Overview of Convincing of the Need for Care



How do I convince a loved one of the need for additional assistance?

Convincing a loved one of the need for additional assistance, whether in-home care or through residential care, can be a daunting challenge.  On the other hand, many families and friends encounter this hurdle, particularly as loved ones grow older.  Approximately 75 percent of people over the age of 65 will require the assistance of a caregiver during their lifetimes. 

As a physician who has undertaken discussions about caregiver assistance many thousands of times, I would offer that most reasonable people can recognize when they need additional assistance.  If a person coping with chronic illness declines assistance, it is essential to understand why she is refusing the help of a caregiver.  Often, the answer is one of the following:

  1. “I don’t want to leave my home.”
  2. “I don’t want a stranger in my home.”
  3. “I can’t afford the costs of a caregiver or assisted living.”
  4. “I don’t want to be a burden on my family.”
  5. “I don’t want someone telling me how to live my life.”
  6. “I don’t want to give up my independence.  I can take care of myself just fine.”
  7. “I don’t want to go to a nursing home.  Those places are awful.”
  8. “There’s nothing wrong with me.”


I can also tell you that I have come across many situations in which a patient cannot provide me with a good reason for declining care.  Frequently, the family and I have offered good solutions to every one of the excuses listed above, and the person in need of care will still resist assistance.  These people are often the individuals most in need of caregiver support.

It is also very important to understand that some patients with medical illnesses are gravely disabled and incapable of making safe, informed decisions regarding their own behalf.  Patients with dementia or some psychiatric illnesses, particularly patients with Alzheimer’s disease, often exhibit diminished insight and impaired executive function.  This means that they are not capable of recognizing that they are unsafe and at risk, even when all of their friends and family are certain that they need care.  Patients with dementia or psychiatric illness may not be capable of making rational decisions promoting their own best interests.  In these situations, it is often necessary to enlist the support of physicians, attorneys, and the court system to obtain a conservatorship.  A conservator is a responsible person or organization appointed by the court to make medical and financial decisions on behalf of a person who can no longer safely make these decisions for himself.



Understand and Allay Concerns

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