Helping People Who Don’t Believe They Need Help

Sometimes, the people who need our help the most do not think they need any help, from anyone. These individuals may thwart our efforts to help them in various ways: (1) they try to cover up their problem(s); (2) they deny a problem exists; (3) they cancel appointments we make with medical providers or providers of psychological services, such as counseling; (4)they become angry, threatening to sever ties with us if we insist on helping; and more. Often, their denial of the problem and anger toward us, for exposing the problem, are due to their unwillingness or inability to face the reality of their situation. These negative reactions to our offers to help can be turn offs, to the point many would be helpers give up. Giving up is precisely the wrong thing to do. For example, when my late mother showed obvious (at least, to me) signs of dementia, I went to great lengths to conceal our destination on the day we went for her initial cognitive evaluation. Only when she saw the sign on the door, “Memory Center,” did she realize where we were going. She was, understandably, quite angry with me for a long time. She “acted out” in several ways, including cancelling follow up appointments I had made for her, throwing her medication in the garbage, and screaming at me. Did I give in, allowing her to rapidly decline in cognitive capacity? Of course not. I strengthened my resolve, including asking the neurologist, psychologist, and social worker to ensure their staff members confirmed Mom’s appointments with me, instead of her. I allowed Mom to scream at me to her heart’s content, never once responding in kind. When my brother, Frank, became her primary care giver, I worked closely with him to help him understand that helping Mom would not be easy. We devised several methods to work around Mom’s non compliance, such as grinding her medications in a nightly milkshake, then characterizing the milkshake as a treat she deserved for being such a wonderful mother to us. (It worked!) All of this is to illustrate the old maxim, “When there is a will, there is a way.” Sometimes, one has to move outside a comfort zone, particularly with mentally ill or cognitively impaired people, to provide help they do not believe, or understand, they need. Looking the other way is an option, but it is a poor choice when someone’s life is in our hands.

Helping those needing help is especially challenging when that person is an adult, a parent perhaps, as Melissa noted.  Our experience with my parents was certainly difficult because, for a long time, neither of them realized what the rest of us did – they needed help.  They needed help to move, while they were still independent, into a community where appropriate levels of care would be available.  What was obvious to us was that Mom’s cognitive abilities were in decline.  Dad refused to admit it, preferring to “cover” for her.  That is a pretty common scenario.  But, Melissa and I, along with my brothers, pressed the issue as a united front and finally got things in motion that needed to be done.  The fact we approached this in a united manner took work but was critical to the success we had in making changes, getting help, and ensuring that their quality of life was as good as it could be for as long as possible.  The goal of maintaining their quality of life drove the decisions, the help, medical care, and living arrangement decisions.  Having a goal is a big part of helping those who may not want help.  It is difficult to admit needing help, to admit things are changing.  Butting heads is not a solution.  Arguing is not a solution.  Logic, love and compassion go a long way in helping those who need help.  Of course, if the in need person has dementia, logic is sometimes not too helpful.  And, it is at that stage that one must do things that must be done sometimes, behind the scenes.  With dementia especially, this means getting legal documents such as a health care surrogate and power of attorney while it is possible (or face the need to have this done by court order).  These things become the tools that allow medical or other care providers to take direction from those other than the person in need.  We handled this well in advance of the need – planning ahead is a plus!  In other scenarios, such as “Cousin” who I previously mentioned, the challenges of getting the needed paperwork became an impediment to obtaining help.  There is a risk in getting involved, or in trying to help.  One must do a personal “cost-benefit” analysis, with the realization that things can get much worse than they are at the time of the analysis; they probably will.  

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