Color & Control:

“Don’t tell me what to do!”

How to care for the stubborn, the determined, and the inflexible   

By Anjolina Rankin-West

Health professionals and family members often struggle to move decision-making forward. We know that providing care can be a big responsibility with unique challenges. But just how many of us are exasperated when trying to support individuals who are grumpy, resistant to change and acting in ways that make us feel worried, underappreciated and like a broken record repeating the same thing over and over again.

The tables have turned
Studies have shown that 77% of children with aging parents report that they’ve experience stubborn behaviour. As with teenagers, the desire for independence often collides with reality. In an older adults case it’s the need to acknowledge that the time has come to move, ask for assistance or give in to some safety modifications that sometimes causes the strong reaction to potential change.

Put yourself in their shoes and slow things down. Initiate the “future proofing” conversation early, when your parents are fully in control of their decision making. Talk about how they want things to look, and help them get a perspective on how expected and unexpected changes in their future needs could impact you and your family.

Open conversations
Make sure this is a fair exchange, where everyone feels equal and has a chance to express opinions and concerns. Some questions to consider:

• What type of care costs could be in their short- and long-term plan?
• Who would they want as their power of attorney? And is the paperwork in order.
• What aspects of their current lifestyle may need to be adapted so they can remain healthy?
• Where do they want to live and with whom?

Let’s dive into different ways to approach stubbornness and resistance, while maintaining positive day-to-day relationships: 

Understand their side
It’s important to remain empathetic, and understand that experiencing physical and cognitive losses is no fun. The threat of declining autonomy will have a great impact in most cases. Take time to listen. A respectful, non-patronizing person centred approach lets them know you still value their opinion.

Be sensitive
Though the recommended changes are clear and obvious to you, they may not seem that way for them. Being sensitive is important, changes can be scary, overwhelming and distressing. Don’t be surprised if they want to avoid the topic all together.

Approaching these conversations with compassion can help alleviate or at least reduce that fear of being pushed aside, left along or uncared for. Put an emphasis on the solutions and benefits that are available for them and the role you and others in the family are willing to take on. This could frame the situation in a more positive manner.

Constructive conversations
When emotions are high, conversations can quickly go off the rails. In order to stop this from happening, try not to talk at your parents. Rather, ask open ended questions to get them talking, even if they do have objections:

• Focus on “I” statements such as, “I’m feeling concerned due to…” instead of, “You need to change this…”. Address any concerns they have honestly and clearly.
• If you don’t know something agree to find out. This will help develop trust, showing them that you appreciate their desire to be included in decision-making and their wish to maintain autonomy. 
• Ensure the timing is appropriate, approach the topic when everyone is thinking clearly. If either party is feeling upset or anxious, put things on hold… chances are the conversation will be ineffective if you keep going.

Outside support system
Sometimes this back and forth can make a relationship feel like a “you vs. them” scenario. To avoid this, it can be beneficial to connect to trusted health professionals, close friends, siblings, and or good neighbours who can be helpful during transitions. 

The hardest thing to remember, especially in the midst of a crisis, is the importance of giving a little. When no one will budge you’re all stuck. Often, it’s impossible to get everyone to agree 100% with all of the decisions that are being made. Trying to find an agreeable alternative for now or a temporary solution will help move things forward.

Highlight the ‘why’
While maintaining independence can be a natural instinct, many seniors fail to understand the consequences of resisting care. Helping them understand potential downfalls  and how they could affect others around them is one way to show them the bigger picture. While they may not feel they need care, their actions could affect others around them. Refrain from speaking in punitive terms, or talking down to them, just assist in recognizing the reason behind the care, beyond just being told what they need to do.   

Live and let live
Emotions and anger can get pent up. Try and stay calm and take one day at a time. Don’t count on their mindset shifting overnight. It is important to treat your elders as adults, and remember how a shift in the relationship’s dynamic can affect not only them, but you. 

Don’t blame yourself or make accusations. The goal is to stay positive and worry about yourself too. Make sure you have a support system of your own in place that will give you an outlet for a) help b) expressing your concerns c) helping you deal with ongoing issues.

Anjolina Rankin-West is an editorial assistant who is part of the Canadian Abilities Foundation (CAF) partnership program.

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