“Whenever I ask dad if he wants to go out for a drive, go into the garden, work on some chores, or take a walk, he always declines. I get so frustrated; my new nickname for him is Dr. No!”
One of the most common frustrations among family caregivers is the propensity for people with dementia to say “No!” Loved ones can’t understand why people with dementia so often say no and refuse to do the very things they’ve done willingly and eagerly in the past.
The reasons are actually pretty straightforward. Dementia impacts memory, reasoning and language. It’s hard for the person with dementia to understand what we ask of them. When we are asked to do something we don’t understand or we feel uncomfortable with how do we respond? No!
Like the rest of us, people with dementia have the right to say no. Because of their dementia, however, they often make poor decisions. A good way for family members to approach the no’s is to ask themselves, “What would dad have done years ago? Would he have enjoyed the outing? Would he have wanted to be dressed in clean clothes? Would he have wanted me to be this stressed or would he have been willing to get some in home help so I could be sure he is safe and healthy?”
In most cases, the answer is yes. But to turn that no into a yes when dementia is present, family members and professional caregivers have to become leaders and provide lots of encouragement. Home Instead, a leading provider of Alzheimer’s in home care, trains their professional CAREGivers to try three times, in three different ways, to turn a no into a yes.
Here’s an example of how you can use that technique with your family member:
Let’s say you are trying to get Mom to sit in the garden on a beautiful day.
One: Ask her the way you always have. “Mom, it’s a lovely day out. Let’s go out to the garden to look at the roses.”
Two: Use some information from her life story to make a more personal request. “Mom, let’s go out to the garden and see your roses. I need your advice on how to prune them properly and you are a master gardener!”
Three: Take her hand into your hand and point to the garden (to give her physical cues) as you say, “Mom, it’s a lovely day out. Let’s go to the garden to look at the roses.” [Pause] “I really appreciate your help in the garden. After we’re done, let’s get some strawberry ice cream.”
This time you are giving her a physical cue to the desired response and offering your hand for support. Adding another sentence showing that you admire her willingness to help you and offering a favorite reward afterwards both increase your chances of success.
This time she says yes.
Sometimes the stakes are higher than a social visit to the rose garden. Getting Mom to agree to go to the doctor or use in-home services can be a matter of safety, security, and overall health.
David Troxel, author of The Best Friends Approach to Alzheimer’s Care, recommends that when you have your family member’s best interests at heart, it is sometimes easier to get forgiveness than permission. You may have to line up services that you need and start them, even without your family member’s initial consent. Once you get the ball rolling, the person with dementia often goes along.
If you face resistance when starting in home care services or starting any new routine, stress that it’s on a trial basis or mention that it’s “doctor’s orders.” Mom or Dad may be mad at you for taking him or her to the doctor, but once it’s over he or she may soon forget and move past the negative feelings. If you can get the person with dementia into a new routine centered on additional home care services, he or she may actually begin to enjoy the socialization and attention.
Remember, while it may be tough going, with patience and compassion, you can learn to turn that no into a yes.
Turn No to YesIn this video, Home Instead franchise owner Becky Beanblossom and CAREGiver Charity Rotolo discuss how techniques such as redirection and role playing are helpful in caring for a person with Alzheimer's or other dementias.
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To find a caregiver in your area, contact your local Home Instead office.