What to Do When Elderly Parents Fire Caregivers

What to do when you hire —  and elderly parents fire in-home caregivers? There are two sides to this story, both 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 the perception of the elderly parent, who may only want family members to be their caregivers.

After considering both sides, 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 are exhausted and burned out.

The caregiver wants and needs someone else—an in-home caregiver, another family member, or even a volunteer—to step in and ease the time devoted to care activities. It may be time for the caregiver to shift attention to focus on their career, family, friendships, or social interests.

It is perfectly normal to want to hire a paid caregiver to help out with elderly parents so that caregivers can go on with life. More caregivers should have early conversations about hiring caregivers. 

Let’s look at an example of a situation where an elderly parent refuses to have a caregiver in the home. The caregiver spent time investigating care services to set up a caregiver schedule and let the parent know to expect the caregiver.

The paid in-home caregiver shows up for work on day one and is promptly sent packing by your mom or dad. If you are the caregiver, all you can think is, “what the heck just happened? I did all that work, and 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 caregiver’s activities, 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 and an experienced manager who is empathetic to the elderly parent’s hesitation about having a caregiver can make it easier to resolve 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 reasons that are not always 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 in achieving 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 paid caregivers.

The aspect of elderly parents believing that family, not strangers, should be the caregivers can be the first hurdle in establishing cooperation and agreement about hiring paid caregivers. How do you jump this hurdle if you are an adult child or a spouse?

How to Shift to the Idea of a Hired Caregiver

One 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. Their expectations that you will do everything are unrealistic.

Making the need for hired 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.

Dependence on others may not be viewed as a positive behavior in Western cultures, which 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 remains within the family. When paid caregivers come into the home, everyone might know the family business.

What to Do When Elderly Parents Fire Caregivers?

Watch More Videos About Caregiving and Aging on Pamela’s YouTube

Hiring caregivers is one of the first hurdles that many family caregivers face. Elderly parents can believe that spending money on care is unnecessary when adult children are available. 

Invasion of Personal Privacy

Additionally, parents may value independence and personal privacy. Allowing strangers into the home to perform personal and relational tasks might threaten a parent’s self-esteem.

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

Research about the link between self-esteem, motivation, and avoidance from Park and Maner is available. Another helpful article on this topic is available. This information might offer insight into care relationships where independence or self-esteem seems to be a concern and make it easier to discuss these concerns with elderly parents.

Link Between Self-Esteem and Relationship Quality

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, people 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 a loved one. As a result, a 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 everything they struggle to do. In a sense, parents beat themselves up for needing the help of others—for being dependent.

Along these lines, the caregiver may regret and be resentful about helping too much and making a parent dependent. Changing this dependency dynamic after it has been in place for some time can seem like a rejection to a parent.

How Stress Affects Caregiving Relationships

While the caregiver may not have low self-esteem, a parent’s refusal to be flexible can result in a battle. Parents may be critical of the adult child’s efforts to find a suitable caregiver. The elderly parent is not 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 challenging situation when a caregiver has the primary responsibility for the care of an elderly parent or spouse.

Low self-esteem can result in parents feeling like a care burden. As a result, parents may fight the caregiver every step when they try to be helpful to make the care situation easier for the caregiver. You hire elderly parents fire can feel like a losing the battle when all you are trying to do is lessen your workload.  

How to Deal With the Elephant in the Room

How do you deal with the subject no one wants to mention, which may not be that an elderly parent is stubborn or difficult but that they suffer from low self-esteem? This can take time and emotional attention or labor.

The concept of time is easy to understand. Emotional attention or labor means feeling “it’s all on me (the caregiver) to keep things running smoothly” in this relationship.

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

1 Resentful and frustrated

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

3 Unappreciated

4 Like the other person in a relationship doesn’t care as much or isn’t putting forth equal effort

5 Emotionally drained and exhausted

If you are a caregiver in this situation, what can you do to relieve the emotional burden of caring for elderly parents?

Why Do Caregivers Feel Emotionally Burdened?

Look at the relationship and ask why you have taken on so much responsibility. 

• 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, there may be unresolved emotional needs from childhood or communication difficulties. 

Let’s talk about how parent-child relationships translate to relationship interactions when 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 caring relationship based on feelings of responsibility and duty.

Of course, not all caregivers love the parents they care for. If you are caring for a parent you don’t like, then being involved in the care of a parent can require a lot of emotional effort, tolerance, and patience.

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 about parent-child relationships, your sibling may or may not want to be involved in caring for mom or dad. While this can be due to life’s priorities like careers, marriage, and 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

Low self-esteem 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 seek support 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

Sometimes, a nurse or a social worker at a doctor’s office or community health center may investigate and recommend services. A tip to avoid you hire —  elderly parents fire caregiver issues is to involve those most affected by the decision to hire a caregiver. If you are a busy caregiver this may consume more time than you have. 

