Understanding Resistance to Care

As a care provider we often receive tentative enquiries from concerned sons or daughters realising a parent needs some help “but mum or dad is resistant”. 

Full of good intentions the caller tells us of recent falls, of decreasing appetite, weakening eyesight or decline in the home or personal appearance.  However, despite all the warning signals, mum or dad often appear defensive, resistive or negative towards the suggestion of a ‘little help’.  They remain resolute in their ability to cope, soldiering on as best they are able – it’s important to understand where this resistance originates and why a parent may be adverse to some assistance.

As a person ages, we may lose aspects of our independence and lifestyle, for example the loss of a driving licence or car impacts our social life, and ability to get out to appointments, purchase food etc and we may become more reliant on others for this provision.  We may lose our friends, because they become unwell, frail and housebound, or they may move away to be nearer their family, and some will pass away.  Frailties associated with ageing may also diminish lifestyle, eg deteriorating eyesight or mobility may the way a person lives in their home (no longer able to go upstairs, unable to cook or maintain the home as before) and the way they conduct their lives. These adjustments may come rapidly or develop overtime, all however mean the loss of independence and control over life, they may be embarrassing to admit and there is likely to be sadness over a life which is more restricted.

At a time of loss, and sadness the suggestion of well intentioned ‘help’ can be perceived as a recognition of failings or inability to cope.  An older person may be grimly hanging on to limited independence and the thought of having ‘help’ with the very few chores they remain able to achieve seems an invasion of those remaining abilities. 

Whilst some elderly fight vehemently to maintain independence, others see it as their ‘duty’ to stoically care for a failing spouse. A wife may see it as her ‘duty’ to care for an ailing husband and similarly an elderly husband, who fears losing his failing wife will do anything to care for her and keep her at home. 

Pride at independence will often play a factor in resistance to care, we are all very proud people.  We may be proud of achievements, of goals met, of family or success to date – this is no different for an older person who remains proud of what they have achieved and what they are still able to accomplish at their age.  Care may be seen to diminish independence and ebb away at that pride.

What is abundantly clear is that the provision of a little well placed, professional help at appropriate times of the day/week not only promotes independence but can actively encourage continuance of daily activities and abilities. Well chosen, sensitive, bespoke care enhances life and enables a person to remain independent for longer, in their home for a greater period of time. Home Instead is ideally positioned to provide supportive help due to the Company’s policy of longer visit times – if time is restricted it can be impossible to allow a frail person to achieve simple activities. Whereas with longer time, independence can be encouraged and facilitated. In task driven calls, it is necessary for the carer to ‘do the task’ as time is short (eg with no time to wait while a person struggles to tie shoelaces, it is quicker for the carer to time them for the client, thereby disabling and potentially embarrassing the client).

It is recognised that for human beings one of the greatest fears is that of failure, the acceptance of help can be seen as a failure – a failure to achieve.  Therefore, when carefully analysed it is possible to see why well meant ‘care’ can be viewed as a threat to an older person. 

In a later post we will examine how to propose and implement a little ‘low level’ support beginning and navigate around the resistance to promote the independence and well-being associated with professional, bespoke care.