Seniors and Pain
When Your Loved One Resists Care
One of the most frustrating ordeals a caregiver can experience is trying to look after a loved one who doesn’t want help. Ranging from dangerous (e.g., refusal to take prescribed medications) to simply irritating (e.g., unwillingness to bathe), an ailing person’s negative response to care can escalate into a war of wills. And the caregiver’s natural responses of anger, anxiety, fear and sadness only tend to make the situation worse.
If you find yourself trying to give care to a combative person, try to remember that he or she may simply be trying to tell you that something is wrong. Due to memory loss, stroke, pain, depression or other illness, many older people have difficulty getting their specific needs across. Like a child, older people may resort to physical actions or body language to communicate. Take a breather and think about what your loved one’s actions may be trying to say. Thinking of yourself like a detective trying to find clues to get to the bottom of the “case” may give you the distance needed to evaluate the behavior.
Following are some tips and advice about how to handle the situation:
Take inventory – Is there anything happening at home that may be the root of the problem? Is the thermostat too high? Are the lights too low? Is there construction or commotion? Is there tension? Try to create an environment that is comfortable, warm, loving and familiar.
Act With Empathy – Try to imagine that you are the person you are giving care to. What would you be frustrated by? What would cause you to act out?
Assess Before Reacting – Refusing to change clothes is different than refusing to go to the doctor. Be realistic about the situation, and remind yourself that you are not going to win every battle. Save your reserves for the ones that matter.
Be Creative – If your method of handling a situation isn’t working, think creatively about what you might do differently. For example, maybe a bedtime bath (when your parent is relaxed) would work better than a morning bath (when they are more likely to be agitated). Perhaps inviting your parent to help in mealtime preparation or menu planning would get them more interested in eating.
Ask and Listen – Simply asking your parent what is wrong may spark an open conversation about the situation. Be direct about the problem and thoughtful about what you say. If you find your emotions are running too high, take a break and wait to approach the topic when you are feeling more calm.
Change Your Approach – Rather than issuing a directive, ask for cooperation. Words to remember are “please,” “can,” “could,” and “will.”
Take a Time Out – Calmly walking away for a few minutes may help both of you address the situation with greater understanding. If you can’t walk away, moving on to a topic or action you both agree on may help change the mood, and allow you to readdress the problem more positively on your second go-round.
Get Help – If you are at your wit’s end – or if your parent is treating you in a physically aggressive or hostile fashion - get help. Check out the links on our Resources for Caregivers page for more information, or call the National Eldercare Locator Service at (800) 677-1116.
Symptom: Won’t get out of bed
Possible Causes: Illness, injury, infection, depression or pain
Symptom: Won’t bathe or groom
Possible Causes: Embarrassment, depression or shame
Symptom: Won’t eat
Possible Causes: Dental problems, digestive problems or difficulty with utensils
Symptom: Won’t leave the house
Possible Causes: Depression, fear
Symptom: Won’t participate in family outings
Possible Causes: Stress, depression or environmental factors
Symptom: Won’t perform daily tasks
Possible Causes: Depression or pain
Symptom: Won’t take prescribed medication
Possible Causes: Side effects such as nausea, dizziness or constipation; confusion
If you find yourself trying to give care to a combative person, try to remember that he or she may simply be trying to tell you that something is wrong. Due to memory loss, stroke, pain, depression or other illness, many older people have difficulty getting their specific needs across. Like a child, older people may resort to physical actions or body language to communicate. Take a breather and think about what your loved one’s actions may be trying to say. Thinking of yourself like a detective trying to find clues to get to the bottom of the “case” may give you the distance needed to evaluate the behavior.
Following are some tips and advice about how to handle the situation:
Take inventory – Is there anything happening at home that may be the root of the problem? Is the thermostat too high? Are the lights too low? Is there construction or commotion? Is there tension? Try to create an environment that is comfortable, warm, loving and familiar.
Act With Empathy – Try to imagine that you are the person you are giving care to. What would you be frustrated by? What would cause you to act out?
Assess Before Reacting – Refusing to change clothes is different than refusing to go to the doctor. Be realistic about the situation, and remind yourself that you are not going to win every battle. Save your reserves for the ones that matter.
Be Creative – If your method of handling a situation isn’t working, think creatively about what you might do differently. For example, maybe a bedtime bath (when your parent is relaxed) would work better than a morning bath (when they are more likely to be agitated). Perhaps inviting your parent to help in mealtime preparation or menu planning would get them more interested in eating.
Ask and Listen – Simply asking your parent what is wrong may spark an open conversation about the situation. Be direct about the problem and thoughtful about what you say. If you find your emotions are running too high, take a break and wait to approach the topic when you are feeling more calm.
Change Your Approach – Rather than issuing a directive, ask for cooperation. Words to remember are “please,” “can,” “could,” and “will.”
Take a Time Out – Calmly walking away for a few minutes may help both of you address the situation with greater understanding. If you can’t walk away, moving on to a topic or action you both agree on may help change the mood, and allow you to readdress the problem more positively on your second go-round.
Get Help – If you are at your wit’s end – or if your parent is treating you in a physically aggressive or hostile fashion - get help. Check out the links on our Resources for Caregivers page for more information, or call the National Eldercare Locator Service at (800) 677-1116.
Refusal of Care: Symptoms and Causes
Symptom: Won’t get out of bed
Possible Causes: Illness, injury, infection, depression or pain
Symptom: Won’t bathe or groom
Possible Causes: Embarrassment, depression or shame
Symptom: Won’t eat
Possible Causes: Dental problems, digestive problems or difficulty with utensils
Symptom: Won’t leave the house
Possible Causes: Depression, fear
Symptom: Won’t participate in family outings
Possible Causes: Stress, depression or environmental factors
Symptom: Won’t perform daily tasks
Possible Causes: Depression or pain
Symptom: Won’t take prescribed medication
Possible Causes: Side effects such as nausea, dizziness or constipation; confusion