Hiring in-home care for my elderly neighbor, Joe, was quite an ordeal. The company we chose and their professional caregivers were great, but the quality of care they provided wasn’t the issue. The problem was that Joe resented anyone but me helping him.

He locked one in-home care aide out of his home, let another inside but was rude to her, and thoroughly enjoyed one young man but only because they could discuss golf together.

I’m not the first family caregiver to struggle with getting a senior to accept home care. Families hire these services to secure quality care for seniors and valuable respite time for themselves, but what is a caregiver to do when their loved one refuses to cooperate with this new addition to their care plan?

Reasons Why a Senior Won’t Accept In-Home Caregivers

An in-home caregiver’s best efforts are often met with anger (or even abuse) dished out by the elder they are supposed to be helping. It is crucial for the family and hired caregiver(s) to determine the underlying reason for a senior’s lack of cooperation and find ways to remedy the situation.

I believe that fear is the foundation of much of a senior’s reluctance and even disrespect for non-family caregivers. The presence of an outsider may suggest to them that their family can’t (or doesn’t want to) see to their needs. It also magnifies the extent of the elder’s care needs, making them feel especially vulnerable. This combination of concerns can create the perfect storm, especially if they are prone to lashing out when angry. Of course, the family members who arrange these services get an earful, but the professional caregiver becomes the primary target for sending the message that outside help is neither wanted nor needed.

Fear of Losing Their Independence

People of all ages dread the idea of losing their independence, but many seniors are living this reality and struggling to come to terms with it. Aging is hardly a graceful process, so who can blame our elders for digging their heels in?

If a senior is still of sound mind, emphasize that home care enables them to continue living safely in their own home. This in itself is an overarching symbol of independence. The right caregiver will pick up on the senior’s strong desire to be self-sufficient and provide assistance in ways that allow them to retain as much control as possible. In-home care usually doesn’t sound like such a bad idea when it is presented as the alternative to moving to a senior living community.

Fear of Strangers

Trust issues can also trigger anxiety in some seniors and their family members. Inviting a professional caregiver into the home to care for someone you love is a very personal decision. The best way to alleviate worries about a new caregiver’s character and trustworthiness is for the family to take an active role in the hiring process. If the senior is capable, they should participate as well. Again, a sense of involvement and the ability to have a say in these decisions can reduce anxiety.

Adapting to in-home care is much smoother when the family is confident in who they have hired. Know what to look for in a provider and interview caregivers before services begin to determine a good match. With this approach, if something seems off, you have the opportunity to correct your decision before it actually becomes a problem.

Read: How to Select a Home Care Company

Dementia Contributes to Fear

It can be challenging to encourage a mentally healthy senior to accept outside help, but Alzheimer’s disease and other forms of dementia can make this process even more complex.

Depending on the progression of their condition, a senior may not be able to fully participate in the hiring process. Nonetheless, it is still wise to introduce potential caregivers before services begin to see how both parties get along. Dementia patients’ moods and capabilities fluctuate from day to day, though, so keep this in mind when trying to help a loved one warm up to someone new.

Paranoia, hallucinations and delusions are common symptoms that a dementia caregiver should know how to handle. Look for someone who is trained in dementia care and knows how to communicate with and calm their clients. Having a family member present during the first few shifts while everyone gets to know each other can reassure a senior that they are safe and in good company.

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Some dementia drugs and psychiatric medications currently in a senior’s regimen could contribute to outbursts and negative reactions. If your loved one is unusually agitated and fearful, talk to their doctor about adjusting medications. While drugs should not be a go-to solution, behavioral symptoms may be managed through a combination of modifying prescriptions and altering the caregiving environment.

A senior with dementia may never be comfortable with a particular caregiver, even though the home care aide is making a considerable effort to do everything right. Regardless of the reason, some matches just do not take, and the care team may have to simply request another caregiver.

Getting a Senior to Accept In-Home Caregivers

You know your loved one best, so do whatever you can to help make them more comfortable with this new arrangement. Assure them that you are still their primary caregiver but explain that you need help. Emphasize that the professional caregiver is there to assist both of you and that you are closely monitoring the process and their well-being.

Communicate openly with the caregiver and the home care company about any challenges you experience. Elder care providers are very used to dealing with stubborn seniors. Understanding the source of their resistance will help you cope with this problem, and a care plan meeting will allow all members of their care team to brainstorm solutions together.

If an aging loved one is mentally competent and still adamantly refuses in-home care aides despite your protests, then that is within their rights. All you can do is your best to get them to accept help, and you do not always have to be the one to provide it. Make it clear that the offer to hire help at home is always available, but then set and maintain your own boundaries determining how much you are willing support them in the meantime. Sadly, many family caregivers must wait until their elders have an accident or experience a medical setback that increases their care needs before they’ll accept professional caregivers in their own homes or in senior living settings.