Are you having trouble convincing your parents to let you help them keep track of their doctor's appointments or balance their checkbook? You’re not alone.
According to a 2017 analysis of National Health and Aging Trends Study data conducted by The Commonwealth Fund, 45 percent of community-dwelling Medicare beneficiaries age 65 to 74 required help with at least one activity of daily living (ADL) or instrumental activity of daily living (IADL), or have probable dementia, yet reported receiving no assistance. Results were similar (42 percent) for seniors age 75 to 84.
This equates to millions of seniors who are not getting necessary help with simple activities like bathing, dressing, grocery shopping and managing medications. The problem is that older adults are often resistant to receiving assistance from their grown children, even (and sometimes especially) when they desperately need it.
A 2013 study conducted by an Oregon State University (OSU) researcher sheds some light on why convincing an aging loved one to accept help can be so tricky. After a series of in-depth interviews with seniors, their adult children and hired caregivers, study author and OSU associate professor Michelle Barnhart and her colleagues concluded that many adults offer assistance in a way that makes their parents feel “old.”
Addressing the Stigma of Aging
In America, going grey is regarded in a distinctly negative light.
We equate advancing age with a host of undesirable traits, including dependence, forgetfulness, grumpiness, confusion, disengagement and a lack of productivity. It's no surprise that few adults—even those who are technically “senior citizens”—categorize themselves as being old.
“We go from thinking of ourselves as children, then young adults, then adults—then we stop,” Barnhart says. She goes on to explain that conflicts often arise when younger family members interact with their aging loved ones in ways that challenge their identity as a competent, capable adult.
How Seniors Assert Their Independence
When their identity is threatened, older adults may lash out—sometimes even engaging in dangerous behaviors to prove their abilities and reinforce their own self-concept.
Barnhart identifies four strategies a senior may use to push back against feeling marginalized:
- Hashing It Out: Outright arguments are a common way for seniors to express their frustration at being categorized as old or frail. An elder will try to persuade others that they are not as old or incapable as they seem.
- Proving Themselves: Mark, one of the adult children who participated in the study, repeatedly offered to help Bea, his 82-year-old mother-in-law, with household maintenance tasks that required a ladder because he was afraid she would lose her balance and fall. Bea responded by rebuffing Mark's offers and proudly informing him each time she used the ladder to do something.
- Exclusion: Another interviewee named Abbie (89) took a different stance. When her cardiologist started addressing her two adult daughters instead of her during an appointment, she banned them from the exam room. “I wanted to grab him by the collar and say, ‘Look, talk to me! I'm the patient!’ ” she recalled. “But that was easily corrected. They don't go in with me anymore.”
- Hiding Indiscretions: After Abbie's daughters tried to get her to stop driving, she pretended to follow their advice and continued secretly driving her sister around.
How to Get Elderly Parents to Accept Help
Study authors identified two key tactics to help concerned adult children better communicate with their aging parents about delicate topics like increasing needs and planning for long-term care.
- Assess the Situation: Before jumping in with suggestions, take the time to observe how your parent is doing. What are they still capable of doing? What do they have trouble with? How do they think of themselves? Knowing your loved one's strengths and weaknesses and which of these are tied to their identity can help you figure out what they really need help with and how to best offer your assistance.
- Choose Your Words Carefully: According to Barnhart, many conflicts can be avoided if the adult child takes time to frame their proposal in the right way. For example, instead of telling your parent that they're too old to drive to a doctor's appointment, offer to take them and then spend the day together afterwards. Avoid emphasizing your loved one’s weaknesses and forbidding them from doing certain activities. Each person places different value on qualities like respect, self-reliance and a sense of purpose. A better approach is to appeal to the values that matter most to your parent and stress your desire to enable them to maintain and enjoy what independence they still have.
Of course, there are limitations to these suggestions. Some seniors simply do not respond to logic and refuse to accept help from anyone on any terms. Stubborn elders who are of sound mind usually must forge on alone until they are no longer able to do so. Older adults with dementia are another story, though. Since they are often incapable of acknowledging the true extent of their cognitive and physical decline, it often falls to close family members or friends to intervene (often legally), ensuring their health, safety and quality of life.
Ultimately, Barnhart hopes her study will help bring awareness to younger generations regarding how they communicate with their elders on any topic.
“The most surprising thing to me was how much control we actually have in terms of determining how we treat the people we're trying to help and how they see themselves in terms of old age,” she says. “Losing a bit of your independence by getting help from others doesn't have to equate with becoming a devalued and marginalized member of society. Everybody ages; you can't stop that. But what we can do is respond to someone's limitations in a way that preserves dignity and value.”
Sources: Use of Paid and Unpaid Personal Help by Medicare Beneficiaries Needing Long-Term Services and Supports (https://www.commonwealthfund.org/publications/issue-briefs/2017/nov/use-paid-and-unpaid-personal-help-medicare-beneficiaries-needing); Who Are You Calling Old? Negotiating Old Age Identity in the Elderly Consumption Ensemble (https://academic.oup.com/jcr/article/39/6/1133/1825272)