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5 Creative Ways to Gain Cooperation from a Senior with Dementia

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March 4, 2015

According to the University of California’s Berkeley Wellness newsletter, “nearly all people experience some form of cognitive decline later in life.” Cognitive decline can cause memory impairment and loss of the ability to reason. This may explain why elderly parents or other loved ones can become increasingly stubborn as they age. Of course, older people can become stubborn for a variety of other reasons as well—like simply being set in their ways. That stubbornness can do more than cause caregiver frustration, however. In certain situations, it can even lead to non-compliance with doctor’s orders. In fact, a study conducted for the Prevent Senior HospitalizationsSM program by Home Instead, Inc., franchisor of the Home Instead Senior Care® network, cited unwillingness to change as a top cause for not following doctors’ orders.

So how can you overcome your loved one’s constant refrain of “no”? Try these practical tips to gain cooperation and reduce your feelings of caregiver stress.

5 Creative Ways to Turn a No into a Yes

1. Be willing to compromise.

If your loved one won’t shower, will he or she at least agree to a sponge bath? What about washing the hair? What about simply washing the hands before eating? Sometimes compromise leads directly to a “yes.”

2. Don’t be afraid to use bribery.

Sometimes adult caregivers can view their elderly parents’ uncooperativeness as a type of temper tantrum. Realize this is not the case. Small children possess the ability to reason, which is why you don’t want to reward a tantrum. However, cognitive decline in seniors can lead to an inability to reason effectively. That’s why reward systems are A-OK when trying to elicit cooperation from an older adult.

When you make a request you expect will be met with resistance, try adding a reward to it. You may be surprised to discover how eager your loved one is to please you when they think they’re getting something out of it.

3. Use the ‘three tries’ rule.

The Home Instead Senior Care network trains its professional CAREGivers℠ to try three times in three different ways to turn a no into a yes. You can do the same thing.

-- Ask your loved one to do something: “Mom, let’s work on a jigsaw puzzle.”

-- If she declines, wait awhile and then ask again with additional information from her life story: “Mom, can you help me with this jigsaw puzzle? I’m stuck, and you’ve always been good at this.”

-- If she declines again, use physical touch and the offer of a reward for complying: Take her hand and look her in the eye. Say, “Mom, can you help me with this jigsaw puzzle? You’ve always been so good at this. If we can get just three pieces into place, let’s reward ourselves with some ice cream.”

4. Don’t take the no personally.

Understand that a ‘no’ is not a rejection of you. In people experiencing cognitive decline, ‘no’ may represent a loss of memory and the ability to use good judgment. Asking your parent to take a shower may seem like a perfectly reasonable request to you, but your loved one may be thinking, “I just took a shower earlier this morning. Why on earth would I want to take one again? No!”

5. Make it easy to cooperate by offering choices.

It’s easy to say ‘no’ to requests that seem unilateral: “Eat your lunch right now. I went to a lot of work to prepare this delicious food.”

It’s easier to say ‘yes’ when you’re given a choice: “Would you like to eat lunch at 11:30 or at noon? Would you prefer tuna sandwiches or egg salad?”

Unilateral: “Take this pill right now. It’s time.”

Choice: “The doctor said to take this pill with your lunch. Do you prefer to take it before you eat or after?”

Remember: A Lack of Cooperation Is Not the End of the World

It’s easy to get so invested in the power struggle that you lose sight of the overall goal. If you’re aiming for 100 percent cooperation and compliance from a stubborn parent or spouse, maybe you need to revise your expectations. The world will not end if someone refuses to shower today (or even for two or three days). By setting reasonable expectations and using tricks to foster cooperation, you can reduce the stress you feel as a caregiver each time you hear the word ‘no.’

