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Transitioning your parent from their home to an assisted living facility can be a challenging and emotional process.
“This transition can often signify a loss of independence, which can be difficult for both the individual and their loved ones to accept,” says Erin Oczkowski, therapist and transitions specialist at SilverStay. “It is common for this experience to bring feelings of sadness, anger, fear and denial.”
These strong feelings and fears can lead many parents to reject the idea of moving to assisted living or a nursing home, even when they need the extra help or could use the social engagement. When an elderly parent refuses assisted living, you will likely feel stressed out and unsure of what to do. Here, we’ll go over what to do when an elderly parent refuses to move, along with expert tips and advice.
Key takeaways
- The idea of leaving home and moving to assisted living brings up feelings of fear and sadness in many individuals.
- Tips for managing this situation include validating your parents’ feelings, making a pro and con list and taking a guided tour of the facility.
- Sometimes outside help from a health care provider or therapist is needed to negotiate the move to an assisted living facility.
Why do some refuse assisted living or nursing home care?
There are many reasons why a parent might refuse to go to a nursing home or assisted living facility.
Fear of the unknown
At the core of someone’s refusal to move for care is often the fear of the unknown, says Oczkowski. Your parents may not be able to picture what their life will be like when not living in a home they are familiar with.
Not only that, but a major life transition like moving out of one’s home brings up lots of emotions. “It may represent a loss of independence, a shift in identity or coming to terms with aging and mortality,” says Oczkowski.
Concerns about facilities
Furthermore, adds Pooja A. Patel, an occupational therapist who’s board certified in gerontology and the founder of Aging Together, assisted living facilities and nursing homes haven’t always had the best reputations when it comes to quality of care. “There is a fear associated with loss of independence, isolation and the unknown when it comes to moving from your familiar home to an unknown ‘dorm-like’ facility,” she describes.
According to Patel, some of the questions and concerns that may run through a senior’s mind when considering this move include:
- Will I have privacy?
- Will my family still visit me?
- Will I be taken advantage of?
- Will I still be able to do things whenever I want?
Cultural considerations
Finally, in some cases, cultural perspectives come into play. In some cultures, younger generations are expected to care for their elders at home. As such, placing a parent in a facility may be looked upon as shameful or dishonorable.
“This can further create an internal conflict for younger generations who are trying to balance cultural expectations with the reality of caregiving demands, especially in a Western society,” Patel describes.
“Recognizing and addressing your loved one’s feelings with empathy and support can help ease the transition to assisted living or a nursing home.”
— Erin Oczkowski, therapist and transitions specialist
What to do when an elderly parent refuses assisted living
First of all, if your aging parent refuses assisted living or a nursing home, try not to panic. This is something that many families go through, and you are far from alone. Here are some tips to get past this hurdle and find your parents a warm, supportive place to spend the golden years of their life.
1. Validate their feelings — and your own
You may feel frustrated, stressed and upset. All the emotions you’re feeling are normal, and it’s important to let yourself feel these.
Likewise, it’s important to acknowledge that how your parents or loved ones are reacting is understandable as well. After all, this is a huge change for them. In fact — even though it may not feel this way — validating your parents’ feelings is the first step in moving forward with a care plan that works for everyone involved, according to the experts we spoke to.
“Recognizing and addressing your loved one’s feelings with empathy and support can help ease the transition to assisted living or a nursing home,” says Oczkowski. “Validating concerns while providing accurate and current information about the benefits and quality of care available can help reduce anxieties and help to make a well informed decision.”
2. Take a tour of the facility
If you haven’t already, it’s vital that you tour assisted living facilities. Seeing the facility up close in real life makes it less of a theoretical idea, and can give your parents a real taste of what life may be like.
“Arrange for a tour of the facility and maybe invite your mom or dad’s neighbor, trusted friend, bridge buddy or golf buddy to join them for lunch,” suggests Page Dickey, a therapist at Key Counseling Group who specializes in life transitions. “The assisted living facility may even match your parents with a resident at the facility who can share about their experience.”
