Help Not Wanted – No Caregivers Need Apply!

In-home caregiver showing up for work and being greeted by client at front door

One of the most common and frustrating issues family members of elderly seniors face is their parents’ resistance to accepting care in the home. It is the epic battle between safety and autonomy, and every day it plays out across America in different communities in different ways. It is often an agonizing time – one where adult children feel guilty and powerless as they watch their stubborn, vulnerable and cognitively intact parents make choices that are fraught with danger. If this sounds like dealing with adolescents all over again, in many instances, it is. Seniors  want to continue to assert their independence, but are in denial or chose to accept risk high levels of risk rather than lose their sense of control. Here are some strategies to consider if you think you may be facing a similar situation in the future.

Prepare and plan in advance

Initiate conversations with the senior ahead of time about their core values and goals about aging. Ask open-ended questions like “Where do you see yourself in your older years?” Explain that having a strategy to achieve these goals is important in making them a success and that you would like to help them plan. Just as one prepares for other life transitions such as a selecting a school or a college or planning a wedding or retirement, one should also have a plan for what happens when assistance is needed with basic activities of daily living. Revisit the conversation regularly and reassess as needed.

Explore attitudes and feelings about having care in the home

Is it about a lack of privacy, economic fears about the cost of care, losing independence or all of these factors? Empathize and validate their feelings, but also cite the benefits of a well-matched home care assistant – more socialization, a structure that can support independence and peace of mind for families.

Start low and go slow

Offer seniors options and some control over the hiring process – this may be allowing them to interview and choose the candidate or hiring the caregiver for shorter care hours than you may be comfortable with initially, with a plan to incrementally increase the hours once the caregiver relationship has been established in the home.

Make sure the caregiver match is right

Introducing a caregiver and vulnerable senior can often be seen as like a dating game – there needs to a certain chemistry between them to allow a bond to form and develop a mutual trusting relationship. Care and consideration should be given not only to care competencies and experience but also matching personality types. Seek out reputable placement agencies and home care agencies that allow you have some control over the candidate selection process.

Turn a crisis into an opportunity

If there is a fall or hospitalization, use that crisis to introduce or reintroduce the plan for having a caregiver in the home. Get the support of the medical team and social workers to reiterate that a safe discharge home will necessitate hiring home care. Offer the option of this being renegotiated if the senior’s abilities to care for themselves improves to the point where they no longer require assistance oversight so that you don’t take away their hope of one day being fully independent.

Engage the services of outside expert such an Aging Life Care Professional/Geriatric Care Manager

Seniors often respond better to professionals over family members and will be more likely to follow their advice even if the counsel is identical. A care manager can assist in assessing seniors’ care needs and hours, research financial options to support care, vet and screen caregivers and provide oversight and guidance with managing a caregiver team. Go to to find an aging life care professional near you.

Written by Anne Sansevero