Thank You, I Don’t Need Anything: Overcoming Resistance to Accept Care and Support

Caregiving Team members often are amazed and frustrated that prospective care partners, who would obviously benefit from the team’s assistance, refuse the offer of care and support. In order to properly respond to the refusals, it is helpful to have some understanding of why people tend to refuse the kindness of others. Societal factors that contribute to resistance to accept care and support include the following. Independence and individualism are primary, if not ultimate, values in American society. Children are taught to live self-sufficiently, not inter-dependently. Mobility, time limits, energy limits often result in shallow attachments with others, including family, and presumably validate an ethos of putative self-sufficiency. Social connections tend to be less intense with others and organizations. Individualism and shallow connections insulate us from the fate and feelings of others. Individualism undermines mutuality or interdependence. Life evolves into a collection of movements that overlap or intersect, but are compartmentalized mainly because they are partial expressions of one person’s existence. We think of relationships as one-to-one, rather than an intertwined connected web or network. Family structures evolve within cultural and ethnic communities and across the lifespan. In general, the extended family now looks different than in the past. In some cases, it seems to be a loose network of nuclear families. Values and responsibilities of kinship continue to change as the social context changes. A goal of parenthood is a child’s independence, not reciprocal ties and obligations between generations. These values are revealed by older adults through comments like “I don’t want to be dependent on my children,” “I don’t want to be a burden,” or “I want to be my own person,” even when the sustaining company of kin would be reassuring, comforting, and prudent. Despite the devotion to the American ideal of individualism, people tend to think that the good life cannot be lived in isolation, connectedness to others in work, love, and community are essential to happiness, self-esteem, and moral worth. In short, people think relationships are important.

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Individualism and self-reliance predispose people to not call on others for a gift of care. It is thought impolite to ask for a gift which can be seen as ‘begging.’ If care is needed and obtained, then it ‘should’ be purchased, a sentiment captured by the comment, “I don’t want charity.” Thus, ‘care’ becomes a service that one purchases. Private insurance and public service programs foster this expectation that ‘care’ can be bought at someone else’s expense and responsibility. Care becomes commercialized and secularized within a capitalist economy. A psychology of individualism and independence legitimize a turn to strangers for service, rather than family or friends. Accordingly, ‘caregiving’ becomes an occupation, not a gift from one person to another or an expression of relationship. Formal or paid service may be necessary at times, however, gifts of care from family, friends, and volunteers bring an added level of support and quality of relationship. The isolation, disconnection, and shallow social bonds with others that pass as the norm in society and the reality for many are some reasons why people need and should accept care from a Caregiving Team. Support by a team offers a strong counter statement to prevailing social values and norms of conduct. Team engagement with a care partner offers unique opportunities for new relationships that enrich everyone’s life. It also affords an opportunity for intergenerational contact for children and families. For example, involving children with care partners may be a type of ‘grandparent’ experience. Youth may have an opportunity to complete a service project during the course of which they learn about giving and helping. Families as a whole may relate to a care partner and do ministry together as a family, rather than having all ministry opportunities segregated by age or gender. Youth can take oral histories of older care partners and learn on a first person basis about social changes and personal life experiences. Personal factors may contribute to a person’s resistance or ambivalence about accepting care and support. People may simply minimize, not recognize, or deny their incapacities or limitations. A survey by the National Council on Aging conducted in 2000 of adults 65+ illustrates this lack of self-recognition. For example, 92% said health is a very or somewhat serious problem for most people 65+, but only 42% said it was for them. They said loneliness is a very or somewhat serious problem for

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org

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84% over 65, but only 21% said it was for them. These data may not be surprising if we consider how we see ourselves with respect to our own age. We hardly think or feel that we are as old as we are or that our age does or should entail any limits on our activities. Pride may inhibit a person from accepting care. Admitting one has need is felt to be a personal failure. It is contrary to self-reliance and, accordingly, a sign of personal shortcoming. We live in a culture that idealizes perfection which results in anything less being disvalued and hidden. Asking others for assistance requires one to recognize and reveal one’s shortcomings. Rather than do this, people often think that it is better to accept and compensate, than to reveal, one’s loss or need. Losses are kept secret to protect oneself or a loved one from the changed opinions or pity of others. Embarrassment about one’s circumstance or feeling ashamed in some way may add to resistance to accept care. Polite people tend to be reluctant to make others uncomfortable. If it is felt that others would be uncomfortable with one’s situation, people resist allowing them in. People are reluctant to bother, impose, disrupt, burden, or intrude on others. The presence and assistance of others may be perceived to do this. People tend to never have learned how to ask for or accept assistance. They have had no good role models. Rather than make a blunder, they resist assistance. People may resist offers of care because of some anger or grudge about some past offense. This may be true more of people who are members of a Team’s congregation than non-members with no history with the faith community or members. People may minimize or underestimate a desire or willingness of others to assist. The offer of support may not be taken seriously. Accepting ‘help’ may carry a social stigma (one is not independent or selfsufficient) or feel like one is accepting ‘welfare,’ a good or service that has not been purchased.

