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Elder reluctant to try in-home caregiving, but help is necessary

Carol Bradley Bursack, Forum columnist Michael Vosburg / Forum Photo Editor

Dear Carol: Mom had a stroke two years ago and Dad provides her care. She's had health issues for over 10 years so he's actually been a caregiver for a long time. Now, Mom's developed vascular dementia. I don't think she's ready for a nursing home, but I do feel that Dad is risking his health by doing too much. They need help. The problem is that Mom doesn't want "outsiders" in her home, and Dad does what Mom wants. I help when I can, but I have a job and family and not much time. How do I convince them to accept assistance from an in-home care agency? — GB

Dear GB: Having strangers come into their home is hard for many people, so your mom's reticence is understandable. However, you are right that it's time for a change.

Start by truthfully telling your mom that unless your dad has some assistance around the house, his health may give out and then she'd need full-time care from others. She may be so used to having him care for her that she's never even considered this, but if you explain it straight out, she may understand.

Understanding the situation doesn't mean that she will welcome help in the home, so you may have to be a little pushy. Ideally, your dad will get involved, but if not, find an agency on your own. Look for an agency that has a local reputation for being dependable, and ask for references when you've narrowed down your list.

When you interview the agency, explain the situation and tell the intake person that you'd like to start by having a caregiver come to the house for coffee just to get to know your parents.

When the time comes, arrange to be there to welcome the caregiver. Have coffee and treats ready. You and your dad can and sit down to visit with the caregiver. If your mom takes part, that's great. If she won't, accept that graciously. Eventually, she may join you out of curiosity. This get-to-know-you session should help your dad feel more comfortable.

You and your dad can show the caregiver around the house and set up a time for her to come in and do some light housekeeping, fix lunch or do anything else that needs doing except providing direct care to your mom.

By the next visit, your parents should be more comfortable and the caregiver might be able to help your mom in a small way. As trust grows, your dad could use the time to go out with friends. Slowly, the relationship with the caregiver should increase and we can hope that your mom will accept personal care from this person who is no longer a stranger.

Not everyone has the luxury of making this change in such a gradual manner, so you are fortunate. Accept that you may have to try more than one caregiver to find a fit, but don't give up. This needs to be done.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of Minding Our Elders: Caregivers Share Their Personal Stories. Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached at carolbursack@msn.com.