How to talk about care without starting a war

Psychologist Emmanuella Murray explains the key to the conversation of care.

How not to start a war about care

Emmanuella
When you notice a parent living at home alone is starting to struggle – as Phillip has – how do you say ‘you might have to move into care’ without starting a war and hurting the parent’s confidence? Clinical psychologist Dr Emmanuella Murray offers advice.

Phillip:

My sister, two brothers and I believe Dad needs to be in care. We fear he may suffer an injury at home – and he is home alone. We touch base with him most days and have suggested we all visit some residential aged-care places, but he resolutely refuses to listen. What’s your advice? Do we just try to keep him as safe as possible and continue the conversation? 

A: What a hard place you are in. You all love your father so much, but are concerned for his safety. This is a common struggle for caregivers when an elderly loved one refuses help. Our elderly may have been grappling with life’s ups and downs for some time and to suddenly relinquish this control can be very frightening and daunting for them.

I love that you are touching base with him and trying to involve him in future decisions that concern him. Your instinct is right. Keep him as safe as possible and continue the conversation.

When talking to him about how he is going, try to keep it as relaxed as possible and look for natural opportunities to check in with him. For example, if you notice your dad looks tired after washing the dishes, you might say: “Dad, you’re looking a bit tired, it’s not easy doing the house chores.” See how he responds. If he doesn’t say much, you might self-disclose: “Gosh, we find it hard enough to keep the house clean and there’s four of us. I can’t imagine how hard it is for you.”

If he agrees or gives some version of a nod, then you have done an excellent job at letting your dad know you understand how he is feeling – even if he doesn’t say it out loud. Now it’s the time to offer some options.

You might suggest a housekeeper if your dad is warming to the idea of help, and you may find yourself having several conversations about the same concern. This can be frustrating for all involved but it can open the door for other deeper conversations about eventual residential care, somewhere of his choice, and not too far from you.  

In a nutshell, be patient. Consider it an ongoing conversation and remind your dad how much you all love and care for him.

If you have a question for Dr Emmanuella Murray, please send it to newsletters@yourlifechoices.com.au

Dr Emmanuella Murray is a clinical psychologist who has been practising for more than 10 years. She works with children, adolescents, adults and couples and presents to professionals and community groups. Visit her website here.

 

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    COMMENTS

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    Rosret
    27th Jun 2018
    12:22pm
    Find a place for him in your home and take care of him. The positive side is that you will get to keep all his inheritance instead of giving it to a Malaysian billionaire. He will thrive on the shared love your family has to offer and you will know he is being fed and looked after properly.
    I wouldn't have said this even 5 years ago. However I see what is being built over the road from me and its Auschwitz for the elderly. Nothing to look forward except death.
    KB
    27th Jun 2018
    12:29pm
    /I agree with Rosret. My mother took care of my grandmother and I moved home to take care of my mother, You can still access care at home for them if you need to be out or are working. Yes it can be an emotional and physical struggle but you need to remember that your parents raised and loved you, Not about the inheritance. Rosret
    Rosret
    27th Jun 2018
    12:43pm
    No, it was just a cynical comment as some young are so happy to dispose of their parents.
    Its like the plastic flowers on the graves. They make look pretty before they blow into the ocean but all it says is - we aren't coming back for a long long time.
    Kaz
    28th Jun 2018
    12:49pm
    Or get an ACAT assessment for him so they can help him receive help to stay in his home. The govt wants you to stay home as long as possible
    SKRAPI
    18th Jul 2018
    6:05pm
    Try your best not 2 put him in a home , There is very little nursing care .Oh they get showered, dressed & pills given but R mostly on their own otherwise. And most very lonely Shut off from familiar places & faces .I had 2 puthusband in when I broke my arm. He had Dementia He was terribly lonely Tried 2 places. All R understaffed . Staff don't have any spare time . I looked after husband & although I was ragged most of the time I'd do it all again in a heart beat . It was funny , tragic, amazing , miraculous but never boring .Nurses who came 2 shower him , all told me how it was in the homes where they had 2 do a stint 4 training , How they were always pressed 4 time not allowed 2 mske friends or speak 2 patients . Just money machines those places & once you R in their hands R always in your pocket . /May B U could share with your siblings & get home help , U won't regret it & U can always put him in 1 of those places if U have 2
    Hoohoo
    26th Dec 2018
    3:24pm
    It's all very confronting, for everyone.
    Be careful not to impose your own ideas (of what you want for yourself when you're elderly), rather than listening to your Dad's ideas. Obviously he wants to stay in his home for as long as possible, which you should help facilitate (with outside care coming in, if necessary). But he has to know that this decision will probably mean that towards the end, when he absolutely needs full-time care, he may have to go somewhere far away where he won't know anybody.
    The choice is to put off that scenario for as long as possible, or biting the bullet & putting his name down now, to somewhere close that has a great reputation.
    Recently, three of my very close friends have had to put their mothers into residential care. One Mum was already in an independent Aged Village (while her hubby was in a full Dementia facility), with the option to switch to a nursing Home. The Dad died recently & my friend was VERY careful not to put any pressure on her Mum, even tho she was becoming very frail & my friend (the only child), was exhausted physically & emotionally from long, long hours of care she & her husband were giving. So Mum has decided the time has come & is now in a new place very close by, where she knows the staff & the reputation.
    But for the other two Mums it's an opposite story. They were both in their own homes but recently hospitalised, & now physically unable to stay there. Both were quite dependent on the child in the family (who still lives locally). They've both just been forced to go into Care (at the next available room/bed - not their choice) & they both hate it (they weren't that happy at home anyway). The caring child in both cases were at their wits' end, AND they copped a lot of criticism from faraway siblings. Like Phillip, they wanted to help but knew they'd feel guilty if something happened to their parent while they weren't there. This DID happen to one of the Mums & she lay on the floor for half a day before someone found her.
    I suppose the lesson is for the aged parent to have power in the decisions made about their own care. But they can't make unreasonable demands on their children to provide all the care. Hopefully the children will offer it where they can. As Kaz suggests, get an assessment to see what assistance is available to stay at home - at least this might lift the burden on the children, so they can go on holidays or just even to take a break.
    Luckily Phillip has three siblings to spread the caring with, but it must be remembered that it's not easy for a single carer, especially if you have to give up working (with this possibly having a very negative effect on your own retirement options).
    There are plenty of really good Care Places out there (even wonderful dementia places), but if you're forced to jump when you can't possibly stay at home any longer, than you'll have to just put up with where you end up.


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