When aging parents refuse help, it can be an incredibly frustrating experience. When that parent is exhibiting symptoms of dementia, it can cause the worries to skyrocket. It is important that we understand two of the main reasons older adults tend to refuse care and deny the presence of dementia – anosognosia and fear.
Anosognosia is the inability to recognize an illness or disorder that is clinically evident. As the brain changes due to the damage associated with dementia, the individual may literally not know or have the capability to understand that they have dementia. When this occurs, it can add another layer of stress to an already challenging situation.
Denial is a coping mechanism that can bring comfort and keep fear within arm’s reach. Can you imagine being told your brain is in decline and you will lose the ability to remember those around you? Admitting that you have dementia makes it real, and some of our aging loved ones are not ready to live that reality just yet.
It doesn’t really matter why they are refusing help, although it can help us be more understanding. Whether it is because of fear or anosognosia, the gravity of the situation remains the same: our loved one is refusing help.
Here are five strategies experts recommend to help you approach the situation so your aging loved one can get the assistance and attention they need.
Sometimes our parents won’t believe something unless it comes from a professional. Getting help from doctors, healthcare professionals, social workers, or even priests or ministers, can help smooth out the difficulties you face when your loved one is refusing caregiver services. An expert can explain to them how different therapies will benefit them. Professionals have a lot more experience than we do, and they are able to give the right answers to any questions you may have.
Non-threatening, open-ended questions that require more than a yes or no answer can be extremely helpful. This helps provide information about the underlying reasons for resistance or the type of help your loved one thinks they need. Even though dementia can make it hard for your loved one to express themselves, their need for communication is as strong as ever. Slow down a bit, work at their pace, and see if you can find deeper reasons for why they are resisting help.
Assigning the appropriate weight to each issue being faced is often an effective way to approach multiple problems simultaneously. We need to decide how important each challenge is. Are we looking at a matter of safety, or are we looking at a matter of preference? An example of a high-priority problem is forgetting to eat. An example of a low-priority problem is wanting to stay up all night. Make a list and organize it from most important to least. Each point can then be assessed regarding what steps have already been taken and what is required next. Caregiving can become a huge weight, and making a list based on priority can help reduce stress.
No one likes to feel as if they’re being forced into doing something. Giving your loved one options will allow them to feel as though they have control over the decisions that are being made. Let your parents select which day of the week works best for them and what they may like a companion to help with. It can be hard to admit to a spouse or child that extra help is needed, so don’t be afraid to have a professional caregiver come in to go over the available options.
The bulldozer approach will only create greater resistance. We have to remember that our loved one has been living independently for the majority of their life. We can spend a lot of energy trying to get them to accept a dementia diagnosis or to try and bully them into getting help. But in the end, we must remember they are adults and want to be responsible for their own decisions. Don’t be afraid to back off for a couple of days (for both yourself and your loved one) to give each other some space. We may also need to take a break for ourselves to build up patience and empathy before readdressing the situation.