What can you do when you see that a loved one needs care, but he or she will not accept help? How can you encourage someone to accept assistance? The tips below may help.

Involve the person in decisions.

  • Approach the person with respect. If at all possible, the person should remain in charge of his or her care. Your role may be to facilitate decisions rather than to make them.
  • Watch for openings in conversations. For example: “You mentioned feeling tired. Are you having trouble keeping up with your chores?”
  • If the person doesn’t think he or she needs help, give examples of instances that have caused you concern.

Evaluate specific care needs.

  • Ask, “What kind of help do you need or want?”
  • Consider very specific needs, such as help with meals, household chores, or personal care.
  • Ask about needs for social support, transportation or medical care.

Ask the person about his or her concerns.

  • It may be easier to find solutions if you know the reasons for the person’s resistance. Acknowledge all concerns–they are very real for that person.
  • Some of the common reasons people resist care include:
    • Not wanting to give up their independence.
    • Being afraid of strangers coming into their home.
    • Feeling that the care would be too expensive.
    • Concern about burdening others.
  • A list of other health care providers the person is seeing.
  • Paper and pencil or tape recorder to take notes.
  • Necessary equipment like walkers, hearing aids, etc.
  • Calendar or datebook for scheduling follow-up visits.

Present Options.

  • A person may feel more empowered–and more likely to accept help–if he or she has options.
  • For example, a person who can no longer keep up a big house might: choose to hire someone to help with the chores; use only a portion of the home (for example, living only downstairs); move to a smaller space.
  • A person who needs daily care might choose to hire a home care company to provide a professional caregiver to help in the home.

Talk about your needs, too.

  • Sometimes people will not accept care on their own behalf but will accept it if they believe it will lessen their family’s burden.
  • Say, “If I know you are cared for, it will ease my worry” or “I’m sure you could do it yourself, but it would make me feel good to do it for you.”

How do you know when a person can no longer make decisions about his or her care?

  • Some of the signs that indicate a person is unable to make decisions include:
    • Not eating, bathing, or providing basic self care.
    • Not paying bills, or answering mail.
    • Doing dangerous things like leaving stove burners on.
    • Showing symptoms of memory loss or confusion.
  • All of these signs are subjective. Ask the person’s doctor to help you evaluate his or her ability to make decisions.

If the person still refuses care . . .

  • If the person’s health or safety is at risk, say gently but firmly, “We have to address this. We can’t put it off any longer.”
  • Bring in other people. Call a family meeting to strategize about how to help the person accept care.
  • Ask the person’s doctor, clergy or another outside person to step in. Sometimes an unrelated person will have more influence.

Don’t give up.

  • A person might refuse care at first, but over time may accept help.
  • Keep offering and providing what care the person will accept.
  • Take advantage of windows of opportunity. For example, you may be able to start providing help during an illness or following a hospitalization.

Take care of yourself.

  • Knowing that a person needs care but won’t accept it can be very difficult emotionally. Try not to take it personally. It is not your fault.
  • Consider talking about the situation with supportive friends, family members or a counselor. Think about joining a caregiver support group.

How will you know when to insist on providing care for a loved one who resists help? If you are unsure, ask a health care professional. If the person’s health or safety is in danger, consider contacting your local social services office or Adult Protective Services for assistance.

To learn about social and support services in your area, consult your local Select Home Care office. You can also call the Eldercare Locator at 1-800-677-1116 or visit its website at www.eldercare.gov on the Internet.