Dakota Travel Nurse Home Care

Keeping home an option!

When an elderly parent refuses care, what can you do?

Senior Couple QuarrellingEvery story is a little different, but if you have an elderly parent who refuses in-home or even a doctor’s care, or who says “No!” to things like bathing (see previous blog), giving up the keys to the car or accepting help with housekeeping, you are not alone.

Two personal examples

I have found some sources with what seem like excellent ideas to try, but if they don’t work for you, I hope you’ll take comfort in two of my “failures.” First, a little background. My 95-year-old father has had pneumonia 7 times and suffers from pulmonary fibrosis. Each hospitalization was followed by time spent in a rehab center. Because his wife is 9 years younger, she thinks that means she can adequately care for him, which sadly isn’t true.

After one rehab stay of several weeks, Dad was told he could only go home if he had around-the-clock professional care. With much resistance from his wife, my brother and I hired a caregiver. We found after several days that she had been told not to come upstairs from her room in the basement because there was “nothing for her to do.” We had to let her go and do what we could with short visits from family and hourly home healthcare aides.

After his most recent bout of pneumonia, Dad was told by his rehab center case worker that he could not be released to home unless he and his wife agreed to the following conditions indefinitely: use a walker, use oxygen 24/7, crush all pills, sleep less and exercise more. Sadly, after only a few weeks, he gave up the walker for his cane, refuses to use portable oxygen when he goes out, takes supplements that aren’t being crushed (the nurse who gives him an insulin shot daily crushes his prescriptions), has gone back to sleeping 5 or more hours during the day and he mostly just sits when awake. He insists that these behaviors be on his terms, not those of a healthcare professional or ours. For him, it is a quality of life issue, regardless of the risks.

Advice from “the experts”

Nikki Heinert from The Alzheimer’s Association ND/MN chapter provided us with the following tips for working with a parent who resists getting the needed help:

Pick the right time to talk. Avoid times of high stress. Look for openings when your parent expresses concern, then listen actively, trying to understand. Don’t jump to solutions. Ask how you might help with the concerns they have mentioned.

Earn your right to talk. Make sure you give hands-on care, preferably overnight and for a few days, before offering advice.

Stay focused. Focus on the care of the patient and the health of your well parent. Find other ways of expressing your own feelings of frustration or grief.

Prioritize. The patient and caregiver’s health and safety are main concerns; management of anxiety, depression and anger are important. Don’t sweat the smaller stuff.

Begin small. Suggest easy-to-take steps that will make a real difference, such as having someone whom the caregiver trusts come in and help with specific tasks.

Use allies. A family meeting allows all to express their concerns and agree on a plan of shared care. A doctor or social worker may lend authority to discussions of health needs and community resources.

Have a Plan B. In the course of demands, crises such as accidents or decline in health will dictate changes, despite caregiver resistance. Have a plan for crisis care.

Use tough love, if necessary. If a parent is being abused or denied needed health care, call Adult Protective Services. A social worker will ensure that needed care is given.

Respect your parents’ choices, if they are legitimate. This may be the way they want to live out their lives together, even if it involves some uncomfortable choices.

Dakota Travel Nurse Home Care can help

When you call Dakota Travel Nurse Home Care, we will come to your parent’s home, and with you and him or her present, do a Free personal care consultation. Our consultations are confidential and there is no obligation. We offer services on an hourly, daily, or live-in basis. When you engage the services of one of our certified professionals, we consistently monitor the situation to ensure that your elderly parents are getting the help they need and adjusting well to their caregiver(s).

by Marti Lythgoe, DTN Home Care Writer/Editer

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