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Dealing With Resistance

Caring for the elderly can be challenging — particularly if a loved one is resistant to care. Understand what's causing your loved one's resistance and how you can encourage cooperation.

One of the toughest challenges you can face when caring for the elderly is resistance to care. How do you help a loved one who doesn't want help? Understand how resistance to care can develop and strategies for fostering cooperation when caring for the elderly.

What causes resistance to care?

If your loved one is in need of care, he or she is likely dealing with loss — physical loss, mental loss, the loss of independence. Accepting care may mean relinquishing privacy and adjusting to new routines. As a result, your loved one may feel frightened and vulnerable, angry that he or she needs help or guilty about the idea of becoming a burden to family and friends. In addition, your loved one may be stubborn, have mental health concerns or simply think it's a sign of weakness to accept help. He or she might also be worried about any associated costs.

What's the best way to approach a loved one
about the need for care?

If you suspect that your loved one will be resistant to care — whether from family, other close contacts or a service — you may be hesitant to bring up the topic. To start communicating with your loved one about his or her need for care:

Choose a time when you and your loved one are relaxed. This will make it easier for you and your loved one to listen to each other and speak your minds.

Ask questions about your loved one's preferences - This will help you provide the type of assistance your loved one wants. What type of care does your loved one want or need? Does your loved one have a preference about which family member or what type of service provides care? While you may not be able to meet all of your loved one's wishes, it's important to take them into consideration.

Enlist the help of family members - Family and friends may be able to help you persuade your loved one to accept help.

Don't assume that your loved one is unable to discuss care preferences - While your loved one may be ill, he or she may still have care preferences and be able to make some decisions regarding care. If your loved one has trouble understanding you, be sure to simplify your explanations and the decisions you expect him or her to make.

Don't give up - If your loved one doesn't want to discuss the topic the first time you bring it up, try again later.

What are the most effective strategies for
managing resistance to care?

Getting an aging loved one to accept help can be difficult. To encourage cooperation, you might:

Suggest a trial run - Don't ask your loved one to make a final decision about the kind of care he or she receives right away. A trial run will give a hesitant loved one a chance to test the waters and experience the benefits of assistance.

Enlist the help of a professional - Your loved one may be more willing to listen to the advice of a doctor, lawyer or care manager about the importance of receiving care.

Explain your needs - Consider asking your loved one to accept care to make your life a little easier. Remind your loved one that sometimes you'll both need to compromise on certain issues.

Pick your battles - Focus on the big picture. Avoid fighting with your loved one about minor issues related to his or her care.

Explain how care may prolong independence - Accepting some assistance may help your loved one remain in his or her home for as long as possible.

Help your loved one cope with the loss of independence - Explain to your loved one that loss of independence isn't a personal failing. Help your loved one to stay active, maintain relationships with caring friends and family and develop new physically appropriate interests.

Keep in mind that these strategies may not be appropriate when dealing with a loved one who has dementia.

What else can be done?

If your loved one continues to resist care and is endangering himself or herself, you may need to take steps to protect his or her health and safety. Consider consulting a lawyer about elder care issues.

Resistance to care is a challenge that many caregivers face. By keeping your loved one involved in decisions about his or her care and explaining the benefits of assistance, you may be able to help your loved one feel more comfortable about accepting help.

Visiting a Person with Dementia

Visiting family and friends with dementia is important for their emotional wellbeing.

However people with dementia are usually not able to initiate activities or ‘entertain’ you, the visitor.

Here are a few tips you may find useful when visiting your friend or family member, whether they live at home or in residential care.

Develop a flexible attitude - We all have high and low energy days and your friend or family member may be tired the day you visit. While things may not go as you had planned, remember your visit is still important – for you and the person you are visiting.

Be kind to yourself - Visiting can sometimes be sad and difficult, and you may need nurturing – perhaps take a supportive friend with you or plan a treat for yourself on the way home.

Take something with you - You can engage the person you’re visiting by taking a magazine or newspaper with you. Read out interesting articles or do a quiz together. Take flowers, a food treat or old photos or postcards. This then becomes an activity which helps with stimulation and reminiscence.

Establish a visiting ritual - Say and do the same things on arrival and departure at each visit. This will add structure for your relative or friend. Introduce yourself on arrival. For example say “Hello Mum, it’s me, Elizabeth, your daughter”. This reduces your friend or family member’s anxiety as you remind them of your name and connection to them – don’t make them guess.

Write cards and letters - Working together, write a letter to your mutual friends or family. This can nourish and maintain important links in their life.

Get to know the care staff by name - If visiting a residential care facility, introduce yourself and explain your relationship to the person you are visiting.

Silence is not a negative thing - Instead, try to learn to enjoy quiet times.

Organize a drink - A cup of coffee, tea or glass of water will help your friend or family member’s fluid intake, socialization and continue normal ‘old’ patterns of hospitality.

Talking isn’t everything - Hugs, hand and neck massages and hand holding can replace or complement conversation.

Start a ‘communication book’ of important things to remember - This can be written in and read by all visitors and act as a memory prompt for your friend or relative.

Make a life book - This is a wonderful way of validating the life journey of your friend or family member and reminiscing old accomplishments. Work through it on your visits. This project can make your time together even more enjoyable and special.

Consider doing tasks - Sew labels on clothing, assist with food and fluids or take the person you are visiting for a walk. This will not only benefit the person concerned but it will also maintain your vital role and help you to feel useful and important. It can also assist care staff in residential facilities.

Play an instrument or sing If you are musical - Consider playing an instrument or singing for your friend or relative. Music creates relaxation, a return to fond memories and feelings of calm and security.

Take an animal or your pet with you - A visit from a well-loved pet can improve the emotional health and well-being of your friend or relative. If visiting a residential care facility, speak to staff before taking your pet with you.

Know that your visit makes a difference - Research suggests that people living in residential care need emotional support for their well-being and are less likely to be depressed when they have regular weekly visitors.

If necessary, talk to someone - There are many issues around changing roles and grief that affect families, friends and caregivers of people with dementia. It is very important to take care of yourself. Speak to a supportive friend about your feelings