 

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Thoughts and stories from others
  1. March 27, 2015 at 9:51 pm | Posted by Allan Smyth

    My wife and I have watched the classic film "Driving Miss Daisy," in which Jessica Tandy resents having a chauffeur (Morgan Freeman), and there is quite a tug of war for some time, with Jessica Tandy eventually becoming a dear friend of Morgan Freeman. We laugh and laugh, but this story is so true to life in many respects. As we age and need more help, we naturally resist and resent needing help with our private life and Patience and understanding, plus a firm framework win the day. Miss Daisy can resist, but she cannot fire the chauffeur. She gives in little by little to being helped. We feel this film is a wonderful example of helping one who is aging. - Allan and Vercey Smyth, Oregon

    Reply

  2. March 26, 2015 at 11:59 am | Posted by Lynne Cunningham

    This article is very helpful for me-especially about showing empathy! In other words-place yourself in their shoes!

    Reply

  3. March 16, 2015 at 3:46 am | Posted by Frankie from Alaska

    I am a caregiver for HomeInstead in Alaska. I have a client with mid to late stage Alzheimers. My problem is I cannot get her to bathe. She takes it as a personal affront. In fact, one day she told me I was over stepping her boundaries. I have tried offering washing her hair in the sink, sponge baths, the promise of ice cream (her favorite) or shopping trips to the grocery store/going to her favorite garage sale locations, basically any reward I can come up with. I am worried she may get a skin infection of some kind. She will easily go 3-4 weeks without a shower. Any helpful suggestions?

    Reply

    • March 17, 2015 at 8:32 pm | Posted by Tara Hoffmann

      I had a new foot care client who his caregivers said he refused to take a shower claiming it washes away his natural oils in his skin. He was pretty odorous. I asked him would he take a shower to keep bugs off his skin? He said yes, so I told him that his body is always producing oils but it can't fight off bugs from the dirt that the oil on his skin collects. He didn't like the thought of having bugs so he took a shower after I left! I had a other client who liked to be squirted off with the hose in the backyard, like when she was a kid and that's how her caregiver got her bathed!

      Reply

      • April 15, 2015 at 8:00 am | Posted by Joan

        Oh my...I don't think showering a delicate modest senior with a hose in backyard seems right at all.

        Reply

  4. March 12, 2015 at 11:55 pm | Posted by sandy rodwell

    Many times when I am with a client I will always ask what their interests are so I can learn more about them as a person. I also share my interests and bring some of my projects to show them. This makes our relationship more personal.

    Reply

  5. March 12, 2015 at 8:10 pm | Posted by William F. Rimmler

    My wife has LBD Dementia and woul like to have information on the various stages with examples

    Reply

  6. March 12, 2015 at 5:52 pm | Posted by Ruthann Truesdell

    Thank you for the article. It came a a perfect time. I will use the article to augment the dementia course I am teaching. It will help with a request I just received from one of the student's to teach her ways to get therapy patients to agree to particpate in therapy sessions.

    Reply

  7. March 12, 2015 at 10:25 am | Posted by pam carlin

    I so enjoy all of the articles you send me about alzhiemers and dementia. My mom moved in w/ me last August and I have found your articles tremendously helpful and up lifting, thank you

    Reply

  8. March 12, 2015 at 9:36 am | Posted by Kim

    Thanks so much for this article. It's really helpful with specific examples and reminds me I'm not alone in my caregiver role.

    Reply

  9. March 9, 2015 at 2:56 pm | Posted by Barbara Charlton

    Home Instead (Highland Village, TX) helped me care for both of my parents for the last 3 years of their lives. It is easy to see that they trained their people in how to gain cooperation as outlined above. I would often get stuck on logic (especially before I realized I was dealing with true cognitive decline), and I got frustrated. But I learned from our caregivers to approach them a few different ways, and not to give up -- just don't try to argue with logic. I can highly recommend Gianna Loftis (owner) and Mary Swan RN (Dir. of Nursing) for those needing help with their aging loved ones.

    Reply

    • March 12, 2015 at 10:52 am | Posted by Nancy

      Does Home Instead actually have aides that come to the home, or is it more of a support system, via telephone or online?

      Reply

      • March 12, 2015 at 10:59 am | Posted by Cat Koehler

        Hi Nancy! Our CAREGivers provide care to seniors in their homes. You can learn more at www.HomeInstead.com. - Cat Koehler, Home Instead Senior Care

        Reply

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