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What to Do When Elderly Parents Fire Caregivers
From:
Pamela D. Wilson - Caregiver Subject Matter Expert Pamela D. Wilson - Caregiver Subject Matter Expert
For Immediate Release:
Dateline: Denver, CO
Wednesday, November 16, 2022

 

The Caring Generation® – Episode 154 November 16, 2022. What to do when elderly parents fire caregivers. Caregiving expert Pamela D Wilson shares tips for adult children frustrated with parents who need help but refuse assistance from anyone other than a family member. 

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What to do when you hire and elderly parents fire in-home caregivers? There are two sides to this story, both being valid. The first is from the family caregiver’s perspective—who put hours of time and effort into setting up in-home care. The second is from the vantage point of the elderly parent, who may only want family members to be the caregiver.

What to Do When Elderly Parents Fire Caregivers?

After examining both sides of this matter, the discussion will move to ways to work together and collaborate to meet the needs of elderly parents and family caregivers. So before discussing expectations, let’s start with the frustrations experienced by caregivers, who we assume to be exhausted and burned out. 

The caregiver wants and needs someone else, like an in-home caregiver, another family member, or even a volunteer—to step in and ease the time devoted to care activities. In addition, the caregiver may need time off from care activities to focus on their career, family, friendships, or social interests.

Realize that there is nothing wrong with a desire to hire a paid caregiver to help out with elderly parents so that you can go on with your life. I wish more caregivers would do this to better care for their health and pursue careers.

So let’s look at an example of a situation where an elderly parent refuses to have a caregiver in the home. The adult child or another family member spent time investigating care services to set up a caregiver schedule for a parent.

The paid in-home caregiver shows up for work on day one and is promptly sent packing by your mom or dad. Of course, if you’re the caregiver, all you can think is, what the heck just happened? I did all that work, and poof, all of my efforts went up in smoke.

Allow Elderly Parents to Be Involved in Hiring the Caregiver

So let’s take one step back. What was the outcome of the discussion with your elderly parent about hiring a caregiver? Was there understanding, agreement, or disagreement about the activities the caregiver would perform, the work shifts, and adjusting to having someone other than you involved?

Did your parent have the opportunity to meet the caregiver before he or she showed up at the house the first time? Involving a parent in the decision-making process is vital to avoiding you hiring and elderly parents firing caregivers. 

Working with a non-medical care agency with an experienced manager who is empathetic to the hesitation the elderly feel about having a caregiver can make it easier to work out the situation.

Now, let’s look at the other side of why elderly parents fire paid in-home caregivers.

While most adult children chalk this up to a parent being stubborn, negative, or difficult, it is more than this. Reasons for refusing paid caregivers can be about multiple considerations that might not be so obvious.

Family Culture May Affect Willingness to Accept a Paid Caregiver

The idea of dependence on others can have a cultural basis. Westerners—often defined as people living in the United States—focus on independence and pursuing personal goals. However, this assumption is not always accurate because people living in the United States come from many cultural backgrounds.

For example, the Asian culture focuses on positive family relationships above personal goals. Latino and African cultures also strongly value family and social relationships.

So when you think about caregiving relationships and combine these with health and well-being, differences exist about how to achieve these goals. Westerners or Americans tend to believe that health and well-being depend on personal control and mastery.

In contrast, other cultures believe health and well-being depend on harmonious relationships. Actually—a little of both can be the magic potion for success in family caregiving relationships to avoid the you hire and elderly parents fire those you hire to help.

So this aspect of elderly parents believing that family, not strangers, should be the caregiver can be the first hurdle in establishing cooperation and agreement on the need to hire outside caregivers. How do you jump this hurdle if you are an adult child or a spouse?

How to Shift the Idea of Who Needs a Hired Caregiver

parents fire caregiversOne way to shift the idea about who needs a hired caregiver is to make the need for hiring a caregiver more about you than a loved one. It’s no secret. You have a busy job, a family, and children.

You are the one who needs help in meeting an elderly parent’s need for care and their expectations that you will do everything.

Making the need for paid caregivers about the caregiver, not the care receiver, leads to the second point for you hire and elderly parents fire caregivers. Coping with parents who won’t accept paid caregivers coming into their homes.

Being dependent on others may not be viewed as a positive behavior in Western cultures. Western cultures value independence above all.

This means that your elderly parent doesn’t like having to rely on others or have outsiders know their business. If children are the caregivers, the need for care issue remains within the family. But if paid caregivers come into the home, everyone knows the family business.

Invasion of Personal Privacy

Parents may value their independence and personal privacy. So allowing strangers into the home to perform personal and relational tasks threatens their self-esteem.

Likewise, accepting help from a non-family member can be viewed as a threat. This can mean that the person receiving care cannot help themselves or might be less competent to manage their own needs or affairs.

