Well … You are not alone. Anecdotally, I can confidently report that 80-90% of clients coming onto service for care with Aberdeen were initially very resistant and insisted that they did not have unmet needs that required this type of intervention. “I don’t want anyone in my home. No one is trustworthy. No one needs to tell me what I can and cannot do in my own house. I am perfectly fine and don’t need anyone to babysit me. I’ve never fallen down the stairs before and do not intend to do that any time soon.”
In most cases, independence is not lost in one fell swoop. Aging is an insidious process, often clouding our eyes from what IS…and we are sometimes stuck on what WAS. We age inconspicuously even though it feels like warp speed. The body changes so slowly that afflictions like vision and hearing loss often go undetected by older adults. I know very few folks who have decided on their own with no help, solicited or otherwise, from well-meaning loved ones to go ahead and get those hearing aids, walkers, canes, or lifeline emergency alert systems.
“Dad is in complete denial about Mom’s memory loss.”
Families share that they are beyond frustrated when their suggestions are repeatedly refused. “We hope you have better luck than we did” is often a familiar greeting as we meet with new families and begin to peel the proverbial onion. Let’s take a new look at what this hesitation is all about.
Whether the issue is driving the car, money management, staying alone in the house, or other areas of vulnerability, removing any part of what is considered normal adult independence can be a crushing blow. We are Yankees. We hang onto the last vestige of self-determination … with all our strength.
Somehow, the “normal” aging process has become something to be ashamed of. The Old Grey Mare… ain’t what she used to be. Our entire society is based on refusing to age. Almost every product pitched to us via every possible method claim: Look Younger, Feel Younger, Be Younger. The word isn’t vibrant, relevant, active, or happy. Just Younger.
So, where does that leave those who are (like everyone) aging with normalcy? We are not all Jane Fonda … If we are not aging like the superstars, how does that make us feel? Worthless, used up, irrelevant?? The hit to the ego is big and, depending on the size of the ego in question, the strategy may be to keep this reality at the forefront of both thought and action.
There are indeed issues … and then there are ISSUES. Most of the time, we get more than one warning. Suppose something goes awry now and again, like a minor car accident, loss of something significant, or missing appointments. We can usually rationalize that these things can happen to anyone at any age. True. But do the math, add them all up, and see what you get for a picture. If you assess that safety of any kind is at risk, the game is officially changed.
Since most of us do not see ourselves objectively, we can relate to the feelings that arise when we are even gently confronted with behaviors of concern. When you do not see the need and do not acknowledge what IS, even if your own safety is at risk, you will refuse help. Some families are even struggling to get their loved ones in need to accept family help and intervention. The notion of rugged independence and self-sufficiency has landed many an elder in the emergency room, nursing home, or worse. How can we “break through” the resistance?
In one way or another, most of our dear ones have participated in the care of their own elders. They have been down this road before but are now in the hot seat. Gentle reminders of their own experiences can be incredibly helpful. “Dad, remember when you had to take the car keys away from Grampa? That was so hard for both of you. I know you hated to do that, but he clearly couldn’t drive anymore, even though he thought he could.”
What is the ultimate goal?
For most elders, it’s retaining as much independence as possible. Position the interventions that you deem necessary to support the ultimate goal. Maybe Dad can drive around town but not on the highway. Perhaps he drives between the hours of 9-3 and never in inclement weather. It’s not all or nothing. Make that clear. “Dad, if you are willing to modify your driving, you may be able to keep driving and your license for much longer.”
What could happen?
I have stories, actual accounts of what could have and did, in fact, happen, and it was not pretty. Imagine the long-term fallout of hitting a pedestrian who stepped off the sidewalk. When you are dealing with visual and hearing loss, maybe a touch of cloudy brain, which, of course, we all have from time to time, and a reduction in the speed of reflexes (normal aging process), add that up and see how easy it is to imagine this scenario. Even as a very defensive driver, I am amazed at how often I experience a “near miss.”
What to do?
Seek out education and draw from the experience of those in the know. If you were in a dental crisis, don’t bother calling the dermatologist; they can’t help you. If you are going through this, your friends, colleagues, and neighbors with elder responsibilities are going through the same things. We’ve never been here before, so it’s brand-new territory.
Like anything, everyone you ask has their own story and choices. They may have been “just right” in that situation, but not for yours. You know the players, the personalities, and the potholes in the family road. Trust that.
Where’s the help?
During the years when the tide flips, and parents et al. become less independent, especially when this goes against the very grain and core of a personality, it will be hard. Sorry. Truth. Do not navigate this on your own. Help is all around.
There are many excellent newish books that offer wisdom and insight. Councils on Aging and Senior Centers are great resources, too. Start the conversation. Be honest with yourself about the difficulty of challenging “family rules,” get support, and talk to those you respect who have been down this road. Personal narratives and experiences from those I value and trust have always been my best teachers.
The worst thing would be to ignore what you see and know. It’s not going to get better, and you know that already. Ask for help. There are lots of us ready, willing, and able.
Joanne MacInnis, RN, is the founder and president of Aberdeen Home Care, Inc., of Danvers, a concierge private duty home care agency in business since 2001. With 35 years of nursing practice, management and administration experience focused on home care and hospice, Joanne and her team specialize in advising and supporting families addressing the elders in their lives retain dignity and quality of life.
