There may come a time when one notices their parents experiencing difficulties with everyday activities, such as dressing, cooking, or doing laundry, and other household chores. Bills may be left unpaid or mail may be left unopened.
As a person ages, keeping up with tasks that were once done with ease, may become more difficult. Upon observing this, an older adult’s child, family member, or friend may inquire about their health and well-being and try to initiate a conversation to suggest different options. This discussion may include asking them to consider having a caregiver come into the home or transitioning to an assisted living community. However, introducing this subject may spark resentment or denial.
Why an Older Adult May Be in Denial
If attempts to discuss options with an aging parent are met with denial or resentment, there may be underlying causes. One must understand the source of these feelings to progress toward having an open conversation.
There are many reasons why an older adult may be in denial about aging and the need for assistance. Some may include:
Pride: Independent individuals do not want to admit they can no longer do many of the things necessary to live on their own. They don’t complain, despite pain or hardship.
Embarrassment: Older adults may become self-conscious or ashamed they can no longer accomplish what they once did. They may need help with activities that are very personal and private, such as using the toilet or bathing or they may be uncomfortable admitting that they are having financial trouble even though this can lead to the inability to afford food or medications or to make needed household repairs.
Fear: Older adults may be afraid they will no longer be able to enjoy independence and things they once did. More seriously, thoughts of end of life, suffering, or pain may cause them concern.
Depression: Senior parents who are depressed may not talk as much as they used to, may smile less, and may seem withdrawn. They may make comments about their passing or life after they have passed away.
Any of these underlying causes can make a meaningful conversation about the next steps difficult.
Best Ways to Support a Senior Parent in Denial
Knowing why one’s senior parent may be in denial and refrain from having a conversation about the future can be helpful in better supporting them throughout the discussion.
Below are some tips to keep in mind when trying to have a difficult conversation with an older adult:
- Sometimes it is best to leave the subject alone if it is not a crisis. Return to the conversation another day, but make sure to not give up. Having these difficult conversations with older adults is a process, not a one-time chat.
- Be mindful when speaking with them. Don’t focus on the past or delve too far into the future—concentrate on the here and now. Eliminate distractions and potential interruptions from phones, televisions, etc. Pay careful attention without judgment and show the older adult a physical, mental, and emotional presence. Active listening conveys care.
- Prepare as best as possible for the conversation. Start with observations and be honest about concerns. Offer the older adult some options to consider. For example, start by suggesting a housekeeper or a cleaning service come in several times a month to help with household chores or a personal caregiver to assist with bathing several times a week.
- Explain that it is for their health and to prevent possible consequences such as medical intervention or transition to a community that is not desired. When a senior agrees they may need help, it benefits them in the long run.
- Talk to siblings or other family members and friends beforehand so everyone agrees with how to best address the situation.
- Keep in mind that it may be helpful to speak with a geriatric care manager, clergy member, or counselor who can provide guidance about how to best approach or mediate a potentially difficult conversation. Geriatric care managers in particular can best explain how to help an older adult navigate their options.
- Certain situations may provide a better opportunity to initiate a conversation. For example, temporary help after a hospitalization or illness can give a senior a chance to get used to having assistance at home—take advantage of opportunities to introduce the idea.
Develop a Support System
Having a difficult conversation with a senior parent or older adult can also be challenging for their child/children, other family members, or friends.
- Talking with siblings or other close family members or friends about concerns.
- Enlisting the support of the other parent when appropriate.
If there is no progress towards helping an older adult get the help they need, it may be beneficial to set some boundaries. It may be important to communicate to a parent, other senior family member, or friend, that if they choose to do nothing to help themselves, their children and others may have to cope with the repercussions.
If things progress to a crisis or if there is a question of competency, undue influence, or self-neglect, enlisting the help of an attorney about guardianship proceedings may be required.
Having these more difficult conversations will be more effective for everyone if there is a sincere understanding of the health and safety concerns involved. It is helpful to remember that starting the discussion and presenting an older adult with options is sometimes the best thing to do.