Seize the opportunity presented by a health scare.
    Any change in health status, whether it's a fall, the diagnosis of a new condition, or an illness, presents the perfect opportunity for a move to assisted living. As one Caring.com caregiver said, "Seize the moment and use an injury to explain the necessity of the move -- this is the only explanation my mother-in-law would accept. It's for her safety, so it really is for the best."

  • Use respite care to transition.
    Many assisted living communities offer short-term stays, usually called respite care. Some family members use respite care when they need to be away or just need a break. But respite care can also be the perfect "bridge" to assisted living, offering a chance to introduce your parent or other loved one to an assisted living facility in a nonthreatening way. Several Caring.com members said they'd introduced the idea of assisted living via respite care, then used that positive experience to convince their parents to stay, or to plan ahead for a future move. In some cases, particularly with a loved one suffering from dementia or memory loss, caregivers have moved a parent into respite care and then simply extended the stay into permanence.

    SEE ALSO: Find Assisted Living Near You

  • Enlist the doctor's help.
    We all know that sometimes a loved one can hear things from a professional that they can't hear from us. If you have the ability to contact your loved one's doctor, ask her to explain to your loved one why her health needs now require more care than is available at home.

  • Involve a geriatric care manager.
    When it comes to assessing an older adult's care needs and figuring out the relative costs of multiple options, no one has more experience than a geriatric care manager. For example, if your parent is arguing that getting some in-home care will be sufficient to allow her to remain in her home, a geriatric care manager can run the numbers and explain that assisted living is likely to provide that care at a more affordable cost in the long term.

  • Say, "I just can't do this anymore."
    Caregiving reverses roles, putting adult kids in the responsible role and making their parents dependent, which is uncomfortable for everyone involved. And older adults often become more selfish as they age, their worldview narrowing to encompass primarily their own aches, pains, and needs, which makes them sometimes overlook the difficulties they're causing for others. As adult children, we often play into this dynamic by being long-suffering and downplaying the toll that caregiving is taking on us. (No one wants to complain, and we don't want to make our parents feel bad.)

But in reality, your parents love you, and they don't want you to suffer. If you're exhausted, sick, sleepless, and stressed, that's dangerous for you -- and of course it's not what your parents would want for you if they were able to see the situation clearly. So when all else fails, speak up. If you've compromised your work so much that you fear losing your job, tell them. If the burdens of caregiving are interfering with being a good parent or are harming your marriage, say so.

Help them see your situation as clearly as possible and explain that being responsible for their care is taking too great a toll on you to sustain. You have the right to say, "I just can't do this anymore" -- and they have the right to know what's really going on.

Find Assisted Living Near You -> Start Here


Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio


2 months ago, said...