3. Make a pro and con list
Consider sitting down with your parents and making a list of the benefits (and downsides) of moving to assisted living. “Helping to create a pros and cons list can give a sense of control in the decision-making process, making the transition feel more like a collaborative decision rather than a choice that has been made for them,” Oczkowski offers.
4. Bring in a healthcare provider or other support person
“Sometimes, parents will listen to a third party outside close family members because they are more objective,” says Saxena. “You may ultimately be saying the same thing, but sometimes, proximity to the situation can make it harder.”
5. Don’t force them into making a decision
Pushing your parents to move will only push them away, make them more angry and erode their trust in you. Instead, says Silvi Saxena, a licensed social worker and certified oncology social worker at Recovery.com, ask about their feelings and their fears without trying to fix them. Put on your listening cap and give your parents a chance to air out their grievances and share their feelings. Sometimes that’s all they need to move forward.
6. Help them meet their own goals
“Self-determination is strong, and if they are adamant about staying put, help them see what options are available in that setting so they are safe versus moving them,” Saxena suggests.
Sometimes it can be helpful to consider alternatives to assisted living or nursing homes as part of the decision process. In some cases, doing so will even help convince your parents that moving to a facility is actually the best choice. At other times, there will be other viable options that work for everyone involved.
Alternatives to assisted living and nursing homes
Here are some assisted living alternatives to consider, according to Patel:
- Home health aides. Aides come into your home to assist with regular tasks, personal care and activities of daily living. “They are best for individuals who require some level of medical and personal care (e.g., bathing, medication management, blood pressure checks),” says Patel.
- In-home skilled nursing care. “Skilled nursing care at home is medical care provided directly by a medical professional, such as a registered nurse,” Patel explains. Services may include physical and occupational therapy, wound care and post-surgical care, all of which require an order from a physician, and they may or may not be covered by certain health insurance companies.
- Adult day care. “Adult day care provides social, recreational and health-related services in a group setting,” Patel explains. Typically, the senior spends five days a week for three to six hours per day at the facility. “It is ideal for someone who needs structured daily routine and supervision, while allowing the caregiver relief during the day,” Patel shares.
- Hospice care. This care is for people in the terminal stages of an illness, typically with a life expectancy of six months or fewer. These services are usually covered by insurance and can take place at home or in a facility.
- Palliative care. This is specialized medical care for people with serious illnesses, with a focus on relief from symptoms and stress. Services are often covered by insurance.
“If they remain resistant, you may have to accept that they have the right to make their own decisions, even if we do not agree with them.”
— Erin Oczkowski, therapist and transitions specialist
Managing stress when an elderly parent refuses assisted living
As stressful as this process can be for aging parents, it can also be extremely stressful on caregivers. It’s essential that you take care of yourself during this time, Oczkowski says, because it’s very easy for caregivers to experience burnout.
Here are her tips for managing stress and avoiding caregiver burnout:
- Seek support from family and friends.
- Engage in regular exercise.
- Get plenty of rest.
- Eat nutritious meals.
- Practice meditation or other relaxation practices.
- Consider seeking spiritual or religious support, if applicable.
- Join online or in-person caregiver support groups.
- Reach out for guidance and support from a mental health professional.
What to do if you can’t reach an agreement
If you and your parents can’t come to a decision that everyone agrees on, it may be time to take a step back from the conversation and revisit it later when the dust has settled, Oczkowski suggests.
“If they remain resistant, you may have to accept that they have the right to make their own decisions, even if we do not agree with them,” she says. “Letting them know that we are always here for them if they change their mind, may give them the time and space to make the decision on their own.”
Sometimes, though, you can’t afford to wait, especially if you are concerned about the health and well-being of your parents, including their ability to remain safe and cared for at home. In this case, it may be time to seek help and support from your parents’ health care professional, a geriatric care manager or a licensed therapist who specializes in geriatric issues.
