Winning the cooperation of a dementia patient depends in large part on the caregiver’s attitude and skills. Following these tips will likely result in cooperation.
Attitudes That Invite Dementia Patient Cooperation
Many caregivers get emotional satisfaction from their relationships with dementia patients. Nancy L. Mace and Peter V. Rabins, authors of The 36-Hour Day, remind readers that “confused people and their families do still experience joy and happiness.” If happiness and companionability exist in the relationship between a dementia patient and caregiver, cooperation is likely to follow.
Caregivers should remember the physical and psychological devastation of dementia. Physically, it is the result of brain atrophy and a biological situation that cannot be helped. Dementia patients are not deliberately incompetent or uncomprehending. They are suffering from a degenerative brain disease. Psychologically, the dementia sufferer may be acutely aware that he or she has grown incapable to perform basic tasks. Mace and Rabins remind caregivers that, “The person who has dementia probably feels lost, worried, anxious, vulnerable, and helpless much of the time.” He or she may feel miserable and ashamed. Empathy can help engender attitudes in caregivers that are more conducive to seeking and winning cooperation from dementia patients.
A cheerful, calm, open and soothing demeanor of the caregiver helps ensure cooperation. Even extreme dementia behavior such as pacing, rummaging, and wandering should be met with serenity and compassion. This usually wins more cooperation from a dementia patient than anger or shouting, which add to the person’s mental burden.
Caregivers must make sure their own needs are cared for. That way their approach to their patients will encourage cooperation rather than resistance. Hurried, impatient, exasperated caregivers usually set themselves up for very uncooperative behavior of dementia patients, who can become highly agitated by such emotions.
Skills that Ease the Way
A set routine is one of the caregiver’s best ways to win the dementia patient’s cooperation. Established routines affirm a rhythm and predictability in life that is soothing to dementia patients, “We always get ready for bed at eight-thirty. Eight-thirty means it’s time to brush your teeth, doesn’t it?”
To gain cooperation, the caregiver should break down directions and instructions into simple steps. Likewise, questions should be asked with one of two choices as answers: “Do you want to go for a walk now or later?” “Do you want to wear the beige pants or the green ones?” This allows dementia patient’s struggling brain to process a little at a time with more likelihood of a positive, cooperative result. It also respects the person’s freedom of choice and enhances self-esteem and a sense of autonomy, both of which engender more cooperative attitudes.
It is important that caregivers are aware of difficult times and to prepare for them. Dressing, bathing, and toileting often trigger rebellion in dementia patients. It should not be hard for a caregiver to relate to the feelings of vulnerability elderly persons may feel when their bodies are exposed. The caregiver’s sensitivity to the person’s feelings will go far in gaining cooperation.
Arguing with a dementia patient is counter-productive, the Alzheimer’s Association warns. It is useless, for example, to argue with a frantically rummaging dementia patient that he doesn’t need to find certain papers because he hasn’t gone to the office in twenty years. Caregivers should let this person rummage freely or gently re-direct him or her to a routine activity: “Dad, ten o’clock is tea time. Do you want graham crackers or cookies with your tea?”
The Ultimate Question for Gaining Cooperation
When persons afflicted by dementia are uncooperative, the best question caregivers may ask themselves is, “What am I not seeing here?” Is the person physically uncomfortable? Is the person too cold, too hot, tired, hungry, or in pain? Anyone can become cranky in such circumstances. Or, is a deeper psychological need being overlooked? Does the person feel frightened, powerless or ignored? The person is expressing some need by being uncooperative. Once the underlying need is discovered and tended to, cooperation may result.
Alzheimer’s Association. (n.d.) Wandering and Getting Lost. Available online at http://www.alz.org/care/alzheimers-dementia-wandering.asp. Accessed February 2, 2017.
Corcoram, M.A., Gitlin, L.N. (2001). Family caregiver acceptance and use of environmental strategies provided in an occupational therapy intervention. Physical and Occupational Therapy in Geriatrics 19(1): 1-20.
Mace, Nancy L., and Rabins, Peter. V. (September 2012). The 36-Hour Day. A Family Guide to Caring for People Who Have Alzheimer’s Disease, Related Dementias, and Memory Loss. New York: Grand Central Life & Style. Originally published by the Johns Hopkins University Press, 1981.