As a Social Worker who has dedicated her professional career to working with older adults, one of my challenges has been working with older adult couples who are in need of assistance and they refuse help. I have found that couples who have a 40 plus year relationship, married or partnered to be steadfast in their commitment to each other and “their plan.” This plan involves denying and refusing all help and presenting a united front. They have cultivated and honed a verbal and non-verbal language that to the average person, and even a trained Social Worker are unable to penetrate. Their loyalty to each other and “their plan” is commendable even though frustrating to their children and Social Workers who feel we have the solution to their age related difficulties.
Often, adult children have thrown in the towel after years of trying to help with no success. These well-meaning offspring of the united couple are concerned about their health and safety, and their suggestions are quickly dismissed. With the advent of the profession of Care Managers aka Aging Life Care Mangers, adult children have sought solace in the knowledge and skill of a trained professional. There are times; I have been successful in being the professional who is not genetically related to the couple and thereby able to discuss potential services. This, of course, has to be done in a very slow, respectful approach. There are times that I have been viewed as an outsider and the walls of denial and rejection are fortified.
I recently met a woman whose father is overwhelmed with caring for her mother due to her memory loss. This dutiful daughter has attempted to talk with them about the idea of getting help in the home. Their answer is NO; we don’t need any help. She even took her father on an outing, to an event her mother would not want to do, for the sole purpose to speak with him privately. This daughter notices his fatigue, slower gait, and his less cheerful disposition, and still her father claims they are managing well. Upon return to the home, her mother demands to know all that was discussed while they were away and reminds her husband of “their plan” of remaining independent. And so, the fortress continues!
I often wonder what the secret pact meeting was like when couples vow never to let any help into the home, even at the expense of the other spouse’s energy, health and mood. What is apparent is their desire to remain together and the many years that they have spent together has sealed the deal.
My recommendations are always to enter this situation knowing you might have an easier time breaking into a bank than to get much-needed services into the home. I have cultivated recommendations to the adult children:
- Find the person that your parents are most likely to listen to and enlist their help. This may be their sibling, a Physician, a clergy member, a former co-worker, their Attorney, Financial Planner, neighbor, another child or grandchild. It is recommended if all family members are in agreement in recommending help. The more often the couple hears the same suggestion, the better.
- Realize the process is going to take time for this valued person to lay the groundwork for the conversation about accepting help. This is not a one-time Be patient!
- Remember to listen, a lot! It is important to learn the reason why they don’t want help in the home. Most often it is fear of losing their independence. Knowing what concerns them will help you to reassure their specific fear.
- Ask the couple if they can envision what it will look like when they need Try to see if they can formulate what has to happen for them to accept help.
- Normalize the idea of accepting help: reassure them that throughout our lives, we have benefited from the assistance of others. Reminisce about giving and accepting help.