I want to share research about the link between self-esteem, motivation, and avoidance from Park and Maner. I’ll place hyperlinks in the show transcript to the original articles if you are interested in reading this information.

This information might shed light on aspects of your care relationship. To find the transcript for this podcast, go to my website pameladwilson.com, click on the Media Tab, then The Caring Generation Radio Program, and search for episode 154.

Link Between Self-Esteem and Relationship Quality

So how does self-esteem link to relationships with others? How does self-esteem relate to the relationship your parents might have with in-home caregivers?

Research from Park and Maner states that people with higher self-esteem believe others will be responsive to their needs. On the other hand, persons with low-self esteem, like a parent or spouse with health problems, may worry more about protecting themselves from rejection.

So, in this case, instead of accepting the opportunity to get to know a hired caregiver, the most straightforward response is to reject the caregiver before the caregiver rejects your loved one. So in a sense, your parent purposely pushes away strangers who might be helpful for fear of being judged or rejected.

Instead, parents may withdraw from relationships and focus on all the things they struggle to do, in a sense, beat themselves up mentally for needing the help of others—for being dependent.

Add to this the complication of an unhappy family caregiver stressed out from dealing with a parent who drives much-needed help out the door.

How Stress Affects Caregiving Relationships

While the caregiver may not have low self-esteem, the reaction to their inability to make a parent happy or please a parent may be criticism by telling a parent that they are difficult or hostile. So as a result, the elderly parent isn’t happy, and neither is the caregiver.

People who fear rejection and those who criticize are more likely to be unhappy and react negatively toward others. This is a challenging place to be when you have primary responsibility for the care of an elderly parent.

Low self-esteem can result in feeling like a care burden. As a result, parents may fight the caregiver every step when they try to be helpful to improve their care situation. You hire elderly parents fire can feel like the caregiver is losing the battle.

How to Deal With Unspoken Issues

So how do you deal with the unspoken problem, which may not be that an elderly parent is stubborn or difficult but that they suffer from low self-esteem? It’s not as difficult as you might think, but it can take a time commitment and emotional labor.

The concept of time is easy to understand. Emotional labor means feeling “it’s all on me to keep things running smoothly” in a relationship.

How do you know if the concept of emotional labor is negatively affecting your caregiving relationship? You feel:

1 Resentful and frustrated

2 Taken advantage of as if you don’t do something, it will never get done

3 Unappreciated

4 As if feel like the other person doesn’t care as much or isn’t putting forth equal effort

5 Emotionally exhausted.

If you are a caregiver in this situation, what can you do?

Why Do Caregivers Feel Emotionally Burdened?

Look at the relationship and ask why you do so much.

  • Does fear drive your actions?
  • Do you wonder, will mom or dad be angry with me if I don’t do this?
  • Do you feel that you can’t express your feelings because doing so will result in more conflict with your mom, dad, spouse, or the person you care for?

If any of these apply, then there may be a communication gap that will benefit from a bit of attention.

Let’s talk about how parent-child relationships when we are young translate to relationships when we are older.

If you are the caregiver, it’s likely—more than not—that you had a positive relationship with the parent you care for. Or you may be in a care relationship based on feelings of responsibility and duty.

Of course, not all caregivers love the parent they care for. If this is your situation of caring for a parent you don’t like, then all of this can be much more difficult.

Complexities of Being the Primary Caregiver

Most families have one person, the primary caregiver, who steps up and takes on the majority of responsibilities even if other siblings exist. If you are an only child, all of this falls on you.

Thinking again of parent-child relationships, your sibling may or may not want to be involved in the care of mom or dad. While this can be due to life’s priorities like careers, marriage raising children, I talk to many caregivers who express concern about siblings who want nothing to do with a parent.

If this is your situation, consider that there may be something that you don’t know about your brother or sister’s relationship with your parents that has led to this breakdown. If this is the case, these siblings haven’t had regular contact with your parents since they moved out of the house. Therefore, asking them to become involved suddenly will probably not happen.

When Elderly Parents Experience Low Self-Esteem or a Lack of Motivation

So let’s talk about low self-esteem and how this can affect the willingness of elderly parents to accept outside help when they lack motivation or don’t want to allow insiders into their lives for fear of rejection. Let’s say that hiring a paid caregiver was your idea.

In most cases, the adult children or the spouse seeks services. Unfortunately, the person who needs care usually isn’t in a position physically or mentally to investigate this unless it’s following up on a plan they made when they were healthier.

Tips for Hiring Paid Caregivers

Or in some cases, a nurse or a social worker at a doctor’s office or community health center may help investigate and recommend services. Tip one for self-esteem support and avoiding you hire elderly parents fire caregiver issue is to involve the individuals most affected by the decision to hire a caregiver.

