Caring for a loved one with Alzheimer’s disease or another form of dementia is demanding – emotionally, mentally, and physically. It becomes especially challenging for caregivers whose loved one frequently resists assistance with daily tasks, doesn’t want to engage in various activities, or refuses necessary care needs.
Sometimes, resistance or refusals come in the form of a direct verbal refusal, such as the individual saying, “No!” or “I don’t want to do that.” However, as the disease progresses and communication becomes more difficult, these challenging behaviors may manifest through non-verbal means.
A loved one may try to get away or hide from the person offering help. They could simply ignore the caregiver’s efforts, refusing to acknowledge them at all. In some cases, the resistance or refusal could lead to stronger responses, such as the person becoming visibly agitated, yelling at the caregiver, or becoming physically aggressive.
Understanding the types of resistance and refusals that you may experience as a caregiver can allow you to approach your caregiving tasks with more patience and empathy. This approach ultimately reduces stress for both your loved one with dementia and you, as the caregiver.
Common Types of Resistance & Refusals in Dementia Care
Resistance to assistance or refusal to cooperate in dementia care can stem from various factors, so it’s important for caregivers to assess the situation to understand the cause before responding. Common causes or situations may include:
- Routine-driven resistance: Individuals, especially those in the early stages of dementia, may resist due to disruptions to their daily routine.
- Personal care resistance: Sensory sensitivities or processing issues can trigger a resistance or refusal response for certain tasks like bathing or dressing.
- Food refusal: Issues like difficulty using utensils, food texture preferences, or inability to identify items can cause a person with dementia to refuse to eat.
- Medication refusal: A loved one may refuse to take prescribed medications due to not understanding why they need to take it. Another reason could be difficulty with swallowing as a result of Alzheimer’s disease. Finally, there may be a fear of an unpleasant taste or the side effects that the medication may cause.
Common Reasons for Resistance and Refusal
There are many factors that can contribute to these challenging behavioral symptoms, including cognitive, sensory, and environmental changes.
By understanding what may lead to resistance and refusals, caregivers are better equipped to manage these behaviors effectively. Some of the triggers that may cause refusal to cooperate or resistance to care or certain activities include:
- Pride and dignity: Early dementia can cause difficulty accepting help with personal tasks, as individuals may feel embarrassed or frustrated by their declining abilities.
- Loss of control: The fear of losing independence may drive refusal as a means of regaining a sense of control.
- Diminished awareness: The individual’s cognitive decline may make it impossible for them to recognize their need for help with daily activities.
- Timing and mood: A person’s mood or the time of day can impact their willingness to cooperate, with agitation leading to resistance.
- Changes in routine: Disrupted routines or a new routine being added may cause confusion or distress, resulting in refusal to cooperate.
- Dementia-related symptoms: Dementia can alter perception, causing confusion, paranoia, or hallucinations, leading to difficulty understanding a particular task.
- Environmental factors: Overstimulating environments with loud noises or bright lights can overwhelm and confuse the individual.
- Physical issues: Health-related issues, such as pain or discomfort that the person cannot express, may play a role in resistance.
- Depression and fatigue: Mental health issues that can arise with dementia, such as anxiety, depression, or fatigue, can lead to apathy and reluctance to engage, increasing the likelihood of refusals and resistance.
When faced with resistance from their loved one, caregivers should take a moment to pause and consider:
- What behaviors or actions trigger the resistance?
- Does the environment (lighting, noise) affect my loved one’s response?
- Does the person react differently based on who is helping them?
- Are there specific times of day or conditions (e.g., hunger, fatigue) contributing to their refusal?
- Was there an earlier event that caused frustration or confusion?
Addressing Resistance Through Environment & Communication
Small adjustments to your caregiving approach can make a big difference in reducing resistance and gaining a loved one’s cooperation. By modifying the environment and improving communication, caregivers can create a more positive experience for everyone involved.
- Modify the environment:
- Reduce distractions by turning off TVs or radios.
- Ensure good lighting and create a calm atmosphere.
- Introduce familiar objects to evoke a sense of comfort and familiarity.
- Improve communication:
- Speak slowly and clearly using short, simple sentences.
- Reassure with a calm, gentle tone and appropriate physical touch.
- Offer choices (e.g., “Would you like to wear the blue shirt or the red one?”) to give a sense of control.
- Provide step-by-step instructions and be patient, giving extra time for responses.
- Adjust tasks to be more manageable:
- Break tasks down into smaller, manageable steps to avoid overwhelming the individual.
- Use visual demonstrations alongside verbal instructions.
- Approach tasks as a partnership, rather than giving commands, to build trust and cooperation.
Managing Resistance and Refusals
Despite your best efforts, resistance will still happen at times. When it does, it’s important to approach the situation with patience and understanding:
- Stay calm and supportive – Remain calm and avoid displaying frustration or anger. Your loved one will pick up on your emotions and respond accordingly. Try to approach with kindness, understanding, and reassurance.
- Use gentle reminders – If your loved one refuses, gently repeat your request without raising your voice. Be sure that the task is broken into simple and easy-to-understand steps.
- Be flexible – If a certain approach doesn’t work, be open to trying again later. Changing the time of day, environment, or approach may yield better results.
- Promote independence – Encourage your loved one to do as much as they can on their own, even if it takes longer. This helps preserve their sense of dignity and can lead to improved mood and results.
- Monitor medications – Certain medications can cause changes in behavior. If you notice sudden shifts in your loved one’s mood or actions, consult a healthcare provider.
Managing Stress for Caregivers
Caring for someone with dementia is physically and emotionally demanding. Caregivers must prioritize their well-being to provide the best possible care for their loved one.
- Engage in self-care – Take breaks, exercise, eat well, and rest to prevent burnout.
- Use sensory activities – Music, art, aromatherapy, and pet therapy can help calm both caregivers and those with dementia.
- Join a support group – Connecting with others in similar situations provides emotional support and reduces feelings of isolation.
Embrace a Fulfilling Lifestyle
Bridges® by EPOCH is dedicated to providing a fulfilling lifestyle for those with dementia. Through our specialized memory care services, we create a safe, secure, and engaging environment that promotes dignity and respects individual preferences.
Our compassionate memory care professionals receive ongoing training to maximize each resident’s independence and quality of life. Whether your loved one is in the early stages of dementia or requires more comprehensive care, you can be confident that they will receive the best support possible.
Bridges® by EPOCH communities are located throughout Connecticut, Massachusetts, and New Hampshire, including Andover, Hingham, Lexington, Mashpee, Nashua, Norwalk, Pembroke, Stamford, Sudbury, Trumbull, Westford, and Westwood. Find a location near you.
Please reach out to learn more about our memory care services. Our team will be happy to help with any of your questions.