Aging can be a challenging time. Aging often brings pain, aches, ailments, weak immunity, reduced mobility, and cognitive decline. Despite these changes, many seniors strive to remain independent. Although many of our loved ones may prefer to age in place at home, there may come a time when we may need to consider assisted living options. Our loved ones may need assistance with accomplishing routine tasks, but may refuse to move to assisted living, even if it is the appropriate time to consider assisted living options. As the caregivers, we need to understand that it may be excruciating for our loved ones to realize they may need the additional support, when they are determined to maintain their independency and current lifestyle. Many families may endure challenges with persuading their elderly loved ones to consider the transition into an assisted living home.
In this article, we will discuss a suggested plan of action to help equip you for when an elderly parent may refuse assisted living.
Why May A Parent Refuse Assisted Living?
There is a variety of reasons why our elderly loved ones may refuse assisted living. Knowing these reasons will help you prepare to better understand your parent and to help successfully guide them through this challenging transition. If your parent refused assisted living options, have you considered:
- Are they habitual with their routine, home, and lifestyle? They are used to and happy with their current surroundings, environment, and lifestyle, and don't desire change?
- Are they anxious they may be left alone with strangers and isolated from the rest of the family, their friends, and other loved ones?
- Are they worried they may no longer have the opportunity to visit their children, grandchildren, and other loved ones? Are they concerned about no longer playing an important role in the lives of their family members? Do they fear loss of independence?
- Are they concerned about letting go of their favorite possessions?
As caregivers, we must understand that these are legitimate reasons, and must understand these concerns from our elderly parent’s perspective. By better understanding their worries, you will be able to assuage and reassure their doubts and worries. Together, as a team, you can create solutions, so that they are more interested in the transition into assisted living.
How to Deal with a Parent Who Refuses Assisted Living
On a superficial level, when parents refuse to relocate to an assisted living facility, it may seem as though they are just being stubborn. We recommend listening to their concerns about assisted living, in order to clarify their doubts and worries, so that they can feel more comfortable about addressing the issue. Here are a few strategies for talking to your parents that are often effective in helping them think more positively about moving to an assisted living facility.
1. Help them understand the common challenges of growing older
In The Loss of Self, a book focused on family care for elderly people facing cognitive decline due to Alzheimer’s or related disorders, the author Donna Cohen cautioned against persistently demanding that your parents move to an assisted living facility. Rather, Cohen suggested helping them understand the aging process and its associated challenges. Cohen wrote that seniors who exhibit anger and dramatic changes in their mood are often aware of their declining abilities; however, they do not always understand the causes behind their condition, whether it be cognitive impairment or physical limitation
When elderly people don’t understand the reasons behind their cognitive or physical decline, they often assume that their children won’t be able to understand their troubles, either. Gentle reassurances can help reduce their worries about losing various abilities and functions. Making them feel more comfortable about their situation can prevent or mitigate existing feelings of helplessness, anxiety, guilt, and frustration.
Do your best to understand that elderly people commonly refuse to consider assisted living, at least initially. Try to reframe how you approach the issue with your parents. Rather than telling them that they have to move to an assisted living facility because of their disabilities, try to emphasize the ways in which assisted living will help them feel better and provide them with new opportunities. If they continue to refuse, try to express how assisted living facilities are specifically designed to understand and address their unique challenges of aging. Show empathy, validation, and reassurance.
2. Stick with them through the good and bad
Our parents have successfully navigated many years, and they value their independence. The co-author of Coping with Your Difficult Older Parent, Barbara Krane, explained how seniors often resist discussing the option of assisted living, and how their behavior can affect adolescent family members. Both older people and adolescents (and even middle-aged adults) can resort to yelling, abruptly leaving the room, and other stressful behaviors as a means of communication about difficult subjects.
We don’t think these behaviors should be a reason to give up on talking to your parents about assisted living. While growing older often introduces many negative situations, try to make the best of it, rather than trying to avoid the bad times. For example, giving up driving is one of the major negative experiences of aging. Rather than forcing your mother to stop driving, try asking her to go on car rides with you, and to enjoy the ride while you drive. You can listen to music together, go places to which she wants to go, or use the time to talk. With this strategy, although one ability might have been lost, the experience doesn’t have to be entirely negative for either you or your elderly parent.
3. Try to change your approach
If one approach isn’t working, then consider adjusting your tactics for persuading an elderly parent to move to an assisted living facility. You don’t just have to repeat the same lines and words again and again. Take a look at these strategies:
- Focus on telling them the benefits of assisted living, such as easier socialization and more independence.
