If you are unsure of what to do with someone with dementia who resists your care, you are not alone. I am frequently called in to offer advice and tips to get cooperation-be it resistance to shower, take medication, change clothing or give up the car keys.
Before I offer tips, it is important to recognize that a person with dementia is not being resistant to cause trouble. They might be feeling afraid, confused, rushed, feeling less capable, or having physical discomfort.
Tips To Gain Cooperation– communicatesimply and directly-before you communicate, be directly in front of the person at a reasonable distance and at their eye level. Reduce the amount of wordy explanations and use visual cues. Using hand gestures and positive facial expressions helps to make yourself understood. For example rather then saying “it’s time to take your medication, open your mouth, put the pill in and swallow, you need to do this because the doctor ordered it” gesture, put the pill in your hand and calmly gesture as if you are putting it in your mouth and taking a drink. Then put the pill in their palm and gesture what they should do. ALz. Assoc.
Focus on the positive– before you engage the person in the task that they might resist, start by having the person do something which they can do independently and successfully. For instance, prior to showering, go into the bathroom, ask them to hand you the bath towel and then maybe the bottle of soap or shampoo. Then stop and praise. Smell the soap. Have enjoyable music playing softy (music that they like). Make the experience enjoyable. This sets the tone and will encourage cooperation. American Senior Communities
Break the process into steps– keep in mind that although you have a plan of action of what you want to accomplish, this is unexpected news to the person with dementia and due to their brain illness they might not understand why they need, for example, to brush their teeth. So start with giving them the toothbrush to hold, then pause. Ask if they want to put the toothpaste on the brush or should you (you can communicate this by gesturing). Pause, then pretend to brush your teeth and tell them it’s now their turn. When this is completed, let them know ”job well done” or give a thumbs up gesture.
Look to the underlying problem that causes resistance– Verbal or physical resistance might be their way of communicating physical discomfort. They might be resisting because they are in pain, have a UTI that they can’t identify or communicate, they’re too cold or too hot, constipated, clothing is too tight. Look for indicators of discomfort by a mood change, change in their body movements, facial grimacing and unwelcomed response to your touch. medscape.com
Gaining Cooperation– Combine personal care with a rewarding outcome. For example- say “Your friend is coming to visit and it will be nice to freshen up”. Also, it is helpful to know their past routine especially in personal care such as showering and dressing. Some people had routinely showered in the morning, followed by coffee and then got dressed. Some took a warm bath before going to sleep. Knowing their routine and sequence can make a world of difference in gaining cooperation.
Acknowledge their concern- Let them know verbally or non verbally that you are sorry that they are upset. Stop whatever you are doing and let them know you care. Be flexible- If there is resistance, take a break and return to the task at hand later. Instead, do something else that the person enjoys, take a walk, listen to music, have ice cream. Let it go and get back to what the two of you enjoy.
For more tips addressing your particular challenge, contact me