How do you get a person with early to moderate dementia to accept outside help?

kath, I love that strategy, I’m going to try it!

Penny2018:

Since your MIL lives in part of your home, there should be ways around bringing in outside help. Our mother lived alone, 1.5 hours away, making it hard to assist, or even know how much help she really needed! We tried the home aides, initially just one hour/day, mainly to check on her and ensure she took her meds (we put in a locked dispenser.) Mostly they would just chat, but one tried to do some minimal cleaning for her. The plan was to increase what they would do and how much time was needed as her dementia progressed, but this was not to be. It only lasted a few months and then she refused to let them in. So, we had to work on getting her into MC (refused help, refused to move ANYwhere, felt she was independent, could care for herself and cook!)

I would suggest having the cleaning/meal prep person come while you are home (the suggestions of calling this person a friend who is helping YOU is one I would also recommend.) Since you both still work, unfortunately that would have to be on a Saturday when you are home (it will likely cost a little more being on a weekend, but worth it to get started.) Aide comes to YOUR entrance, gets introduced as YOUR friend, here to help YOU - then you can "work" a little bit with the person while they clean and perhaps eventually prepare a light meal. If you can get her going with this, eventually you can wean yourself out of the picture, keep drifting off to take care of something on your side of the house. Once she is used to this, have the person say they cannot come on Saturday, but will be free on another day and see how that goes.

As for shopping, you have to do your own, just pick up what she needs while you get yours. That should be easy enough to do. It might take a little more time, but really does not incur a huge impact - probably less time than if she went with you to pick out her own! Also, many stores do have that order/delivery option now as well. Just having a person to take over the cleaning and maybe some meal prep will certainly help reduce your stress. Start slow, work slow, see how it goes! One other option for meal prep - include her in your meals when possible, or make enough to set aside some for her later (refrigerate for use on a subsequent day or freeze for a later day - I make meals as if I am still providing for family and then freeze most of it - doing this randomly over a week, I end up with enough meals that I do not have to cook for some time!) I did try doing this to help mom too, putting some in her freezer so she was not always eating those nasty frozen dinners, but she would not remember that she had them in the freezer, so that really did not work well for her!)

Hope something we have suggested helps! Best of luck!

Its trial and error.I broached the subject lots of times and my mum refused.eventually the lady from the agency rang her and had a chat with her and suddenly she agrees.I said oh you've changed your mind and she said well the lady was nice and I didnt like to say no.so sometimes someone else suggesting it is better.they can keep saying no to us but its a different story when its someone else.

My own late mother waited till the virtual eleventh hour and even then, she never said that she needed help. She was falling, starting fires in the home and said in a childlike voice "I don't have to tell you everything." She was none too happy when 2 vehicles pulled into her driveway from 400 miles away-my husband's and mine (I was staying there for as long as I had to. He was returning home).

Mushycat: Your MIL's statement would have to be amended along with way to say "I cannot do what I could." It's good that you had that "friend."

Since you both work, the help will not come from you. Perhaps she can get assistance from a church, as they are always gracious.

MaryFH, my sympathy on the passing of your Mother.

My mom also refused outside help. I lived with her in her home (I'm 60, and she died 2 weeks ago). Sometimes threats have to be made. It's hard, but might need to be done. So, tell her it's either an aide coming in or she'll have to go to a nursing home. While my mom didn't like someone coming in, she grew to like the aide. We used an agency (bonded) and had a 3-hr minimum. She came once a week and helped mom with a shower and did light cleaning, laundry (I also did laundry), and changed her sheets. Eventually we had a 2nd day a week added and it was a different aide on that day - mom didn't like that. Try 1 day a week. But tell her that you need the relief an aide would give to you. Also, someone told me 2 days ago that their mom had been in an in-law basement suite and they'd installed a video camera so they could check in on her when they were at work (from their phones.) Sometimes their mom would leave the faucet running etc, and they could call to tell her to shut it off.

You might engage with a local geriatric care manager. They are skilled at working through issues like this.

