Denial and the Struggle for Acceptance for In-Home Care in Aging Adults

The wrinkles deepen, the gait slows, and forgetfulness creeps in. Yet, for many older adults and their families, the undeniable march of time is met not with acceptance but with a stubborn wall of denial. This resistance to acknowledging age-related decline and the need for professional help can be a significant barrier to accessing crucial in-home care, leaving both the senior and their loved ones in a precarious balancing act.

For many, accepting the natural progression of aging and the associated health declines can be emotionally overwhelming. This denial often leads to a reluctance to seek professional help for in-home care, even when daily living activities become increasingly challenging or when supervision due to dementia is required.

People are living longer, but not all older adults necessarily experience good health as they age. Over time, health starts to decline, mobility problems arise, and dementia and frailty become a more significant concern. The Centers for Disease Control and Prevention tells us many older people face multiple chronic diseases (comorbidities) and associated functional impairment that will lead to a need for long-term care, either at home or in a facility. 

Recent data paints a stark picture of this silent struggle. A 2023 AARP study revealed that 40% of adults over 65 are in denial about their physical limitations, while another 2022 survey found that 62% of families delay seeking in-home care for loved ones due to fear or denial. This resistance can stem from a multitude of factors, from the fear of losing independence and control to the shame associated with needing assistance.

Can't Deny Aging

Melanie Donohue, LCSW, is a licensed clinical social worker who says change is a natural part of life. She writes that people of all ages go through exciting and unwelcome transitions. Aging is one of those that none of us can ignore. 

"Accepting the aging process is easier said than done, especially when aspects of your life are changing that had remained constant for many years. It's normal to feel stressed and upset about some of the transitions that occur in older adulthood. Remember that aging happens to everyone, though, and that worrying cannot stop it."

Yet, both older adults and their loved ones are in complete denial of what seems to be obvious. The denial can place older adults in danger as they are not getting the proper care and attention they need and deserve.

The consequences of unaddressed decline can be severe. Falls, medication mismanagement, and missed appointments can become all too common, jeopardizing the senior's safety and well-being. For families, the burden of caregiving can become overwhelming, leading to stress, burnout, and even financial strain.

Health, Body, and Mind Decline

Laura Carstensen is a psychology professor at Stanford University and the director of its Center on Longevity. Carstensen, quoted in a story published in USA Today, says many people struggle as they witness an age-related decline in their parents' functioning.

As parents grow older and start to have trouble doing things they used to do easily, their adult children may feel a sense of sadness. Sometimes, adult children don't want to believe their parents are getting older and need help. This can be made worse by a culture that tells us to try to stay young and not show the signs of aging.

For families, witnessing a loved one's decline and denial of their needs can be emotionally taxing. It often falls on family members to initiate conversations about in-home care or assisted living options, a task that can be met with resistance and even anger from the aging individual. Balancing respect for their autonomy while ensuring their safety can be a delicate and emotionally draining process.

Some Avoid Using LTC Insurance

Even for older adults with Long-Term Care Insurance, experts say many families delay using these insurance policies that will pay for professional in-home care or assisted living, providing a better quality of life for the care recipient and reducing stress on the family.

• What Is Long-Term Care Insurance? What Does It Cover?

Eliza K. Cha, the owner of a Bellevue, WA home care franchise Amada Senior Care, has noticed a concerning trend. She has seen many people with Long-Term Care Insurance policies that offer excellent benefits waiting too long to use them. As a result, these valuable benefits often end up unused or barely utilized before the policyholders pass away.

"I explain to the older adult and their family that using their LTC Insurance benefits doesn't take away their independence but helps them maintain it in the comfort of their home for longer."

Cha advises that individuals should not postpone using their LTC policy benefits until they are seriously ill. Instead, they should utilize these benefits when they start to need assistance with everyday activities that have become challenging or difficult for them. 

Part-Time Care Can Be Beneficial

Most Long-Term Care Insurance policies will trigger benefits when the policyholder needs either 'hands-on' or 'stand-by' assistance with two of the six activities of daily living or supervision due to dementia. Often, an individual may only need help three or four times a week for several hours, progressing from that point. Even with this level of care, it reduces the stress on the care recipient's family.

Alfred Milan, who operates Amada Senior Care in Memphis, agrees. He says that he has seen that LTC Insurance has been a lifesaver for those with a policy. 

"An LTC policy enhances the care of the senior and wipes away worry and doubt if there is funding need for care."

Still, some families and older adults delay using LTC Insurance benefits that would ensure quality care, provide asset protection, and reduce family burden.

Open Communication

Breaking through the denial barrier requires patience, empathy, and open communication. Encouraging discussions about the benefits of in-home care, the relief it can provide to family members, and the importance of ensuring a loved one's safety can help dispel some of the reluctance to seek professional assistance. 

According to the AP-NORC Center for Public Affairs Research poll, Americans underestimate their chances of needing long-term care as they get older. These results are unexpected, given that the poll discovered over half of those aged 40 and above have previously served as caregivers for impaired relatives or friends. 

These adult children often ignore their aging despite having experienced firsthand the type of assistance they might require in the future. Milan says it is never too early to plan since health can change anytime.

Maintaining Independence 

Ultimately, acknowledging age-related decline is not a surrender but a necessary step towards maintaining independence, dignity, and safety. By embracing the support available with professional care and an LTC Insurance policy if it is in place, both older adults and their families can navigate the challenges of aging with grace and resilience.

Recognizing the importance of preparing in advance for the potential challenges of aging can ease the impact of aging for individuals in midlife who are planning for their retirement. Long-Term Care Insurance, when included in a comprehensive retirement strategy, can serve as a safety net for their children many years later.

• How To Apply For Long-Term Care Insurance

If your loved one requires care, consider seeking the quality care they deserve, whether it's through in-home care services, adult day care centers, or assisted living facilities. While nursing home care is necessary for some individuals, most care can be provided outside of such facilities. Those who access high-quality care in the early stages can maintain a higher quality of life for an extended period.

Find Quality Care Near You

Discover high-quality care by utilizing the LTC NEWS Caregiver Directory, which offers access to over 80,000 providers across the country. You can search for providers based on your location and the type of care services you require. It is free and the largest and most comprehensive directory of its kind in the United States - Long-Term Care Directory | Find Care Near You.

Don't wait. When a loved one experiences the peace of mind that comes with quality care, it brings happiness to the entire family.