Overcoming Reluctance to Accept Home-Based Support from an Older Adult Perspective

Objectives: To understand older adult perceptions about accepting help at home, in particular fears related to potential loss of independence. Design: Qualitative focus groups. Setting: Rural, suburban, and urban areas of Fort Wayne, Indiana, and Chicago, Illinois. Participants: Community-dwelling adults aged 65 and older (N=68). Measurements: Participants discussed decision-making, reluctance to accept home-based care, barriers, and resources that might affect remaining in the home. Three independent coders used constant comparative analysis to interpret results. Results: Analysis revealed that reluctance to accept home-based support was associated with concerns over inability to complete tasks, perceptions of being burdensome to others, lack of trust in others, and lack of control. To overcome these concerns, some participants reframed the concept of independence to be “interdependence,” with people continually depending on each other throughout their lives. Subjects noted that, even if one becomes more limited over time, the recognition that one is still contributing something meaningful to society is important to overcoming refusal of home assistance. Another strategy presented to overcome negative perceptions of accepting assistance in the home was the recognition that helping someone who is in need may engender positive emotions in those providing the help. Conclusion: Older adults perceived multiple reasons for refusing home-based assistance and offered potential strategies to overcome this reluctance. Addressing the reasons and promoting strategies to accept home-based support may lead older adults to have fewer unmet home-based needs, enabling them to remain safely in their homes.