How to handle elderly parents who need help

Handling care for elderly parents

As parents get older, their care needs will change, and you may need to offer them more support with everyday tasks. Sometimes parents can become frustrated and defiant when their children–who they once cared for–start trying to care for them. Here, we are exploring what happens when ageing parents start needing more help from their adult children, how to recognise when this is needed, how best to talk to parents about their advancing needs, what to do when they resist care, how your own mental health could be impacted and how to manage this, and when to enlist the help of a professional caregiver. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about caring for ageing parents, we can help.

How do I talk to my parent about their advancing needs?

Sometimes older people are not as receptive to conversations about care as we might like them to be. If you fear your parent might be stubborn, aggressive or upset by these conversations, then planning ahead can help. Approach this with empathy and a focus on solutions by choosing a calm and quiet environment, and a time when everyone involved is relaxed so they are more open to your comments. You could do this over a cup of tea, or take them on a walk to their favourite place. Try to use a calm tone throughout the conversation, and always use respectful language. These discussions should highlight their struggles in a compassionate way and focus on a shared goal and solution. For example, emphasise that their safety is your number one priority. Try to find solutions together that could enhance their independence at home, instead of focusing on what is not currently working and their perceived shortcomings. As an example of this; if your parent is neglecting their personal hygiene, never assume that this is out of laziness. Chat with them about why this is the case, ask questions about their physical and mental health, and anything that could be stopping them from getting washed and dressed each day, such as mobility issues or depression. It is best to use “I” statements rather than “you”, which could seem accusatory. Use phrases like, “I’ve noticed a few changes recently, so I want to make sure you have everything you need”. This addresses the issue in a more general way and opens it up to discussion, instead of highlighting specific mistakes they might be making, or using patronising or condescending language. Try to use active listening skills and make it easy for them to come forward to you about their concerns, care preferences, and anything they are worried about. By doing this, you can build more trust within your relationship and gain insight into the things that matter most to them. Always reassure an older parent that you are not trying to take over their home and routines, you are simply checking in to see how you can better support their independence. Give them peace of mind that they will always be consulted for their opinions and preferences, and that no one is trying to take away their autonomy.

What if they are in denial about their needs, or resist help? 

One study found that 77% of people believe their parents are stubborn about accepting help with daily tasks. Ultimately, older people do not need to accept care or help that they do not want, so sometimes older relatives may refuse care, and there are a few reasons for this: 

• They may have a fear about becoming a burden to their family members – studies find those who receive care often feel guilty and embarrassed by receiving more care than they can give in return
• They may have a genuine belief that they can continue to live independently without any help 
• They may resent the feeling of losing control of their life and decisions 
• They may experience emotional challenges like anxiety, depression, or frustration with ageing
• They may not believe anyone else could do things the way they like them done, such as cleaning their home or doing their hair every day 
• They may not trust anyone who provides external help, like carers, and may only want help from their family 
• They may believe that getting care means being moved to a care home (not always the case) and will resist on this basis

Keep in mind that stubbornness is fairly normal in older people who become unable to manage their own routines over time, and this is not necessarily a reflection of your relationship with them. As your parent slowly loses their independence and abilities, they may become embarrassed, or continue to live unaware of their advancing need for support.If you are trying to get through to your parent about their need for more care, expect this to take more than one discussion as it may take time for them to come to terms with the idea. It is best to pick your battles and avoid struggling with them over every small need they have. Focus on safety issues and major health needs first, and slowly expand from there. Here are some things you can do to broach this subject in a healthy way: 

• Start by trying to understand the reasons for their stubbornness, denial or refusal of help so you can address this first 
• Focus on their biggest struggles and come up with solutions together that would address these to make their life easier 
• Address their biggest concerns, such as how they will pay for help, stigma about receiving care, fears that loved ones will visit less often, fears about strangers in their home, and more 
• Gently discuss the potential consequences of not taking any action at all 
• Highlight the benefits for them and for you (or their regular caregivers) that would make the transition worth it 
• Give them time to consider the idea and respond calmly rather than reactively 

If your parent refuses to talk about their situation or continually dismisses the idea of extra help, keep in mind that they are still adults with the right to make their own choices, so you should always take their feelings into account. Remember, the autonomy of older people is important for their wellbeing, so respect their needs, wishes and values, unless they are being stubborn about something that could cause them direct harm. You may find more useful information in our guide on how to handle an elderly relative who is refusing care.