My mother accepted in home care only because she lost her driver's license due to dementia. Aides came 2-3 hours a day for a couple of years. She considered them mainly as drivers, and would not allow them to do much of anything else. She often dismissed them after 15 minutes because she "couldn't think of a thing for them to do." After her friends started telling me how much she had declined, I begged her to move to assisted living. She refused (and kept dismissing the aides early.) I got a guardianship, moved her into assisted living, and she is now in a much safer place. It's hard especially when you have a loved one who resists, but you have to do what you have to do.

Great thread! upstream takes another tack :) and ahmijoy and others all have some great themes. ‘It’s for me, not for you’ has worked for me. Also, that ‘it’s someone we know’ - so you should just meet them first. I had a visitor coming in most of last year, she had to move on, now I need someone new and Mom’s resisting again... I think mostly because ‘the person’ is theoretical, which always sounds scary. Lightly repeat that someone coming in is how to prevent her having to move where they provide care. Like some others here, Mom thinks she’s going to get smarter or more capable... it really tweaks your heart. penny, you can do this - it’s really by hook or by crook, YOU need it and you’ll just find ways to make it palatable for her... and let her get over it if she ever gets miffed. Good luck!

My MIL also would not accept help. She used to say “you do what you can, and you leave the rest”. I used to say “you do what you can and get help with the rest” but she would never agree. When I reached breaking point, we started out by saying we could not take her shopping this week but my “friend” could take her. The only way my MIL accepted help was by thinking that these people were my friends. We made up stories about how we were “friends” and we handled the payment on the side. As time went on, this friend stayed longer and did more.

When my mom first refused help we mentioned the problems to the doctor. Mainly that mom wouldn't or couldn't manage her own pills and refused our help. The doctor ordered home care to teach her how to manage the pills. We told mom it had to be done. Now mom did everything to try and get the help not to come, but I intervened. Is there anything you could get the doctor to agree that she needs help? The doc would probably only order a few weeks of help, but then you could continue it on your own. Medicare paid for moms first few weeks and once the home care came they noticed other things mom needed and the doctor ordered that done too. It was such a great help and we ended up with 6 weeks of home visits 3 days a week. Once the weeks of free care were over we were unable to continue it because mom was still in control of her money. By then we were already on our way to get conservatorship and guardianship to correct that problem.

Honestly if you are nice enough to accommodate her living in your home, tell her it's your rules or she will have to find another place to live, such as assisted living. It's insane that you would have to work around this in your own home, especially since you and your husband are still working.

My mom refused home support in the beginning. Part of it was she just thought she was going to get better. Part of it (the bigger part) was she comes from a background where No One Outside the Family Can Ever Know how bad things really are.

The way I got around it was to tell her home support was for ME, because I have a disability now, and I was exhausted and couldn't do all the things she expected me to be able to do. And I did start small as well....AND on the premise that it was just till she was well enough to do things on her own. Now I am about to expand the home support hours we receive, because she is worsening and I am at my wit's end....but she's already accepted the workers, and likes the cheerful help she gets from them, so she is able to accept more of that help.

Thanks so much for all the responses. Lots of good food for thought. Needed to get out of my head. :)

We were in the same situation (my Mom in a MIL apartment). However, my Mom was a bit more flexible. I always had house cleaners but she never was interested. Finally after my Dad died (he helped) we convinced her to try it, and she found she liked it. We started by having them come infrequently and she herself suggested that they come more often.

Later as she developed dementia I needed a break from food prep/shopping/meds/etc for her. So we started having someone come in from a service a couple times a week. At first she didn't like it and sort of pouted. But the service matched up a really great person with her and after a few times she seemed to enjoy the company.

Shortly after that though we felt her dementia was such that taking on her care was more than I could do or wanted to do. So my siblings and I found a very nice assisted living place. She wasn't happy about moving but trusted us kids to make the right decision. I am very glad she moved when she did (2 months ago), because she has become physically weaker and things are set up much better there for her. And I don't think I would have slept well with worrying about falls/periods of confusion/etc.

