My Caree Won't Cooperate


My Caree Won't Cooperate

You've finally decided the time has come: You need help in your caregiving role; you'd like to hire a home health aide to help with your caree's personal care. With your job, your kids, your spouse and your other commitments, you've discovered it's just impossible to do it all yourself. Amazingly, it's a relief to come to this decision.

Until you think about breaking the news to your caree. You know the news won't be welcomed by open arms---and neither will the home care worker.

Worrying about the tussle between you and your caree about getting help can cause you to re-think your decision to get help. It's tempting to give in to guilt, but in the long run, you'll jeopardize your caree's health and safety without the help.

If a caree refuses help in the house, work to get a commitment to use in-home care on a trial basis. For instance, when your caree says: "I will not have strangers in my house!", you might try this approach:

"Mom, I can understand your concerns about strangers in the house. I think you're wise to be skeptical that this will work. But, I also worry about you and want you to be safe at home. So, what if we try this? Let's try using a home health aide for a month. I'll be with you the first few times the aide comes. We'll have her come three days a week for four hours. I'll make sure you have a notebook and pen so you can jot down notes about the aide and how it's working out. I'll still call you every day, but we'll set aside Saturday mornings just to discuss the aide. So, I'll stop by to have coffee with you and we'll go over your notes. What do you say? Can we try this for a month and see how this works?"

It's important to get a commitment on a trial basis because often it's the springboard to a permanent commitment. And, if you take time to listen to your caree's complaints, you may be able to nip small problems before they become huge problems (and huge barriers to a permanent commitment). If, when you have your Saturday morning meeting, your caree shares complaints that concern you, you can contact the home care agency immediately on Monday morning to resolve them.

When introducing the idea of in-home (or any new service) to your caree, keep in mind these tips:

1. Listen for the meaning behind the words. Is your caree angry, sad, depressed? Love and fear are our two motivating emotions; most times, we act out of love or fear. It's easy to see actions from love. Actions from fear are trickier, though, because the fear can manifest itself in anger or guilt. And, those are very difficult emotions to deal with.

2. Once you've understood the message, then acknowledge your caree's feelings ("It's absolutely understandable why you would so angry and upset, Mom. How can I help?"). Acknowledging means you've heard your caree and that's a great way to bridge communication. We all want to be heard.

3. Involve a third-party, a trusted professional or family friend, who can help mediate discussions with your caree. Physicians, lawyers and ministers or rabbis often can help smooth rough waters with your caree. And, bad news is often best delivered from a third-party, rather than from you.

4. You may feel that you wear a t-shirt with a bulls-eye, at which your caree is constantly taking aim. Take off the t-shirt! If discussions become verbally abusive, end the phone conversation, walk away, take a walk, escape to your room. Remember that the disease and illness (and sometimes the caree's disposition and circumstances) are to blame---not you.

5. Give back some control. Be sure your caree has some control (when appropriate) over the decisions about care.

6. Show gratitude with words and action: Give your caree a hug and say, "Thank you for being such a trooper. It's great to be on the same team with you. Who knows what we can do together?" Positive words often create positive actions.

7. We all adjust to changes at our own pace. Your caree may need more time to adjust than you. That's okay. Take one step a time.

8. Bad moments during the adjustment are just that---bad moments. Don't give the bad moments the power to become bad weeks and months. And, when your caree has bad moments, love him or her through them, as Dr. Phil would say.

9. Be flexible in the strategies you use to help your caree with the transition. Some will work, some won't. If a strategy doesn't work, try something else. Think outside the box. Ask others for suggestions and ideas. Focus on your efforts, rather than on trying to control an outcome you think is right. When you keep your attention on your efforts, you control what can be controlled---you. Trying to control an outcome, which is trying to control your caree, will only frustrate and exhaust you.

10. Take breaks from the situation. Breaks will refresh you and provide you with different perspectives. During a difficult transition, you made feel like spending time with your caree is like sitting in front of the TV watching a barrage of bad news. When you take a break, you take a break from the bad news. You give yourself a chance to see the good news, to see what's working and to regain a confident footing.

Finally, have a back-up plan in place. If your caree won't accept help and you're still working on a strategy that will work, still contact home health agencies, adult day centers and facilities in your caree's community. Meet with the staff to learn about services and programs so you'll know which ones will best meet you and your caree's needs. If an emergency happens, you'll know which organizations will help. And, when your caree is ready to accept help, you'll be ready with the right organization.

To find a home health agency in your area:

1. Call the ElderCare Locator at 1-800-677-1116; you'll be referred to your local Area Agency on Aging, which can tell you about local home care agencies.

2. The National Private Duty Association consists of home care agencies throughout the country. To find a member in your area, visit the association's web site at