Obviously, this is you, the caregiver. But it may also be both of your parents if one needs care and you are helping your mom or dad, who is the caregiver, who takes care of your sick parent. Suppose you are fortunate to have siblings involved in caring for parents—ask if they want to be involved.

Let’s talk for a moment about hiring paid caregivers. You can employ independently, which means hiring an independent contractor. If this is the path you take, ensure you investigate what this means with a tax accountant and that you have a well-written agreement to avoid unexpected issues.

Or you can hire through an agency. Both ways work, but you must know what you’re getting yourself into. For more detail on hiring and supervising in-home caregivers, there is a detailed article on my website pameladwilson.com. It’s called 10 Tips to Manage In-Home Caregivers.

If you’re on my website, you can type this title into the search bar at the top. I will also place a link to the article in the show transcript.

This article is helpful because there can be a lot of assumptions about care agencies which result in disappointment about the person sent to care for a loved one or a revolving door of caregivers who never seem to stay.

Hiring Caregivers Can Initially Seem Like More Work, But . . .

Hiring an agency is more work at the beginning because you have to take the lead in choosing the right caregiver with the right background. And then, you have to ensure the caregiver knows what to do.

While some wonderfully experienced caregivers will show up and take the initiative to do what they see is needed, others have to be told what to do and then grow in experience over time. All of this relates to one of the reasons you hire and elderly parents fire caregivers.

The caregiver shows up and doesn’t know what to do. Your parent doesn’t feel like they should have to tell the caregiver what to do or supervise them. So they send the caregiver home.

Let’s look at ways to support collaboration when going through the steps of finding the right caregiver.  Involving the persons most affected by having a caregiver come into the home in decision-making can smooth out the kinks.

As the caregiver, you must be clear about the need for help. Because as you know, your parent will probably say that they don’t need any help.

Having a helper is a blow to the ego. It’s a blow to self-esteem.

Tug of War Care Struggles

hire fire caregiversTo be reminded daily, through the presence of a caregiver, that one can’t do the things one used to do.

So the idea of accepting why help is needed is a hurdle to cross when trying to convince elderly parents to agree to have a caregiver other than you come into the home.

Another obvious issue is money. Who is paying for the caregiver, your parents or you? Or is the caregiver through a Medicaid agency?

It can be tricky to convince a parent that they must spend their hard-earned and saved money on paid help. As a result, many adult children take money out of their own bank accounts to pay for caregivers.

While I understand a desire to pay for a parent’s care, my opinion is that if your parents have the financial resources to pay for care, they should pay for their own care instead of their children. So, let’s take another look at the conversations you want to have.

  • The caregiver is for you, not for your parents.
  • You need a break and time away from caring for your parents.
  • It’s not that you don’t love your parents—you do. But in all honesty, you are burned out.
  • Your children may be struggling with school because you’re never around.
  • Your marriage may be on the rocks because all your free time is consumed caring for your parents.

These examples are not to make your parents feel guilty. Although they probably will anyway. These are the experiences and the challenges of life.

Compromise is Necessary

There’s only so much time in a day. Both sides can compromise if your parents want to stay in their home.

A similar need for compromise exists with parents living in assisted living who may need more care than the community can provide. Parents don’t want to leave assisted living and their friends and routines to move to a nursing home. So hiring paid caregivers to visit your parents at their assisted living community may bridge having to move.

In addition to adult children needing a break, spousal caregivers who are 24/7 caregivers—there’s no time off for spousal caregivers who also need a break. You must be firm about hiring a caregiver if the person who needs care disagrees.

Caregivers experiencing health problems will eventually wear out or become sicker.  As much as you may not want to admit that being a caregiver can negatively affect your health, it can.

Caregivers are too busy to eat healthy, exercise, or maintain regular doctor appointments. So when you neglect these areas of your life, what do you think happens over time? You get sick.

I have caregivers who tell me, “I’ve never been sick before.”  My response is usually, well, perhaps this is a sign or a warning that it’s time to take better care of you before you can’t take care of a parent or a spouse who relies 100% on you.

What’s Your Back-Up Plan?

If you don’t wake up tomorrow morning, what’s your back-up plan?

  • Are legal documents in place for power of attorney?
  • Have you created an emergency medical plan for elderly parents?

These are two critical actions every caregiver should take. Unfortunately, none of us are guaranteed tomorrow. You can find article links in the show transcript about making a back-up plan and emergency care for elderly parents.

Embrace Compassion

If you want to hire a caregiver for a loved one, you must do your best to put yourself in their place. How would you feel if your children, friend, or someone else told you what to do or made you feel like you could not care for yourself?

We value independence. It’s tough on the ego when we have to rely on someone else.

And, unless you feel the way a parent does related to whatever chronic disease they have and how it affects their life, you will never know what they’re going through.

If you’ve always been healthy, it’s hard to imagine what it’s like to be sick. So expressing care and concern for the situation of a loved one is an ongoing and vital step to let them know that you understand.