Good luck figuring things out. Mom pouts and gets grumpy about her loss of her life. But we kids think it is more about the fact that she wants her brain and body of 10 years ago that she is most grumpy about.

You could also try telling her you know someone in need of some part time work and you want to help her out. "Would it be okay to have her come do some cleaning, laundry, run some errands? It would really help her out." She might see it as though she is giving service to someone in need.

You could also try things like having groceries delivered, that is getting popular.

Have a house keeper come in and do the entire house... Hers is now just a part of what is being done?

It does not help in your case, but I wonder if it is better to bring in regular outside help earlier than later?

For my former mil, who still lives in her own home at 83, about 10 years ago we had issues with grocery shopping. I would invite her to come along with me, but she only wanted to on the rare occasion, then would complain about not having any food in the house. I told her about a service offered through one of the local grocery stores, that shops on day and delivers the next. It took a couple years to get her onboard, but now she loves the service. She gets a call every Monday to get her order, the person who delivers on Tuesday puts there perishables away and leaves the rest on the counter (once a new person left the bags on the floor) for her to put away.

It was far easier to set up prescription delivery. She is fearful of running out of medication

In your case, perhaps the dementia has progressed to the point where food shopping to food prep is confusing, and she is no longer capable of managing it? Even if you buy her groceries, does she know what to do with them? Would Meals on Wheels be an option?

How long are you prepared to 'keep her at home'. are you and your husband in agreement as to what point her care will be too much to handle at home?

Has she had her dementia reassessed recently? Is she capable of understanding that if she does not accept care at home, you will have no choice but to find an A/L, M/C or nursing home for her? That may change her tune.

What if, instead of telling her SHE needs help, you tell her YOU need help?? “Hey, Mom, I’m super busy this week and can’t get to your laundry/cooking/cleaning. My friend, ——, is coming by to help me out. She’ll be here at 10. Can you show her where you keep your cleaning supplies?” And then, “Thanks for letting my friend come by and help me out. Did she do a good job? That was so nice of her to give me a break! I may ask her to come by again next week, too!”

Edited to add: Also, START SMALL!! My MIL refused to believe they needed any help. After asking her several times and being rebuffed over and over again, my husband finally decided to stop asking and just tell her who was coming. The biggest thing she fought us over was driving, but it sounds like your MIL is beyond that already. All the other things we finally learned she would be OK with if we just did them — med management, bill paying, housekeeper, morning helper, etc. She’s finally to the point where she’s feeling SPOILED with so much help!! Which goes right along with her selfish personality. 😏

Yes well we r stressed because we r doing all those things for her. She has significant memory impairment which complicates everything. She has decided she doesnt want to go shopping anymore, which we have done with her for the past 4 years. So I am really asking how to introduce some outside help in a way that will be accepted.

I’m playing Devil’s Advocate, but I can tell you that I understand how she feels. I need help too. I’m caregiver for my 67 year old husband and over the years, have lost myself, including the energy to clean the house, do laundry, etc. However, to have a stranger, no matter how skilled and kind, to come into my home and do those things, would seem very invasive to me. Someone your mom’s age was raised to believe that men brought home a paycheck and their wives did everything else. What is she doing in her little apartment that is causing your husband to feel stressed? Is it an unhealthy situation as far as spoiled food possibly causing roaches or other insects? In that case, Mom has no choice. Take her out for the day, and while you’re out, have a professional, cleaning service come in. Prepare for an epic meltdown when you return, but firmly and kindly explain to her that she needs to keep her home clean because it’s your home as well. As for the shopping, I’m sure you need food as well. Take Mom with. My mom used to really enjoy our weekly shopping trips and stop for fast food on the way home. Occasionally, when you cook, make enough for Mom too.

Lastly, have a talk with your husband and see if he thinks Mom is still able to live on her own. He may not want to say anything to you if he feels you wouldn’t agree. This may be causing him stress.

Good luck and let us know.