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org

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People may become paralyzed by negative feelings about self and one’s situation which renders one incapable of asking for or accepting assistance. Team members should be sensitive to how one feels about an offer of presence and assistance. They can utilize several strategies to overcome resistance. A key to all attempts to begin a relationship with a prospective care partner is emphasizing the goal of enabling someone to exercise control over one’s life and circumstance. One way to signal one’s sensitivity to the feelings of others is to not describe the team’s presence and assistance as ‘help.’ Initial and subsequent conversations with care partners should highlight how the care partner is blessing the team member‘s life. Be specific about the gift received and explain why it meant so much. Emphasize what would have been missed without the time together and the joy that came from a visit, conversation, or activity, as well as expressing one’s eagerness to be together again. This expression of gratitude may effectively reframe a care partner’s idea that she or he is a burden to others. It may help them recognize and be proud of the gifts they make during the course of a relationship with a team. Gently and sensitively, over time, point out to care partners how much control over their circumstances, increased self-determination, self-esteem, dignity, and enjoyment they have gained since relating to the Caregiving Team. Do not suggest that the team has brought these gains about; rather highlight the achievement of the care partner without pointing out his or her weaknesses, losses, and adversities. If our intent and goal in a gesture of care is to be truly responsive to another’s need, then we need to seek ways to meet that need in a manner acceptable to another person. It is their comfort that we desire, not our comfort. Explore how care may begin without calling it help or care or formalizing the assistance provided by registering the person as a care partner. In short, begin the relationship covertly, so to speak, and casually as a friend seeking to renew or deepen a relationship with another. A team member ‘comes alongside’ a care partner to share a journey. The relationship, as well as the well-being and welfare, of a care partner are primary. For example, a ‘door opener’ may be to deliver a serving of lasagna or cookies and say, “I baked too much and thought you might enjoy some.” It is impolite for most people to refuse a gift like this. Such an overture might be what it takes to start the process of forming a relationship.

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org

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Be mindful that one’s approach to a care partner should always respect his or her feelings. It is the good of the other person that is sought, not one’s own sense of importance. This means that the personhood of another is respected. Care is more a way of being as a person that is a way of relating to someone that develops over time. It is not so much a series of concrete acts of service. It is being engaged in nurturing relationships that engender growth among the parties as mutual confidence and commitment deepen. Care, accordingly, is exchanged, not just given by one and received by another. Caring relationships are experienced as a need for one another, as a kind of stewardship for one another, not as power over the other. Care is a process of sustaining one another while outcomes develop. Assisting with tasks is a means to an end of a deepened relationship that honors the dignity and value of another. What is good for another should be defined by that person, not imposed upon him or her by well-meaning, good hearted team members. A prospective care partner’s resistance to accept care from a team may prompt team members to think they she or he really doesn’t need support or that the team should serve others who are more accepting and appreciative. When team members feel rebuffed or perceive that the need level of a care partner is low, they is a tendency to commit less time to that particular care partner or to become less active on the team. If is often the case, however, that the most resistant care partner is the one with the greatest need for socialization and support. These more difficult care partners should be seen as an opportunity to gain insight into the experience of loss and increased dependency on others that the care partner feels. Rather than being a reason to lessen one’s involvement on a Caregiving Team, it should illustrate how needed the team is to reach people who may have no one else during their dark days. It may be the case that a team’s desire and capacity to assist a person will be rejected totally, despite sensitive approaches and a profound understanding of the issues that make accepting others into one’s life difficult. Gifts of care may be offered, invitations to relationship may be extended, but gifts and invitations may be refused. These ultimate refusals ought to be accepted without anger toward a prospective care partner. Moreover, a team should remain ready to serve if that opportunity develops.

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org

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Case Study Joe is a 38 year –old who moved back to Houston from Oregon to care for his parents. His mother has end-stage lung cancer and his father has chronic obstructive pulmonary dysplasia. There is a younger sister living at home who is bipolar (major debilitating psychiatric diagnosis) and who receives disability income. When approached by a Caregiving Team leader about receiving care, the son responds, “I’m sure there are people who need help more than I do.” How do you respond to Joe’s resistance? If Joe does not agree to visits, how would a Caregiving Team offer care?

Related Modules: Listening Skills: Generous Listening Ministry of Presence Caregiving Principles Building Relationships Life Review

Written by Earl Shelp, Ph.D.

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org

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