Dear Carol: My friend is struggling to convince her father, who lives across the country, that he needs help caring for his 86-year-old wife who has had a stroke. Her dad is somewhat younger than her mom, but he has his own health problems. She knows that he's overwhelmed with caregiving, but he won't hire anyone to help. My friend asked for my opinion and I'm stumped. She says that her dad has always been stubborn and she doesn't know what to do about his situation because she is too far away to be hands-on. - JY
Dear JY: You're kind to try to help your friend. Spouses, perhaps men more than women, often feel that they must "protect" their spouse, and they may fight giving up what they think of as control over their beloved spouse's care. For that reason, adult children may have to keep pressing the need for hired care for the sake of both parents, though unless there's a crisis, they should try to be gentle.
Somehow, the dad needs to accept that getting help now means that he'll stay healthier over time which will, in turn, enable him to continue to be his wife's caregiver and advocate longer. Your friend can remind him that her mom - his wife - wouldn't want to feel that she'd allow him to destroy his own health caring for her needs.
Your friend could also mention that no one can stay alert 24/7, so if he keeps doing what he's doing, he could fall asleep at a critical time that could mean life or death to his wife. Your friend could also stress that if he breaks down there will be no choice but for her mom to move directly to a nursing home. If he does accept enough help to enable him to rest and relax to some degree, this potential move could be put off.
Your friend could start by going online to aging.gov and locating her parents' state. On this page, she should find their local Area Agency on Aging. The direct website for the AAA is n4a.org. This organization can recommend local resources.
If she can convince him to hire help with housekeeping, and perhaps cooking a meal or two, this may present an opening. Once your friend's dad accepts even a little assistance, he may find out that backup isn't so bad. The gradual approach usually works best.
Another option that your friend could try if her dad won't work with her at all is to hire a geriatric care manager or aging life specialist in his community and have this person contact her dad. Often, aging parents will listen to a third party even though they will ignore their kids. One website for locating these specialists is aginglifecare.org.
Most spouses find that once they accept some help things improve. Often, the caregivers become friends. Your friend's dad may even see that her mom enjoys these people, freeing him to get out more if he'd like.
Carol Bradley Bursack is an established columnist, blogger, and the author of a support book on caregiving. She hosts a website supporting caregivers and elders at www.mindingourelders.com. Carol can be reached at firstname.lastname@example.org.