Caring.com Parents This also sounds a lot like what I'm dealing with also. My husband and I moved in almost a year ago to care for my 90 year old Stepdad and 91 year old Mom (both soon to turn a year older). Both of them fractured their hips a year apart (3 & 4 years ago) and have not been the same since. Stepdad walks with a cane and shuffles his feet when he walks not picking them up so it's a hazard. He has fallen outside at least 4 times since we moved in (he loves the outdoors, loves the heat, will sit in his rocking chair half the day watching everything and napping) but then he'll decide to get up to look at a tree, go in the grass or go to the mailbox and down he goes! He is also restless when he sleeps and yells from what I have to guess is from the war memories but it has made him fall out of bed 3-4 times as well at night! He cannot get himself up and so we run frantically when hearing him. He's a tough, stubborn ex-military man (but luckily I have gained his love and trust) who wants what he wants which in this case is his own home. He can no longer care for it in any way nor does he want to (mechanically, yard wise or any way as he used to) but then he also does not want to move into assisted living and leave his familiar place. Ironically though, he let the mortgage go unpaid for months (which I've since saved via modification) with no worry as to the outcome, he thought the mortgage company was automatically taking it out of his bank! In hindsight, it may have forced him into assisted living but I couldn't let it happen that way and he'd lose any of his homes equity. I've also taken over all of the bill paying (with his happy permission) out of sheer necessity. He feels that as long as we're here 'handling' every aspect of things, in his mind everything is just fine. His mind is still working fair for his age, his eyesight is ok but he is very deaf. Besides the walking/falling and things mentioned above, he's been pretty healthy. However, his hygiene seems to not be a very big concern for him over the last year or so (as not much is) and he also recently has been having trouble making it to the bathroom. He is capable of showering (hand rails & bath chair) and grooming himself if he chooses to. As the stubborn man he is, I'm pretty sure he would NOT take kindly to the suggestion of Depends either. So that's Stepdad. Mom, she was in pretty good health other than some back problems and osteoporosis before she fell 3 years ago and fractured her hip. It could be coincidental, but she came out of the anesthesia with her mind not as sharp. Last year she ended up in the hospital with a bleeding ulcer (from the years of strong pain meds for her back & hip). They did mild anesthesia in order to do a scope and cauterization, but she again seemed to have a worse memory afterwards. My Grandma, (her Mom) had Alzheimer's and so we know what that looks like. We have asked the Dr. and she felt no tests were neccassary as Mom is over 90 and it's just 'old timers' or dementia beginning. Mom has left the toaster oven on, smoking up the house, we no longer let her cook on the stove but the toaster oven obviously needs supervision too now. It's her very short term memory, she will often say the same thing or ask the same question many times over in a short period of time. Some days are better than others. She is legally blind from macular degeneration and gave up her license 3 years ago (although sometimes she still thinks she has one!). She is mildly deaf but not too bad. She still cares well for her own personal hygiene, does their laundry and changes their bedding but most everything else is either too exhausting or a challenge she should not have to handle. This all is why we are here. I have POA for Mom, both financial and health but it is 10 years old and I don't think it was even filed with the county clerks office. I don't believe it's what they call 'durable' either, I also don't have a guardianship so I feel all should be updated before she is still of mostly sound mind. Only one of three of my Stepdad's grown children half gives a crap, they live out of state and rarely contacts or visits him. My Stepdad and my Mom have been married over 10 years and we've seen them maybe 3-4 times very briefly. I may have met the other two once in this time. I understand being out of state is difficult but at least make an attempt to keep in contact via phone, it's a shame. I'm all my Mom has (well the only one of three left that acknowledges her) so it's been important and what I feel is my obligation to be doing this thus far. During one rare, brief visit a few months back, my Stepdad's daughter and son-in-law told ME to become his POA and legal guardian. They thought it made more sense since we were here and already his caregiver. I understand that logic but to me it was just another thing they didn't have to think about that I would just take care of for 'their' father. They also suggested and encouraged an assisted living place for them but she also knows how stubborn her Dad is. I will gladly oblige being his POA since my husband and I do everything for them and are the ones who love and care for them anyway. Once we do the POA and Guardianship, then from what I understand, I can legally do what should be done for them and then their home to allow for their continued care in assisted living. I just hope that when I do make decisions on both of the parents behalf, it doesn't bite me in the butt with his practically non-existent children. No worries grown kids, I already know what you want from his house! The son I've met once in 10 years has evidently laid claim on the Grandfather clock at his last visit by attaching a post it note inside the glass door! Grrrrr. I know that I have to and will do what's right and best for our parents, even if they don't think so at the time. Making sure they are well cared for in the best possible way when I can no longer do it, is my priority. I know this is lengthy and I am venting and I apologize for that. I'm sure you can all understand & empathize with our dilemma. Please weigh in with any comments or suggestions that may be helpful to me. Share your own experience, I'd be happy to read. Also, if you're going forward soon with your decision for your parent(s) and how you handled it. Thank you.


2 months ago, said...

In response to chip84105, this sounds identical to what we are going through with our 91 year old Mother. My question is do you need to have a doctor sign of that the person is incompetent on her own before you can place them in an assisted living facility?


2 months ago, said...

Our mother is 88, in moderately good health, however with limited mobility due to back and hip pain. She has demonstrated clear signs of deteriorating memory and capacity to care for herself - not eating, inability to take medications as specified, inability to care for her pets, and most importantly, extreme anger, unkindness with all around her, including her in home caregivers, family and anyone she might come in contact with - we are talking much more than grumpiness. She isolates herself at home, even in the presence of regular invitations from her daughter, granddaughter and 2 grandchildren who she feels are little brats and refers to as "that boy" and 'that girl". We have provided a wide variety of age appropriate activities and opportunities for her, all of which she has some reason for being unwilling to participate in. 'I have to feed my dogs' [which she seldom does].. She has insisted on moving 8 times in 14 years - consistently complaining she is unhappy and her children never help her, in spite of our backbreaking effort to support her. The list is far longer, but for purposes of brevity, I will leave it there. The situation has become increasingly unmanageable for a long period - years. She absolutely refuses to discuss this or see any doctor who might assist - we are truly in the worst of situations. We need help - badly. The option to obtain guardianship is an ugly, expensive one - especially as we are only trying to move her from 5 day care at home to assisted living [she really needs memory care] in a really beautiful, nearby, new facility with graduated living [independent, assisted and memory] currently under construction. Where do we turn for help with a family member who has very substantial needs yet is mean and malicious to all around her. We simply can not continue. HELP.


6 months ago, said...

my dad says he just cant do it anymore. mom has alzheimers. she idolizes him. She is moving tentitively in with my family. how do we explain that dad wont be there. He will be at their home,


over 2 years ago, said...

I am a Geriatric Care Manager, this article has excellent advice.