They need help, but they refuse it.

One of the more difficult things for those affected (e.g. family, friends, neighbors, colleagues) by someone’s chronic condition, injury, life threatening illness or aging is what to do when they reject the help and support being offered. This can play out in a multitude of ways. My husband’s client called to say he was diagnosed with a condition, though treatable, he opted not to do so, and wanted assistance with his estate. His decision was ironclad and no amount of urging from his wife, friends or children changed it.

 It’s not uncommon for someone to hide their illness from family and friends, not unlike what a cat or dog might do. When it becomes obvious something is very wrong, they still may reject help. Many an adult child can write a book about how their parent(s) were in desperate need of help and refused it every step of the way, while the issues faced by family and friends of loved ones with mental health or substance users are legendary

People literally turn their lives upside down trying to be helpful to no avail. Helping is a basic instinct, which is why it’s not surprising that How to Respond When Someone is Ill or Injured is the second most popular post on this blog. While tips abound in this How to post, today’s focus is when someone in your orbit-parent, sibling, friend, colleague, spouse or neighbor- clearly needs help, you’ve offered and they’ve refused it.

Why Help is Rejected: People reject help for a variety of reasons. 1) Sometimes people are literally overwhelmed by the outpouring of support and help, particularly in the early stages of a diagnosis and treatment. 2) They can adopt ideas and beliefs out of fear, and the more you try to get them to change, regardless of your relationship to them, or what you say or do,  the tighter they hold on to them.  

3) Dealing with major illness is all consuming, so if your views are somewhat different, particularly when it comes to major areas like treatment, they may shut you out on general principles. 4) Stigma, denial, low self-esteem and/or lack of funds or health insurance, can also be contributing factors, and in the case of substance users, they may have no interest in stopping. 5) Note that disease and/or aging can cause cognitive impairment not only making the person more fearful, but also rendering them unable to understand what’s actually happening to them.

Assess Your Responsibility:  If  you think the person is in a position to harm themselves and/or others, you can call: a) the person’s family member(s) or b) local police, asking for a well fair check or even c) adult protective services in your state.

If this is an elderly family member, there are resources in your community that can help you, such as  your local Area Agency on Aging,  Senior Center or state office on Aging. The links below offer recommendations to assist parents who are reluctant to accept help. 

• Nine Strategies to Help a Parent Who Refuses Care 

• When a Parent Says “No”

If the person you are trying to help is dealing with addiction or mental health issues, check the following resources.

• Your Family Member Has Bipolar Disorder and is Refusing Treatment 

• National Council on Alcoholism and Drug Dependence Helping a Family Member or Friend 

• Al-Anon/Alateen: Support for friends and families of problem drinkers and drug users 

• NAMI (National Alliance on Mental Illness) 

Keep in mind that if they are not a threat to self or others, there isn’t that much you can do.

Recognize that Bad Things do Happen and there are times we can do nothing to stop it. Sometimes a negative experience will help them make a better choice. It may take a few missed meals, or a fall down the steps, for Mom to decide Meals on Wheels or a one level apartment are better options for her. Loss of a job, relationship and/or being arrested may be the wake up call a person with an addiction might need.

Educate Yourself: By learning about the person’s condition, including participating in support groups for affected family and friends, you will have a better understanding of their situation. It can help you decide how you want to live your life in respect to this individual.

Acceptance: As much as you may want to help, when it’s not wanted, there really isn’t much you can do. Many centuries ago, the Greek philosopher Epictetus wrote, "Make the best use of what is in your power, and take the rest as it happens. Some things are up to us and some things are not up to us.” Today’s version of that is the “serenity prayer.” God, grant me the serenity to accept the things I cannot change, The courage to change the things I can, And the wisdom to know the difference.

Ultimately, their body, their choice.