Resistance to Assistance: Empowering Older Adults with Choice

By Regina Salmi, Area Agency on Aging of Western Michigan


As we age and those we care about age alongside us, we eventually enter the territory of difficult conversations and decisions. One of the most difficult discussions with a loved one is the recognition that a loved one needs more help than they currently have. Today, nearly a third of older adults live alone. Often, other family members will step up to help, but as the need for assistance increases many family members find that they do not have enough hours in their lives to provide the help that is necessary. While the caregivers might recognize the need for more help, the person who actually needs the help might disagree, even outright refuse help. 


The range of options as we age has dramatically expanded, because we’ve come to recognize that the most ideal situation for older adults is to be able to remain in our own homes as we age. Now the care comes to people, right into their own home, rather than needing to move to a nursing home for care. Support services are now available, even for lower income adults, making it possible for them to continue living independently. One would think anyone would be thrilled to learn about these options, but often, family members discover just the opposite. When presented with the possibility of having care come to them, some people resist assistance. What can we do?


The first step is to recognize that our loved one has been an independent, capable person, making their own decisions, and determining their life direction for decades. They do not want to hear what other people think is best for them.


Julie Alicki, a Social Work Consultant and Certified Advanced Dementia Practitioner with Area Agency on Aging of Western Michigan, states, “All too often an older child attempts to tell their parent what is “good” for them and in the process builds resentment because the parent feels that their child is trying to tell them what is best for them, when really they are the experts in their own life.”


It’s not wrong to present our loved ones with good options, but it is important that we remember they are self-determined individuals. Alicki suggests, “Using facts instead of emotional pleas for them to make changes is usually the best way.” This approach respects them as the main decision maker in their own life.


Timing is also important. All too often, families wait until either they are at their wits’ end or there is a crisis before they seek help. Wanting to establish in-home services for a loved one might be a good thing, but too much all at once can be overwhelming, presenting a dramatic change to a person’s life and their environment.


Alicki, who meets with individuals and their family members daily to review these options, advises families to “[Bring] help in gradually, for instance having someone come in one time per week for 2-3 hours to clean, is easier than to wait until a person needs help with everything and trying to have someone in the house numerous times per week; start slow and work your way up.”


As they become used to the change and recognize the benefits of the assistance, they may be open to more.


There will always be bumps in the road. Thankfully, there are professionals like Alicki who can help navigate them. If this is a conversation you need to have with a family member, contacting Area Agency on Aging of Western Michigan’s Choices for Independence program might be a good place to start. They are able to look at the situation and help individuals and families understand the range of options available to help them continue living at home. To make an appointment, call 888.456.5664 or email