This is part of a series of articles that walk families through the decision process of hiring a home care agency. Additional topics include how to evaluate home care agencies and caregivers, aligning expectations with home care agencies, and how to choose between residential options and at-home care. Click here for our full series of articles on home care.

Or, start from the first article here: How Do I Know If My Loved One Needs Home Care? 

It’s tricky territory to open the conversation with a loved one about whether additional care is needed in order to remain at home safely.

People want to be independent, and most adults have enjoyed years of autonomy in which they’ve maintained an independent lifestyle. When a family member, presumably a younger person, proposes that their ability to live independently is in question, it’s natural for people to respond defensively. 

It presents a role reversal in the direction of care, usually between a parent and child(ren), and it can be quite challenging.

Approach the conversation as a neutral observer

Approaching this conversation from a standpoint of neutrality will contribute to best outcomes. Think of yourself as an observer who is sharing your perception of the situation that appears to be unfolding; this approach will elicit an entirely different dialogue than placing blame or shame on someone.

You might say, “I’ve been noticing some changes, I’ve observed this about X. Would you be open to talking about some of the things I’m noticing? Perhaps you can offer me insight about some of the changes I’ve seen in you recently…”

Setting up the conversation in this way creates context for exploring something together, rather than a situation in which someone feels interrogated.

Don’t accuse: be an observer, not an investigator

Despite good intentions, questions and statements can be made without thinking that lead to alienation rather than connection. Examples include: “Mom, why are you doing that?” “Dad, I don’t understand why you didn’t shower today. You told me you showered, but you didn’t.” “Your sink is filthy, don’t you ever clean it?” Such accusatory questions and comments cause hurt and create disconnect between people. 

The gateway to open conversation comes from being curious, compassionate, and accepting. In this way, you create space for discovery, to find out what is happening to cause the changes that are of concern.

Be an observer rather than an investigator. For example, are the symptoms you’re seeing are a result of depression or dementia? You may not discern the answers in that first conversation; however, opening up the dialogue will likely provide insights that would otherwise not have been revealed.

Reactions: How you handle resistance depends on urgency

Oftentimes, anger is the initial reaction to the proposition of implementing care at home. Anger is a natural reaction to the perceived threat of losing something valuable; independence, for most people, is their most treasured asset.

People who perceive their own decline may work diligently to cover it up, especially for family members. Others don’t recognize the changes as they are occurring, and respond with resentment and hurt feelings when being asked to accept care. 

Be prepared for a family member to be sensitive, dismissive, or angry. These are natural reactions that happen when people feel vulnerable or disempowered.

Most of us realize, especially with years of adult experience, that pushing anything too hard onto another usually doesn’t lead to our intended or desired outcomes.

Ultimately, the urgency of the situation will inform you of how to handle resistance from your loved one. If you perceive a low level of urgency – your loved one is functioning safely at home with appropriate support from family and friends – then use your judgment around how much attention the conversation about home care requires at this time.

Keeping the dialogue open after the first conversation

You might say, “Thank you. You accepted my invitation to have this conversation and I acknowledge your courage in doing so. What I’m hearing is that you still feel perfectly safe to be at home. I have a better understanding of the situation, and your explanation has lessened my concern about your safety at home.”

You could conclude by saying, “Can we agree to keep this dialogue going? Would you be open to having this conversation again in the future? It would really give me peace of mind to know that we’re open and clear with each other. I’m interested to hear about how you see your life now, and your vision for the future.”

On the other hand, a call from the police that the stove had been left on, and a dangerous situation had been averted by the fire department, suddenly you’d find yourself with an urgent situation to address. Your approach would require more purposeful action in which you would make decisions to ensure your loved one’s safety.

About the Author

Karen Faith Gordon specializes in providing support to individuals and families addressing issues of aging. Services provided include mental health counseling, grief counseling, patient advocacy, medical care coordination, real estate and placement guidance to address short and long term care needs, and adaptive yoga for optimal well being.

In a system fraught with bumpy rides, Karen provides guidance, direction, and reassurance to achieve optimal well-being for older adults and those caring for them.

Karen’s ideal client is someone who is facing the challenges of a spouse/parent/loved one who is experiencing cognitive or physical decline. This client seeks guidance and support from a knowledgeable expert to create a plan to address short- and long-term needs.

Her relationships with clients, colleagues, and providers of care reflect years of collaborative effort to achieve best outcomes. She has presented to audiences locally and nationally to educate on topics of care management, affordable health care, and the benefits of yoga and aging.