How to manage your own emotions during challenging times 

Handling an ageing parent who needs help, is refusing help, or is being obstinate about their changing needs can cause a lot of distress and emotions for adult children trying to manage these care needs around other responsibilities. You might find it difficult to strike a balance between respecting their independence and worrying that they may hurt themselves. If you are in this situation, you may experience feelings of frustration, anger, helplessness, guilt, or sadness when your parent is making it difficult for you to offer the care they need. Some coping strategies that can help include: 

• Being honest about how this impacts your mental health, and speaking to friends or loved ones about the toll it may be taking – a 2023 Carer’s UK survey found that 79% of carers feel stressed or anxious, and 49% of carers feel depressed
• Looking into counselling to process difficult emotions about your parent ageing, which you can do via the NHS or a private counselling service 
• Practising mindfulness or relaxation techniques to reduce stress and learn to manage the load more easily 
• Setting boundaries in order to protect your mental health
• Recognising the limits of your responsibilities for your parent
• Recognising your own need for breaks and time off from caring, and taking action on this before suffering from burnout – research suggests caregivers who are experiencing strain have a 63% higher mortality risk than others
• Keeping an eye on your physical health – the 2021 Census in England and Wales found around 1 in 4 carers reported ‘not good health’ compared with non-carers
• Acknowledging any feelings of guilt, frustration or helplessness that may come up as your parent ages, and recognising these as natural emotions that you needn’t ruminate on unless there is something you can do to change them 
• Looking for support groups in your local area to help you meet others in a similar position who may understand your feelings 
• Knowing that asking for help is not a sign of weakness or failure, and other people are often happy and very willing to take some of the weight off your shoulders 

A National Health Service survey found that 20% of carers felt they were neglecting themselves, so remember, much like the airplane advice to put on your own oxygen mask first before helping others, it is important to take care of your own needs and wellbeing first to ensure you are better equipped to take care of your loved one with the level of patience and compassion they deserve. You may find more helpful information in our guide on what to do if you’re feeling trapped by caring for an elderly parent.

When is it time to bring in professional assistance? 

Understanding when you need respite, and when it is time to enlist the help of a professional care service, can keep both you and your ageing parent in the best health. Your parents may be reluctant to bring a carer into their home, but doing so can help to support their mobility to reduce the likelihood of falls, ensure their basic needs are being taken care of (such as personal care), and help with medical needs such as medication management or catheter changes. Social services in your area can arrange a Care Needs Assessment at any time, and can discuss the best way to set up a care arrangement for your loved one. Similarly, a private care provider like Home Instead can advise your family on the best way to set up the care your parent needs, and organisations like Age UK could provide further guidance, support options and respite services. If you are unsure whether it is the right time to bring in professional help for your ageing parent, you can also speak to their doctor for impartial advice on your parent’s independence and capabilities at home. Financial worries can impact the choice to pursue professional care at home, so if this is the case for you, you may learn more useful information in our guide to paying for care.Ultimately, if your parent continues to resist care and this creates safety risks for them, or they are neglecting their basic needs such as bathing, eating or taking necessary medications, you may need to have a professional, experienced carer visit to help. Always reassure them that bringing in help from a professional carer does not mean their autonomy is at risk, it simply means your parent will receive care that is more aligned with their exact needs, and preserves their dignity and wellbeing. 

How do I maintain a positive relationship with my older parent?

Discussing care needs can cause disagreements in families and arguments that can create a negative atmosphere at home. Maintaining a positive relationship with an ageing parent will help everyone involved, as it can enable you to enjoy caring more, and not fall into feelings of resentment. Find ways to spend quality time with your parent without centering this around their care needs or solving their daily problems, such as doing a hobby together or watching a TV show together each week. Remember to foster trust and cooperation in your relationship with your parent, as this will make the situation easier on both you and them.If you are unsure of where to begin when arranging care for an ageing parent, it usually helps to gauge their exact needs by organising a Care Needs Assessment that can identify exactly what their main issues are, and what types of care, help, resources and home adaptations would help make their life easier. Around the same time as organising this, you should be talking to your parent about how they are feeling, what they think their needs are, what their biggest struggles may be, and more.Once you know what they need most, you can start to create a plan with input from your parent, professionals, other family members, and anyone else who may be able to advise on the best course of action. You may find local services or charities with vast experience of helping other older people like your parent. In addition, private care providers like Home Instead can let you know what your parent may need, how to start arranging this care, what the care arrangement will look like, and more. Our experienced, supportive Care Professionals can become a trusted companion for your ageing parent, providing you and them with the help you both need to maintain quality of life at home. For support in arranging care, reach out to your local Home Instead office to discuss your options.We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.