You’ve noticed Mom wears the same clothes day after day, isn’t bathing, and is wetting herself and hiding the evidence. It’s also obvious that she’s not eating well and forgetting to take her medicine. You’re concerned but don’t know how to approach her, after all, she tells you what to do, not the other way around! When you inquire about how she’s doing, she replies, “…just fine, thank you”. You offer suggestions to help but she gives you “the look”, you know the same disapproving look she gave you when you were a child. So, your dilemma is that if you confront her you risk insulting her but if you don’t she may become ill or in danger of harm. Anyway you look at it you’re going to be the bad guy.

Denial about the need for care usually comes from fear of being ill, getting older, embarrassment, or of being ‘put in a home’. Try to identify the fear and address it compassionately. Never make a promise you may not be able to keep, especially ” I’ll never put you in a nursing home”. Nursing home placement is the last thing any of us want for our loved ones but it may be the safest environment. Instead, tell her that you will do everything possible to see she is taken care of.

Choose a quiet time to talk to her and avoid talking when tempers are short or you’re feeling frustrated. Avoid accusing her of not eating, it will only lead to more anger and denial, just keep telling her that you love her and are concerned about her well being. Because the older generation is less questioning of what physicians tell them, use him or her as an intermediary whenever necessary. Ask the physician to talk to Mom and write down her health problems and a ‘prescription’ for help or services.

Always encourage your loved one to be involved with her healthcare. Collaborate together on a journal. Include day of diagnosis, daily feelings, frustrations, highs and lows, and results of appointments and tests, etc. Also include conversations you’ve have. Use the journal as a reference to remember what was said or done. It’s important that writing take place at the time of the experience or immediately after and that your loved one does the writing. Keep your own journal too. Use it as a dumping ground for pent up emotions and frustrations. Be sure to include those happy and humorous times as well.

Sometimes you must make difficult decisions that your loved one will not agree with. Step back, look at the situation and ask yourself, “Is she safe where she is now?” “Does she have the opportunity to live life to the best of her abilities?” “Are my emotions getting in the way of rational thinking?” When you keep her safety foremost in mind decisions are easier to make.
Witnessing changes in an aging loved one is difficult and role reversal is inevitable. Approaching it with empathy and concern for safety will make decision making easier.

God Bless.