If you’re caring for an older relative, you’ve probably experienced it. You ask your loved one to do something. It could be anything: get dressed, take medicine on time, anything. Your loved one refuses.
Why does this happen? There are as many reasons as there are people. Fear of death, worries about being forced into a nursing home (if they’re not already there), dementia, frustration at the losses that come with advanced age, and depression over those losses are a few examples.
And then there’s the diaper factor, notes Janice Fitchhorn, who has spent her career working with older adults, initially as an occupational therapist and now as an elder care coordinator. “If the older adult in question changed your diapers at any time in the past, be prepared for resistance to just about any suggestion you might make today,” laughed Janice, who works at Truhlsen Elder Care Law of Nebraska just outside of Omaha.
Memory problems can make the situation exponentially worse, especially as the person loses the ability to perform activities of daily living. “As the disease progresses, it may be harder to get your loved one into the shower and to put clean clothes on because they may not remember that they haven't showered for three days. They may think they just showered this morning. This can cause them to be irritable or non-compliant.”
How do you handle this “You have to be respectful,” Janice advised. “Remember that the person is an adult. Don’t talk down to them. The secret is in how you present the request. You have to be creative. Instead of walking into the room and saying, ‘Are you ready for your shower now,’ you might say, ‘It's time to shower. Can you help me pick out the clothes that you'd like to wear when you're done showering?’ You present the task as what’s happening at the moment instead of something that’s optional.”
Another strategy is to make what the elder is being asked to do into a more palatable experience for them. Take the subject of exercise, for instance. Many older adults who have never been big fans of exercise will resist requests to participate in a class. The key is to look at the goal of the activity and find a different way to achieve it. “For most older adults, the goal of exercise is to improve strength or their balance,” Janice explained. “What else could they do to meet those goals? Instead of standing exercises to improve their balance, try functional activities where they are standing at the kitchen counter and baking muffins because they enjoy baking. You have them reach for different items and move along the kitchen counter. They end up doing the same kinds of things that they would have done in a class, but they’re not exercising in the traditional sense.”
As an elder care coordinator working in a Life Care Planning Law Firm, Janice gives family caregivers the guidance they need to navigate these delicate situations. “I had a family that didn't want their mom driving anymore, but they knew their mom would resist if they brought it up,” Janice noted. “I advised them to take their mom to driver's rehab for professional evaluation instead of trying to address the situation themselves. News delivered by a professional is almost always better received than the same news coming from a family member.”