Why Loved Ones Reject “Good” Advice

Making poor choices

Everyone has helplessly witnessed someone making a disastrous choice despite the input given to them.  The recalcitrance becomes even more painful when the choice involves a critical caregiving decision and the person ignoring your advice is a loved one.

Solving the Problem

The usual attempt to solve the problem is to insist your loved one reassess his decision and do what you think is appropriate. Sometimes that can be a successful strategy, but a heavy-handed method often erodes a person’s self-image as someone capable of making sound decisions.

The husband of a caregiver I counseled insisted on driving his car despite an increasing inattention because of a growing brain tumor. His decision to drive was baffling to his wife since he had been considerate of others and always rational about driving.

She feared the tumor was behind his insistence on doing something dangerous. The neurologist said it wasn’t, since the area where the tumor was growing affected only his physical abilities.

The Why of Bizarre Behaviors

The easiest thing for her to do would be to take away the keys. While effective in keeping her husband off the road, she knew it could jeopardize their relationship—a helping one that would become more critical as the tumor grew.

I suggested we determine what “driving” meant to her husband before hiding the keys. If our approach wasn’t successful, the nuclear option would be—hiding the keys. She realized what appeared to be a “bizarre” behavior was an expression of his independence.

The act of driving wasn’t important. The activity’s importance stemmed from what driving allowed him to do: meet with friends at a local restaurant, watch a ballgame, visit the racetrack, spend time by himself at the beach, etc.

She identified transportation acceptable to her husband for each activity.

Her decision to understand her husband’s reason for driving laid a foundation for difficult future caregiving and treatment decisions.

A Decision-Making Strategy

We often want caregiving decisions to be easy, despite complex circumstances. A difficult situation is when a caregiver must decide between conflicting interests, such as balancing a loved one’s dignity and public interest, the emotional health of a loved one vs. the sanity of the caregiver or many other conflicts caregivers daily face.

Our usual inclination is force decisions with or without the consent of our loved one. While it has short-term benefits, future consequences may be disastrous. The woman in the above example could have protected the public by insisting her husband stop driving and hid the keys or moved the car to another location. That course of action would send the message she didn’t care why he wanted to drive.

However, by determining the motivation for a bizarre choice, she addressed her husband’s needs, protected the public, and created a basis for trust—something critical as the illnesses progressed.

It was the best outcome one could expect for a difficult situation.

Always start with trying to preserve the dignity and independence of your loved one. Caregiving decisions often have multiple consequences, many of which aren’t apparent until time elapses. Try to anticipate how what you do today will affect what will happen next month.

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