Elderly clients resistant to help present an ethical dilemma for professionals. This dilemma may climax when assumption of authority over the client for his safety is necessary. Social workers need to work for decisions closest to the wishes of the client. The at-risk client should be informed about changes that will occur and how these changes will help him in order to reconcile the client to these changes. A client may resist assistance because he feels it is interference and signifies the loss of his integrity as a person. The client may defend himself against protective help by opposing changes in his environment, minimizing his problems, blaming outside causes for his discomfort, and manipulating another person to supply his needs. The objective for a social worker is to reconcile his and his client's goals. This can be facilitated by an empathetic relationship and by the social worker's acceptance of the client's choice of alternatives. If the client's cognitive abilities do not support this, a trusting therapeutic relationship must be substituted. Skill and patience with the resistant client are of utmost importance. (ABL)