What to Do When an Aged Person Refuses Care - Supporting Their Independence

Some older people don’t want our help, and despite our best intentions, arguing with the person or their family member regarding their need for assistance can worsen an already complicated situation. If an older person refuses help there is, unfortunately, not a lot we (caregivers) can do without consent.

As caregivers we seem to be constantly looking for signs that seniors in our society are not coping with their activities of daily living.

Supporting Independence

If your client is resisting help there are a few things you can do. For example, see if you can determine whether they can manage the basic functions of living. Furthermore, does independent living pose a risk to their safety or that of others?

• Make sure that they are safe in their own home
• Try and remove or reorganise any obstacles around their home that may be a hazard or falls risk
• Suggest they acquire a personal alarm in case they cannot reach the telephone or call for help
• Consider whether a mobile phone would be useful for them to carry around with them when they are out, and make sure they know how to use it!

Digging Deeper

When it comes to allowing help into their life, some older people may resist. Help tends to be thrust upon the person without their input and a loss of independence can outweigh the actual benefits of receiving this help. Always involve your client in discussing their options and have alternative options ready for them to consider.

• Start by discussing with your client what the minimum amount of help they would accept would be, and build from there
• Ask them whether receiving assistance a few times a week may be preferable to every day
• Helping your client with shopping allows them to make decisions and be active, however, you must be careful to not cross any professional boundaries
• Older people who live on their own may find it hard to be motivated to cook a single meal every day. Discuss whether meals delivered by an outside organisation like Meals on Wheels is something they might benefit from.

Facilitating discussion is the first step to helping your client find alternative ways to maintain their independence, and will make it easier for you to discuss future needs when the time comes.

When They Just Won’t Budge

We must always respect someone’s refusal to consent to care. Some older people have lived through a life of hardship and forced independence. This can make it very difficult for caregivers to instigate help for someone who is determined to live independently at home.

If you are concerned that a person may no longer have the capacity to make decisions for themselves, then seek appropriate medical assistance. Cognitive testing or the appointment of a legal guardian may be needed. If you suspect cognitive impairment, then you must consider both your own safety and that of others; the client’s transportation needs; their capacity to make independent financial decisions; and so on.

Trying Our Best

Often decisions regarding care and living arrangements are made at a time of crisis. The sudden need for solutions may reduce people’s ability to think clearly. Keeping an open, ongoing dialogue with older adults, whilst also developing an action plan, will alleviate some of their potential stress and anxiety. If your client doesn’t want assistance for the time being, have a plan that can be activated in the future. The time when they need more help may arrive sooner than they think.

Author

Susan Tredenick

Susan Tredenick is a healthcare consultant with extensive experience in aged and community care. Operating in a range of industries, including Not-for-Profit, NGO and Private companies, she has a special interest in supporting people to be engaged with their healthcare management. Working with innovative companies allows this to be a reality as well as develop her interest in delivering speaking engagements to the community. With a background in nursing and management, her career includes roles in clinical and case management as well as project management with Telehealth and Telecare Research. See Educator Profile