- Try to present assisted living as an option, rather than a foregone conclusion. Offer them an active role in making choices about their future, and show them that you value their opinion.
- Express to them your care and concern about their well-being, instead of emphasizing your fear and doubts about their health.
- Avoid forcing the issue, and being too pushy about the situation.
- Ask to hear their doubts and concerns, and validate their worries. Discuss ways to address these concerns.
- Offer them examples of other seniors in the community who have moved to an assisted living facility, and are thriving there. Maybe you can set up a meeting for them to talk to an assisted living facility member.
A change in your approach might bring about a positive result. Be patient, and do your best to relax.
4. Show respect
Do your best to avoid talking to your parents in a condescending manner. After all, they are your elders! For example, an elderly man diagnosed with a brain tumor might experience his children talking to him as if he were five years old. No doubt, he might need special care, but his children can still treat him with honor and respect. When talking with elderly people about assisted living, try to speak in a way that expresses your honor and respect for them. You can respectfully ask them questions about assisted living, such as:
- Do you have any fears or doubts about moving to assisted living?
- What are your major concerns?
- How can I reassure you?
- Do you want to visit an assisted living facility before making a decision?
- What do you think you’ll be giving up if you move?
- What are some ways you can achieve independence in assisted living?
Do your best to be empathetic. Consider how you might feel 30 years down the road, in their situation. So, listen to their concerns, and treat them respectfully. Give them time to consider everything, and patiently wait for their decision.
5. Back off from the topic
If you have tried various approaches with no results, back off from the topic of assisted living. Take a few weeks to give your elderly loved ones time to think about it. It is human nature to oppose something when initially introduced, but to then reconsider after a period of time. Giving your parents some time and space is definitely a useful tool for handling the situation.
6. Have detailed discussion about future possibilities
The main concern of both family members and seniors is the health of elderly parents. Both parties may be open to discussion regarding possible future health issues. You can ask questions, such as:
- Where do they want to live when they will reach their senior years?
- Will they hire a housekeeper to help them with routine tasks?
- What is their opinion about elderly people moving to an assisted living facility?
- What did their parents decide about their living situation when they were old?
These kinds of open-ended questions can reveal a lot of information. By consistently having discussions, you can anticipate how your loved one will react to certain living decisions. Elderly people might have doubts about the discomfort of living with strangers, the fear of being isolated, privacy concerns, and many other worries. By talking openly and often, you can pinpoint your parent’s primary concerns, and work towards addressing them.
7. Share your feelings
Instead of focusing on your loved one, shift the focus to your own feelings and well-being. Express how their illness makes you feel, and how the fears that you have about them living alone are causing you distress and anxiety. You can express that you don’t feel qualified or capable of providing adequate care, and that you’d be a lot happier if you knew they were in the capable hands of a professional. For example:
- I am worried about how to improve your health without special care.
- When I am at work, I am distracted because I keep wondering what would happen if you needed emergency help. It would help me do a better job at work if I knew you were safe 24/7.
- I love taking care of you, but it’s becoming really difficult for me to balance my time with you with my parenting responsibilities. I’m worried that I’m not spending enough time with my children.
- Work has been difficult lately, and it’s hard for me to help you adequately after a long day at the office. I don’t think I’m able to give you the care you deserve because I’m too exhausted, and I can sense that you aren’t as happy as you could be. Can we look for a solution that will help both of us?
- I am worried about you, because I love you so much, and want to see you in good health.
- Let me find a way that enables you to live more independently, actively, safely, and securely, and in which you’re in good hands 24/7.
Talking about the issues of assisted living in this way will encourage elderly people to consider the effect of their choices on you, their child. Of course, you don’t want to suggest that they are a burden, or that they’re being selfish for refusing help. Rather, present your worries in a respectful and honest way, and suggest assisted living as a possible solution.
8. Seek expert advice
Many people place more value on suggestions that come from experts or professionals, like doctors or psychologists. Other knowledgeable and respected people, like priests and social workers, can also help you by talking to your loved ones about assisted living. They can explain the advantages of senior living facilities, such as having 24/7 care, and access to more social activities. These experts can also provide thorough answers to any questions about assisted living facilities and treatment. Sometimes, the messenger matters more than the message. Here are a few people from whom you might consider soliciting help:
- Someone who inspired your loved one, such as a religious leader.
- Someone who is a trustworthy companion of your parent, like an old friend.
- A family physician who has been working with your elderly loved ones for years. You can ask the doctor to point out the dangers of living without 24/7 help.
- A relative who has a particularly strong bond with your elderly parent, like a favorite niece or granddaughter. You can recruit them to help you in this matter.
