Do you often feel like a broken record, repeating the same questions over and over again: “When are you going to change your will?” “When do you plan on getting handicapped license plates?” “When are you going to sell that big house and come live with us?”

Getting someone to address a problem they refuse to acknowledge is challenging in any relationship. This situation becomes more significant when one person is disabled, chronically ill, or incapable of independent living. The consequences of this dynamic can be larger and more severe. Navigating this type of situation requires careful consideration and strategy.

“I get so frustrated,” says Kathleen, caregiver to her husband Scott who has Lou Gehrig’s disease. “Every time I say that we really ought to talk about our finances, Scott changes the subject. I don’t want to be a nag, but I’ve got to get him to realize that we have to make plans for my future, and for the kids’ future too. I’m afraid he’ll hate me if I act on my own, but I can’t just wait around until he’s ready. I need to do something. I feel so trapped by his inaction and manipulated by it as well.”

Denial Isn’t Necessarily Bad

This is a common caregiver complaint, and a very difficult situation because both parties are in pain. One tries to hide it with denial and the other wants to work through it and gain some control of his or her life. They are in different places, almost a different time zone in a sense, and so they can’t hear what the other one is saying. This creates a disconnect between the two perspectives.

Denial in and of itself isn’t a bad thing. In fact, it’s a normal response to pain. It only becomes a problem if people don’t work through it, move on, and start picking up the pieces of their lives.

Denial gives people time to adapt and respond to significant life changes. It gives them time to overcome fear.

Recognizing that denial is a normal coping mechanism probably won’t blunt your frustration with your loved one’s inaction. However, realizing that as individuals, we all cope with pain and loss differently, and at different speeds, can help you understand that you need to find a way to break through the denial so that constructive communication can occur.

Showing You Understand

Finding the way may well start with gaining a better appreciation of how the change in your loved one’s life has affected his/her ability to deal with long-term issues or think about the concerns of others.

One of the byproducts of being disabled by an illness or having an accident, etc. is the feeling of “having been done to.” It makes people feel very vulnerable and takes away their sense of empowerment says social worker Linda Samuel.

“It’s hard for people to recognize that despite the initial occurrence they still have choices, many of them, and many decisions to make, too. They have to decide how they want to live the rest of their lives. Trying to convince them of that is a key element in breaking through the barriers they’ve erected.”

Often people who are receiving help from others, or who have experienced a great loss, think that others, even their closest relatives and friends, can’t possibly understand their situation. They become distrustful of any advice that is given.

Empathetic Communication and Empowering Choices

It’s important therefore for caregivers to verbalize the fears their loved one may be feeling, to show they empathize with the situation, that they understand their loved one has suffered a great loss and may be frightened about the future. Samuel agrees and offers the following introduction to a conversation as an example:

“Mary, I know you wish things hadn’t happened this way. Knowing you wish you hadn’t been in that car accident is understandable. Knowing you are frightened is also completely valid. I am too in this situation. Wishing you were still fine and healthy is a natural response, but the fact is you’re not, and we have to start finding out what our choices are moving forward.

We have to start making decisions, so we can move on from here and live the rest of our lives as fully as possible.”

Convincing your loved one that he/she still does have some control over circumstances is an important part of the communication process. Words like choice, options, possibilities, and alternatives are important words to use because they are action-oriented.

Be Clear About Your Own Feelings and Objectives

As important as it is to empathize with your loved one, it is equally important, if not more so, to under­stand your own feelings. Set for yourself clear emotional goals. Understand what it is you’re feeling and what you really want to achieve.

When asked about what concerns propelled them to insist that their loved one take a particular action, caregivers’ answers seem to fall in one of three categories: a concern for the loved one’s physical safety or mental well-being, a concern for some sort of security, or a strong desire not to have to make critical decisions alone.

“I’m afraid she might go into a coma,” said Bill, referring to his wife Sylvia. “If she doesn’t have a living will, what am I going to do? I don’t want to have to decide how much or how little treatment she should receive. I want to know what she would want me to do.”

