If you’re caring for a family member or friend who won’t accept paid assistance, you’ll know that it’s a difficult situation. It can leave you exhausted as you try to meet all of their care needs single handed. It can also put you under a lot of pressure and leave you resenting the loved one who will not accept care and support.

When you have the tough conversation to try to encourage your family member or friend to encourage them to change their mind, there’s no single approach that will work for everyone, but here are some ideas to help turn the situation around and hopefully get the best outcome for both of you.

1. Talk, listen and identify their concerns

Try talking to them about their concerns and why they are refusing assistance. Once you understand their concerns, you may be able to work out how to arrange support in a way that will be acceptable to them. Here are some examples:

  •  Catherine needed help to shower, but didn’t want paid support because she was concerned the staff might be male. She had been showered by men while in hospital and didn’t like it at all. When Catherine was told that she could specify that she wanted female support workers she was happy to accept paid assistance.
  • Mark needed help cleaning his home but was concerned that support workers might steal his valuables. So, when Mark identified the valuables he was concerned about, his mother helped him to ensure his treasured items were secure. Now he is happy to have support workers clean his home and he feels relaxed when they visit.
  • Sharon needed help with fixing meals but didn’t want paid support, because she is a fussy eater and wants her sister, Chloe, to make her the meals she likes. So, Chloe and Sharon identified her favourite meals and have written down the recipes. Sharon has now agreed to accept help, knowing that support workers can use these recipes to make meals for her.

2. Let them know your main concerns

You probably have a lot of reasons why it makes sense for your family member or friend to get help from support workers. Before you start this conversation, identify one or two main concerns that impact on their wellbeing. Also, let them know how providing care unassisted is putting pressure on you. Avoid getting into an argument or berating them with all your concerns. Even if you can’t get agreement straightaway, you may find they think about the concerns you’ve raised afterwards. Staying calm during the discussion means the topic doesn’t become associated with negative emotions, making it easier to talk about again later.

3. Identify the benefits

Clearly identify how they will benefit from receiving extra support. For example, a support worker may provide transport and assistance with outings, allowing them to get out more often. Or maybe, having a support worker to help with basic tasks like cleaning will allow you more quality time together doing the things you both enjoy.

4. Recommendations from others

Enlist others to provide advice. Are there other people whose opinions your family member or friend would listen to? Some people disregard family members, but will listen to a doctor or case manager. Could a trusted friend, neighbour, GP or therapist provide an introduction to a support worker they trust or a support service they recommend?

5. Agree on taking the first step

Even if you can’t agree on getting paid assistance, you may be able to agree to begin the process by applying for funding. The NDIS provides funding for a range of supports, including equipment, transport and home modifications, which your family member or friend may more readily accept. The process of developing a support plan encourages thinking about what they want to achieve and their needs and wants – which can be motivating. After doing the NDIS plan, they may decide for themselves that they could benefit by accepting help from support workers to achieve their goals.

6. Provide alternative options and involve them in making decisions

No one likes being forced into something because there aren’t any alternatives. Always involve your family member or friend in considering the options and making decisions about what will suit them. Selecting the service provider or the individual support worker can provide a level of confidence. They can decide what services they want and when they want them. It might reduce their anxiety if you present these new arrangements as a trial that can be changed if they don’t work out. It’s a good idea to limit services for a few days each week initially, as some people find daily visits too intrusive, disruptive and tiring, especially when they are getting used to new support workers.

7. Take it slowly

Try to arrange a low key introduction to the support worker to establish familiarity and provide the basis for a trusting relationship.

For example, Frank’s support worker, Lisa, didn’t enter his house for the first three weeks. Initially, Frank and his daughter met with Lisa over coffee at a local shopping centre to discuss the types of support she could provide. Lisa rang Frank every few days to ask how he was and establish a relationship. Next, Lisa went to Frank’s house to see him. She wasn’t invited in, but had a short chat at the front door. After a few visits, Frank invited Lisa into his home to talk over coffee. Now Frank sees Lisa as a valued assistant, allowing Lisa to help with social outings and shopping.

Ultimately, it’s their decision

With patience, hopefully you will get your family member or friend to accept needed assistance by using a combination of these techniques. Ultimately, however, if your family member or friend is competent to make their own decisions, they can decide not to accept assistance. We need to remember that we each determine our own way of life and the person you care for may have different priorities than you. Everyone has the right to make their own decisions about their level of personal hygiene, how clean their home is and how much risk they are willing to accept.

Just remember, if you’re exhausted and needing help, sometimes it’s up to you to be clearer about how much help you are able and willing to provide. From that, your family member or friend might better understand your limitations (and hopes and dreams) and it might help them prioritise at least a few areas in which to accept paid assistance.