Advice by Alicia: Honoring Resistance and Refusals

Q: Ever since my mom has been diagnosed with memory loss, we’ve noticed she’s more likely to refuse help and resist our efforts to care for her. Why is this, and what can I do about it?

A: As dementia progresses, you may find loved ones resisting and refusing to cooperate or comply. This is a normal occurrence, but it can certainly cause frustration and stress. Whether they refuse or resist because of pride, depression, their dementia symptoms, changes in their routine, or overstimulating surroundings, identifying resistive behavior and getting an understanding of why this is occurring and what you can do about it is crucial. Below are some tips that can help you identify, manage and approach resistance and refusals.

Managing Resistance and Refusals by Identifying Behaviors

Ask yourself these questions to evaluate and limit your loved one’s behaviors.

  • What happens during the behavior, and what was happening beforehand?
  • Where do resistive behaviors occur?
  • Who is usually involved when these issues arise?
  • When do resistance and refusals tend to happen?

Make notes of these occurrences to look back on and adapt your approach.

Approaching Resistance and Refusals

Consider preferences and history.

Recognizing a person with dementia for who they are and taking their individual preferences into account can help to decrease their likelihood of refusing or resisting support.

If you know there are certain reasons they may be refusing, like a difficult life experience or specific problem they faced, try to come from a different approach and get the whole picture.

For example, for someone who has cared for themself for decades, it can be difficult to accept help. Make sure to provide plenty of opportunities to do what they can for themselves, helping to maintain their independence while offering help or support only when it’s needed.

Think about what stage of memory loss your loved one is in.

The stages of memory loss can affect loved ones differently. By doing your research and knowing what to expect, you might be able to identify points of resistance you could come across.

Don’t forget, dementia affects much more than simply memory; It also affects language, understanding, impulsiveness and sensory awareness, making it important to evaluate if this can have any impact on resistance and refusals, too.

Evaluate what could be causing resistance or refusal in dementia and find ways to help.

Changes in routine

Evaluate how activities and needs fit within your loved one with dementia’s everyday life and preferred routine. Stay in their comfort zone and adjust plans and routines to suit them.

Health issues

Assess your loved one to be sure they don’t have any unmet personal care needs causing frustration or irritability. Treat any pain, emotional distress or fatigue. If they’ve refused to eat, consider if they are hungry now.

Their environment

Are there loud or distracting sounds, shadows and bright lights, or textures and confusing patterns present? This can cause confusion or trigger stress and discomfort.. Try changing the environment or modifying what’s bothering them.

Dementia symptoms

Restlessness, sleep challenges, discomfort or forgetfulness can make it more likely for older adults with dementia to resist or refuse. Find ways to reduce stress, improve problem behaviors and increase their quality of life.

Adapt your reactions.

People with dementia don’t refuse, resist or act this way on purpose; it’s part of the disease of the brain. Stay calm, be patient and supportive. Remember that your loved one can pick up on your own stress and body language, even if they don’t understand what you are saying.

If your loved one doesn’t understand a particular request, take a moment, regroup, and then repeat your request slowly. If you don’t seem to be getting anywhere with your loved one, perhaps let the issue go for now, and try again with them later.

Try to be flexible. Our best laid plans can become easily derailed when caring for a memory-impaired loved one. Be prepared to adjust your plans if necessary.

Above all, take care of yourself, too. Caring for a loved one with memory loss can be extremely demanding and stressful. When you’re stressed and tired, you may lose the ability to remain calm and soothing. Taking care of yourself is not an act of selfishness; it’s a necessity. Consider joining a support group to connect with others who are in similar situations. It is a great opportunity to share your story and swap caregiving tips to ease the journey for you both.

We’re here for you.

If you’re caring for a loved one with dementia, memory loss or Alzheimer’s disease, visit our website for more resources. Or, for additional assistance and tips, attend a support group today.

About Alicia

Alicia Seaver is the Vice President of Memory Care Operations for EPOCH Senior Living and a Certified Memory Impairment Specialist. Every month, she addresses a specific issue related to memory and memory care. If you’re interested in hearing about a particular topic, please send a note to aseaver@epochsl.com.

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