9. Avoid being too controlling
Your goal is to convince your elderly parent that assisted living is a valid option, so while it pays to be persistent, avoid being obnoxious. Arguing and trying to control the situation will probably not yield any favorable outcomes. Someone might finally agree after arguing with you for hours, but they probably won’t feel good about the situation. Controlling behavior can cause elderly people to think they are incapable of handling their lives. By all measures, avoid giving them this feeling; after all, they are your parents! Give them more control of the situation, and let them make their own decisions.
10. Deal with problems proactively
As the need for assisted living is a two-way matter, both parents and children will face problems. One strategy for resolving these problems is to list potential sources of conflict, and set priorities for dealing with them proactively. In most cases, the priority is the health of an elderly loved one, so make a list accordingly:
- How many weekly appointments with a physician are needed?
- Do you need to hire a housekeeping service?
- Which tasks require full-time help?
- What will be the expenses for in-home care vs. assisted living?
- What are the pros of staying at home?
- What are the cons of staying at home?
- What will be more beneficial for your health?
For instance, if a senior person is suffering from dementia, they will need help with their daily chores. So, hiring a housekeeper or moving to an assisted living facility or a memory care community will likely be a better option than leaving them on their own. It’s important that you explain every aspect of care to your elders, so that they never feel helpless or caught off-guard.
11. Love requires time; give it
Do you remember when you were a little kid, and it took you a while to understand or grasp things? Did your parents ever rush you when you were unable to remember the appropriate words? Hopefully, they were patient with you as you took each step of your education and childhood. Patience is a great way to express love; try not to rush the assisted living topic. Some strategies include:
- If they need a doctor, ask the doctor to visit your place.
- If your parent needs to speak to a therapist, request the therapist to give a session in your senior's favorite coffee shop.
All these acts of kindness and love can help your elderly parent or another loved one feel more open to assisted living.
12. The choice is theirs
At the end of the day, your parents are free to make their own choices. If an elderly loved one refuses assisted living even after you implement all the aforementioned strategies, you must accept that they’ve made their decision. They are adults, after all, and if their decision is final, all you can do is accept it and make the best of it. Find other ways to love and care for them effectively.
If you are worried about dangerous outcomes or accidents, then make sure to make safety modifications at their home. This is a great way to express your love and support for your elderly parent.
13. Get Legal Support
There are some cases in which senior citizens must move to an assisted living facility, as they would otherwise be in danger. For instance, a dementia patient who has experienced several accidents at home due to forgetfulness clearly needs to be in a 24/7 care environment.
You can ask for legal help from an elder-care lawyer who has experience with many such cases. A lawyer can help you reconsider your options, give you guardianship advice, or refer you to a geriatric social worker for additional help. Seeking legal help should be used only as the last resort. It might make your parents angry, but this may be necessary if their safety (or that of others) is at risk.
Talking to elderly loved ones about changes in their living situation is not always straightforward, because they sometimes refuse to consider the idea of living support. So, how will you convince your elderly parents to accept the assisted living option? The first thing you can do is to identify the reasons for their refusal. Ask them questions related to their refusal, and try to provide reassurances for their doubts and worries. Once you fully understand their concerns, you may be able to find ways to show them that their concerns will be adequately addressed.
Try to use various strategies to show them the merits of assisted living. Explain that the aging process is often dangerous for someone without round-the-clock support, and that you’re worried about them living alone. Ask experts to advise them about their health conditions, and to present possible solutions. Involve other family members to help them understand the benefits of moving into an assisted living community. Highlight the success stories of other elders who transitioned to these communities, and are enjoying their lives.
Talk about future possibilities, advantages, health benefits, cost-effectiveness, and a longer life span. After these discussions, give them ample time to think. This is a big and tough decision, so grant them space to consider what is in their best interest.
If you are interested in knowing more about senior living services, such as assisted living, memory care, retirement communities, senior living communities, nursing homes, and old-age communities, please feel free to browse through our senior living blog or use our assisted living facilities locator tool.
About the Author:
"Elderly Parent Refuses Assisted Living: Plan of Action" is authored by Anisha Rao, MPP, Healthcare Consultant, Certified Lean Six Sigma Green Belt Healthcare Professional. Anisha holds a Master of Public Policy from the University of Maryland, Baltimore County, as well as a Bachelor of Arts in Health Administration and Public Policy, a Bachelor of Arts in Psychology, and a Minor in Management of Aging Services. Anisha has extensive experience in Healthcare Services and Aging issues, including dementia care, senior health, and nursing home care. Anisha is passionate about ensuring seniors receive the best care possible and empowering seniors to become more involved in their care planning decisions.