You may need to involve both parents if one needs care and you are helping your mom or dad, who is the caregiver, care for your sick parent. If 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 decision, ensure you investigate what this means with a tax accountant and that you have a well-written agreement to avoid unexpected issues.

You can also hire through an agency. Both options can work. You must understand the complexities and your responsibilities. For more detail on hiring and supervising in-home caregivers, read my article 10 Tips to Manage In-Home Caregivers.

This article is helpful because there can be many assumptions about care agencies, which can 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 ensure the caregiver knows exactly what to do at each visit. The caregiver must also be able to establish a positive relationship with your loved one. 

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

For example, a caregiver shows up and doesn’t know what to do. Your parent doesn’t feel they should have to tell the caregiver what to do or supervise them. So, your parents send the inexperienced or uncertain caregiver home.

Let’s look at ways to support collaboration when looking for 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 your need for help. Because as you know, your parent will probably say that they don’t need any help, they can care for themselves. If this was an accurate statement your help would not be needed.

Tug of War Care Struggles

To be reminded daily, through the presence of a caregiver, that one can’t do the things one used to do can deflate the ego. 

The idea of accepting help is a hurdle you must cross when trying to convince elderly parents to agree to have a paid caregiver 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 withdraw money from their accounts to pay for caregivers.

While I understand a desire to pay for a parent’s care, if your parents have the financial resources to do so, they should. Children should not use their personal finances to pay for care when parents can do so. If money becomes a tug of war, caregivers can set boundaries and say, “I can’t do this anymore. You’re on your own. Here is an agency to hire to do everything I do for you.”

Other thoughts to support conversations about hiring a caregiver might include: 

• 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 failing in school because you’re never around to help them.
• Your marriage may be at risk because all your free time is consumed caring for your parents.

These examples are not to make your parents feel guilty—but to describe the challenges that being a caregiver is causing in your life. 

Compromise is Necessary

There’s only so much time in a day. Compromise may be required if your parents want to stay in their home and want you involved.

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, 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 a move to a different level of care.

In addition to adult children who need a break, spousal caregivers also need time off. Being firm specific to hiring a caregiver may be necessary. 

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 and will.

Caregivers are too busy to eat healthy, exercise, or maintain regular doctor appointments. What do you think happens over time when caregivers neglect these areas of your life? The caregiver becomes sick.

Caregivers tell me, “I’ve never been sick before.”  My response is usually, “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 backup 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 before something unexpected happens to them.

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 they were hiring people to help in the home? 

Being independent is a personal value. Relying on another person can be emotionally stressful and challenging. 

If you cannot understand or empathize with a parent’s position, you may not understand their viewpoint. If you’ve always been healthy, it’s hard to imagine what it’s like to be sick or not feel well.

Expressing care and concern for a loved one’s situation is an ongoing and vital step to let them know that you understand. It’s okay to 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 instead of offering suggestions or advice. So do your elderly parents.

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. This is where you may need to set a boundary.

Setting Boundaries

Don’t compromise or lose your job due to caregiving distractions, such as multiple phone calls in a single day, that negatively affect your work performance.

Tell your parents you call them on a lunch break. If it’s an emergency, they can text you. Alternatively, schedule a call with them in the evening.

Remind them that if they allow a caregiver into their home, they will have a readily available person to help rather than calling you at work 5 to 10 times daily.

Paid caregivers can become great companions and listeners. Sometimes, aging parents can be lonely because they spend so much time alone.  

Let’s you have talked with your parent or spouse who 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. If they want to do this, make sure you give them a list of the necessary qualifications and skills.

Create a written agreement with elderly parents that includes a time frame for a trial of the caregiver along with caregiver tasks. 

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. Some agencies hire a caregiver today and send them to a client’s home tomorrow because the caregiver wants the work, yet 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 linked above, 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, immediately call the agency supervisor. Ask the supervisor to express your parent’s concerns to the caregiver before they return for the next shift. If this caregiver wasn’t a good match for any reason, immediately ask for a replacement caregiver. 

To make this work, your parent needs to know that you will 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, the agency will think everything is okay when it’s not.

In some cases, if your parent needs a lot of hours and days of care and one agency can’t staff the entire project, you may have to hire two agencies to work together to fill the needed time slots. 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 you expect them to work together. You may be surprised that this relieves them, especially if they are having difficulties hiring and retaining caregivers.

Last but not least, be encouraging to your parents. Until you age and begin having health problems, it’s impossible to know what a parent is thinking or experiencing.

Years later, you will be more empathetic when you are the person who needs a hired aregiver. 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.

 

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