It can feel overwhelming when an elderly parent refuses long-term care such as assisted living or a nursing home, but there are things you can do. Understanding how to get your parent into a long-term care facility is an important step in getting them the care and support they need. With the right guidance and practical steps, you can navigate this challenging chapter in your family's life. Use these tips to decide what to do if your elderly parent refuses elder care options:

1. Understand Your Parent's Perspective

If an elderly parent refuses a nursing home or assisted living, they usually have very personal reasons that are important to them. Understanding their perspective and validating their feelings lets them know that you are there to help. The more empathy and understanding you offer, the more likely they are to be open-minded about the situation.

Common Reasons Elderly Parents Refuse to Move to Assisted Living Facilities, Nursing Homes, or other senior living facilities

If a parent won't go into an assisted living, nursing homes or other senior living facilities, they most likely have significant apprehensions about it. These are some of the most common reasons elderly individuals don't want to go into nursing homes or other senior living facilities:

• Fear of losing independence
• Anxiety about change and the unknown
• Strong memories and emotions they associate with their home
• Financial concerns
• Distrust of facilities or caregivers
• Previous negative experiences with a care facility
• Denial of their current condition and needs

Before attempting to persuade your loved one, acknowledge their fears as legitimate concerns.

How Cognitive Impairment Can Impact Decision-Making

Cognitive challenges, such as dementia, can impair an individual's ability to make safe and informed decisions that support their well-being. Consider if your loved one is making a rational refusal or refusing elder care due to cognitive impairment. If they make a rational refusal, it's important to respect their autonomy. However, legal measures may be necessary to protect their well-being if a parent with dementia refuses moving to a senior living facility like a nursing home.

2. Assess Their Needs

What are your parent's exact needs? Assess their physical and cognitive capabilities to determine what level of care they need. Focus on activities of daily living (ADLs) such as the following:

• Bathing
• Dressing
• Cooking
• Eating 
• Toileting
• Mobility
• Home maintenance and cleaning

Identify specific safety concerns such as fall risks and medication management. Talk with your parent about the needs that you observe, explaining the potential risks of not obtaining care. You can also consider a professional assessment by a social worker or geriatric care manager.

3. Understand the Options

When an elderly parent refuses a nursing home or assisted living, they may not realize that various care options are available. Senior living facilities often offer the following types of care for seniors:

Independent Living

Independent living enables seniors to live in a private home within a retirement community. While this is different from assisted living and nursing homes, it's a fantastic long-term care alternative depending on your loved one's needs. This option does not include on-site care, but it does include basic home maintenance services so your loved one doesn't need to worry about lawn care or repairs. In some cases, independent living may include laundry and housekeeping services.

Some facilities may offer on-site care visit options, but most facilities require you to schedule external home health agency services if your loved one in independent living requires help with daily living or medication management.

Assisted Living

Assisted living offers help with daily self-care tasks and medication management while letting seniors maintain a level of independence. An individual in assisted living typically has their own room or apartment within a care facility and access to meals and social activities.

Skilled Nursing

Skilled nursing offers a higher level of care, often involving 24/7 nursing supervision. This is the best option for individuals with complex health needs.

Memory Care

Memory care offers specialized services and a secure environment for individuals with cognitive impairment, such as dementia or Alzheimer's disease. Memory care typically involves skilled nursing services, assistance with ADLs, therapies and 24/7 nursing supervision. 

4. Explore Alternative Options

If a parent won't go into a nursing home or senior living facility, it's often because they want to remain in their own home. Approximately 90% of seniors prefer to age in place over living in a care facility, whether it's because of comfort, proximity to friends or the memories attached to their house.

Depending on your parent's personal and medical needs, they may benefit from alternative options and be able to avoid a long-term care facility. Offering alternatives expresses your willingness to compromise and honor your parent's wishes to the best of your ability. Consider whether the following options may allow your loved one to receive the care they need while living in their home:

In-Home Care

Some caregiving agencies can send caregivers to your home, so your loved one receives professional care in the comfort of their familiar living spaces. You can start with a few hours a week to help your parent become comfortable with the arrangement and gradually increase it as needed.  A Continuing Care at Home (CCaH) program can help keep your loved one at home, and then facilitate the transition to higher levels of care as needed.

Home Modifications

Modifications make the home safer, reducing risks such as slips and falls. Consider making your loved one's living spaces safer with the following types of modifications:

• Bathroom and shower: You can make your loved one's bathroom areas safer and more accessible with modifications such as a shower chair, grab bars, a shower wand, a raised toilet seat and nonslip flooring strips.
• Kitchen: Important kitchen modifications include stove alarms, nonslip flooring mats, enhanced lighting and drawer and cabinet pulls.
• Stairways: Ground-floor bedrooms and bathrooms are ideal for older adults. If your elderly parent needs to access a second floor, you can ensure the stairway has a stable railing and safe carpeting or install a chair lift.
• Bedrooms and living areas: Ensure all carpeted areas are smooth and even, removing any bumps or tripping hazards. It's also important to remove clutter and limit furniture, making it easier for your parent to navigate each room.
• Doors: Replace doorknobs with handles for easier use.

Medical Alert Systems

You can also increase your parent's home safety with medical alert systems. Medical alert systems, such as those from Medical Care Alert, come in these forms:

• In-home sensors: Sensors can detect when your parent falls, alerting dispatchers that they need help.
• Wearable pendants: Wearable pendants make it easy for your parent to call for help with the push of a button. You can also opt for a smartwatch with a help button, giving your parent access to helpful health tracking features.

Medical alert systems provide peace of mind for you and your loved ones. They can continue living at home, knowing that help is easily accessible. This is especially beneficial if your parent has an increased fall risk. If your parent currently has a Medical Care Alert system, they can take it with them if they move from their home to a senior living facility.