“Christine and I are in our sixties now,” noted Marty. “We’ve cared for Julia all her life, but when we are gone, she’ll need to live else­ where, have another guardian. Christine refuses to deal with the issue, and I’m afraid we’ll die before it’s been resolved. What will happen to Julia then?”

“My father is the original macho man,” explained Nancy. “Despite the fact that he is 75 years old and recently had a heart attack, he insists that he’s in perfect health. I only want him to wear a personal response buzzer, just in case some­ thing happens again. I’m concerned that he’ll have another attack and it will be too late when someone finds him.”

Effective Family Communication

Look closely at your own feelings and try to verbalize what’s causing you to harp on a particular issue. Try to separate out the solutions to the problem form the issue itself, counsels psychologist Hammond. “It’s the underlying concern that is more likely to get them to respond to your request rather than your insistence on a particular action.”

If you’ve reached your limit with the consequences of inaction, it’s best to change the situation yourself. When making requests, frame them in terms of your own needs, as this is more likely to get a positive response. “People tend to respond more easily to an emotional plea than they do to logic,” suggests Dr. Hammond. By appealing to their concern for you, you are also helping your loved one move outside of themselves, Linda Samuel adds, because you are urging them to think about the impact of their inaction on other family members.

When You Can’t Break Through

By acting, you reclaim your power and control, which is vital for your health and well-being. Moving beyond the status quo offers benefits like chipping away at barriers to your goals, reduced anxiety, and skill development. New possibilities may arise from your steps to change the troubling situation.

The word ultimatum often has negative connotations they noted. It suggests setting up a situation in which one person wins and the other loses. But an ultimatum need not be confrontational, especially when it is presented in terms of your own needs.

“I am so afraid every time you get behind the wheel of the car. You’ve been so distracted lately and you just don’t seem to have the concentration you used to. I am concerned you are going to hurt yourself, and others. I may not be able to stop you from driving, but I don’t have to get in the car with you either. From now on, I’ll take my own car instead of going with you.”

“Obviously the preferred solution is for your loved one to work with you to find answers to the difficult problems you face,” says Dr. Hammond, “but if that doesn’t seem possible, don’t be afraid to do what you can by yourself.”

She adds that your own action might trigger the desired reaction. Nobody wants to be excluded from crucial decisions, especially adults.

Strategies for Encouraging Collaboration in Challenging Situations

If circumstances are such that you must continually act on your own, and if you are consistent in your behavior, sooner or later, Dr. Hammond contends “…your loved one is going to want to be part of the act to regain some self-determination.”

Let your loved one know how you feel and what you think needs to be done, the therapists we spoke with advise. Present your first solution one that includes active participation by both of you. Let your loved one know you want him/her to help solve your mutual problems.

Be prepared to offer alternatives when possible. Note which of your suggestions include your loved one and which do not. Communicate your intent to act independently if necessary, explaining that the current situation is unsustainable for you.

What’s To Be Gained

Acting on your own isn’t a turning away from your current relationship or a disavowal of the other person’s rights. It’s rather an affirmation of yourself as an individual and your commitment to carrying on with life.Taking action helps you regain empowerment and control, benefiting your health and well-being. Moving beyond the status quo offers other benefits too. These include chipping away at barriers to your goals and feeling less anxious. Knowing something has been done reduces anxiety, and you also learn new skills. Additionally, new options may open up because you took steps to change the upsetting situation.

Acting independently to address a problem affecting you and your family may not be your first choice. However, when coping with illness or disability, not all solutions will be perfect. The goal is to make the best of a difficult situation.

By working toward breaking through the barriers of denial, that’s exactly what you’ll be doing. It requires fortitude, empathy, concentration, self-awareness, and a whole lot more. If you manage to do it, even temporarily, you will have accomplished a great deal. “I didn’t realize what a rebirth I would feel,” says the husband of a wife who has rheumatoid arthritis. “Now that my wife is willing to work with me on finding solutions to the problems we face, life is a whole lot easier. It’s a great relief to be able to turn off my broken record.”