Be honest. The situation isn’t ideal for you, and it’s not for your parents.

For this reason, a paid caregiver can relieve a lot of stress when meeting the daily needs of parents. As a family caregiver, combine care and concern with listening.

Caregivers want to feel heard, whether sharing in an online support group or in person support group. You want someone to listen to you and not say a word. So do your elderly parents.

I know listening can be time-consuming. Consider calling your parents while cleaning your kitchen or doing other tasks that don’t require much mental attention. Many caregivers have parents who call them at work.

Setting Boundaries

This is where you must set a boundary. Don’t lose your job due to caregiving distractions or allow multiple phone calls in a single day negatively affect your work performance.

Tell your parents you can call them on a lunch break if it’s an emergency. Otherwise, schedule a call with them in the evening.

And remind them that if they allowed a caregiver into their home, they would have a person there, readily available, who could help with why they feel they need to call you every day at work 5 to 10 times.

By listening, you might gain information that helps support the need for a caregiver. Paid caregivers can become great companions and listeners.

Sometimes the person you care for is lonely because they spend so much time alone.  So let’s say you’ve talked, and your parent or spouse understands and agrees that a caregiver is a good idea.

How do you avoid the risk of you hire and elderly parents fire the caregiver? Whether you are working with an agency or hiring independently, do your best to meet and interview several caregivers.

Don’t just allow the agency to send someone sight unseen. Or if they want to do this, then make sure you give them a list of the necessary qualifications and skills.

Reasons Elderly Parents Fire Caregivers

Deal killers for elderly parents include a caregiver who is supposed to be able to cook, yet all they make is peanut butter and jelly sandwiches. Or a caregiver who is supposed to be able to help mom or dad bathe, but they admit “they’ve never done this before.”

The bottom line is that you want an experienced caregiver who has been with the agency for at least six months or has documented years of experience. I admit that I know of agencies who hire a caregiver today and send them to a client’s home tomorrow because they want the work and the caregiver has zero experience.

These situations are a trainwreck waiting to happen for an elderly parent who is hesitant to have a caregiver. So ask the hard questions of the agency staff.

A reminder to go back and read the article I mentioned that’s on my website, 10 Tips to Manage In-Home Caregivers. It will save you a lot of time and rework.

Let’s continue moving ahead—you’ve chosen a caregiver who you believe has the right skills. They made it through their first day with your parent.

What should you do? Call and ask mom or dad how it went. And listen. Listen to the good and the bad.

Then, if there are concerns, get on the phone with the agency supervisor immediately and ask that the supervisor talks to the caregiver before they return for the next shift. If this caregiver wasn’t a good match for any reason, immediately ask for another caregiver.

To make this work, your parent needs to know that you are going to be involved in every step of the way, at least until this gets off the ground. Be persistent in communicating with the agency because if you don’t, they will think that everything is okay when it’s not.

In some cases, if your parent needs a lot of care and one agency can’t staff the entire project, you may have to hire two agencies to work together to fill the time slots needed. While this may seem like more work, and initially it is, the benefit is that the other agency can probably provide a back-up if there is a call-out.

Be upfront and let the two agencies know that you expect them to work together. You may be surprised that this is a relief to them, especially if they are having difficulties hiring and retaining caregivers.

family caregiver support programsAnd last but not least, be encouraging to your parent. Until you age and begin having health problems, it’s impossible to know what’s going through a parent’s mind.

Years later, when this is your daily experience, you will be much more empathetic. But until then, remember to involve parents or the person you care for in the decision-making process as much as possible.

If a parent has dementia, you probably will have to make the decisions assuming you are legally responsible. Express care and concern about the struggles that result from the caregiving relationship for both sides.

Listen, and be encouraging. And remember to say thank you and ask your parent to do the same. The best care relationships are reciprocal 50/50 relationships, with both parties contributing as much as possible. It is possible to work through you hire and elderly parents fire caregiver situations. Honest conversations and improving communication skills and trust support this endeavor.

Looking For Help Caring for Elderly Parents? Find the Information Including Step-by-Step Processes in Pamela’s Online Program.

©2022 Pamela D. Wilson All Rights Reserved

About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

   Check Out Podcast Replays of The Caring Generation® Radio Program for Caregivers and Aging Adults HERE

Pamela D. Wilson, MS, BS/BA, CG, CSA is an international caregiver subject matter expert, advocate, and speaker. More than 20 years of experience as a direct service provider in the roles of a court-appointed guardian, power of attorney, and care manager led to programs supporting family caregivers and aging adults who want to be proactive about health, well-being, and caregiving. Wilson provides online and on-site education and caregiver support for caregivers, consumer groups, and corporations worldwide. She may be reached at +1 303-810-1816 or through her website.

 

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