Adult Day Care

Adult day care offers care, socialization and activities. Consider recommending a few days a week at an adult day care center.

Respite Care

Respite care is a short-term option that gives you a break from care and helps your loved one experience what long-term care is like. This is a great option if your parent is unsure of or distrustful of assisted living. It gives them the opportunity to meet caregivers, become comfortable with long-term care and build trust. This is also a great opportunity to help them try different facilities and choose one that makes them the most comfortable.

5. Involve Your Parent in the Decision-Making Process

Involving your parent in the decision-making process gives them more autonomy in the situation. Use the following communication strategies to help your parent feel involved:

• Empathetic listening: Actively listen to your parent's concerns and wishes. Avoid becoming defensive, and give them plenty of time to voice their needs.
• Open and honest dialogue: Honestly explain your concerns in a calm, loving manner. Avoid ultimatums and guilt trips, focusing on their safety and well-being.
• Collaboration with additional family members: Additional family members can help your parent feel supported during discussions and decision-making. Be mindful of differing opinions and work through them before talking to your parent so you can present a united front. Try to choose a spokesperson your parent trusts so they feel more open to the idea of elder care.
• Professional mediation: Consider seeking professional assistance from a counselor, therapist or geriatric care manager. A professional can facilitate your conversations, help your parent understand their options and ensure communication remains constructive and supportive.

6. Overcome Resistance With Patience and Persistence

A loved one's resistance to necessary care may feel frustrating, but patience and persistence can go a long way. It may take time for your parent to accept the idea of long-term care, but your support can make a significant difference. Use the following tips to overcome resistance with love:

• Address specific concerns: Discuss your loved one's specific concerns and possible solutions to help them overcome personal hurdles. For example, you can explore financial assistance options if finances are a concern or emphasize long-term care's social opportunities if your parent fears losing independence.
• Facilitate a gradual transition: Start with a short-term stay or trial period, and allow your parent to bring familiar belongings for an easier transition.
• Focus on the positives of long-term care: Highlight the benefits of transitioning to a long-term care facility. You can focus on aspects such as safety, socialization activities and greater healthcare access.
• Offer several options: Let your loved one tour different facilities and choose the one that feels most comfortable.

7. Evaluate Your Parent's Capacity to Make Personal Decisions

In some cases, conditions such as dementia and Alzheimer's disease can hinder a person's ability to make personal decisions. If your parent has a form of cognitive decline, they may not be able to recognize their full range of needs or understand why they need additional care. Evaluating your parent's capacity to make decisions is an important part of determining what type of care they need and how to get them this care.

Can You Force a Parent Into Assisted Living or a Nursing Home?

If you have the legal authority, you can make a decision based on your loved one's best interest. However, it's important to give them as much autonomy as possible and not force them into a situation if other viable options are available. Putting a parent in a nursing home against their will is not ideal, but it may be necessary depending on their situation.

Your parent has legal autonomy to make decisions about their life unless a medical professional deems them unable to make decisions. In this case, you may need to consider the possibility of a court-appointed guardianship or conservatorship. A guardian makes decisions regarding medical and personal needs, and a conservator makes decisions regarding financial affairs. 

Determining Your Parent's Decision-Making Capacity

Meet with a social worker or schedule a medical evaluation to determine your parent's cognitive status, consulting with their doctor about the safest options for care and decision-making. You can also help your loved one choose a durable power of attorney (DPOA) to make healthcare decisions for them if they become unable to do so.

8. Practice Self-Care

Self-care is vital when caring for a loved one. Caregivers often experience an emotional toll and increased stress, which can quickly lead to burnout. As a caregiver, you might experience a wide range of emotions, including guilt and grief. Remind yourself that you are doing your best to find the ideal options for your parent, and give yourself permission to rest. Seek support from family, friends or a therapist, and make time each day to focus on your own needs.

How to Get Your Parent Into a Long-Term Care Facility

After helping your parent understand their need for additional care, you can start the long-term care admission process with the following steps: 

• Research facilities: Research facilities in your area, using websites, online reviews and word-of-mouth recommendations to help your parent choose the ideal option for them.
• Obtain a doctor's recommendation: Nursing homes and assisted living facilities typically require a doctor's order to admit an individual into care. You can obtain this from your loved one's primary care physician.
• Arrange a tour: Touring a care facility is an excellent opportunity to ensure your parent feels comfortable with the staff, environment and amenities.
• Gather documents: Ask the care facility what types of medical, health and financial documents they require so you can have them ready.  
• Fill out paperwork: Once you decide on a care facility, you can fill out the necessary forms provided by the social worker or admissions department.

Explore Alternative Options From Medical Care Alert

Navigating care options and deciding what to do when parents refuse assisted living or nursing homes can feel overwhelming, but understanding your options makes the process much easier. Offering your parent as much autonomy as possible while protecting their safety and well-being is key. A desire to remain at home is one of the main reasons elderly parents refuse to go into nursing homes, and you may be able to explore alternative options depending on your parent's needs.

Medical Care Alert offers emergency response systems such as the HOME system, HOME & AWAY system and the SmartWatch to provide your loved one with fast, easy access to help when necessary. With the touch of a button, your parent can talk with a trained EMT/EMD-Certified operator. Our professionals have your parent's name, home address and important information on file so we can send assistance immediately. We also call and text your parent's emergency contact, so your family knows when help is dispatched.

With Medical Care Alert, your parent can request help quickly and easily, resulting in greater peace of mind. Our mobile, in-home and wearable systems with optional AutoFALL fall detection make it easier for older adults to continue living at home independently. Browse our medical alert systems to learn more about how we can improve your loved one's quality of life.