Dementia Patient Refusing Care – What to Do

When a patient is diagnosed with dementia or Alzheimer’s, the progression of their illness can vary depending on the person and a variety of other factors. 

As their illness progresses, quick or slow, they may not be ready to accept the fact that they need some extra help or even full-time care in some cases. Of course working with them to try and get them to accept the care or move into a long-term care facility on their own would be preferable but sometimes they’re just a little stubborn and don’t want to accept the help. 

If your loved one, who has dementia, is refusing to get the care and help they really need you may feel stuck or at a loss for where to go next. There are a few things you can do, but you also need to understand exactly why they’re refusing the care or what is making them so upset about it. 

Why Are They Refusing Care?

When dementia progresses, some patient’s become non-verbal and they are not able to fully communicate exactly what they want or why they want it. 

And because they are unable to communicate their needs, they may able be unable to understand communication from other people so they can process it. If a patient with dementia is refusing care or help there could be a few reasons, including

  • The person doesn’t fully understand exactly what they are being asked to do, or why they are being asked to do it. For that reason, they don’t want to do something they can’t understand the reasoning for. 
  • They are being asked to do something they don’t agree with or doing it goes against what they believe in, so they don’t want to do it. For example, if you are asking them to go to bed when they don’t want to or don’t feel tired they will probably refused to do it. 
  • The patient feels that, in being asked to do something or being given care, they are being talked down to or belittled and don’t have control over their own decisions anymore. This can be a really big one, especially if the patient is confused and feels lost or like they don’t have control over their own life. 
  • The patient doesn’t trust the person offering care or help. This can be especially difficult with dementia patients as they often don’t remember or recognize people they really do know, or who have been in their lives for a really long time. If the patient doesn’t feel like they can trust the person, then they will be especially reluctant to allow them to offer care. 

You might like to read: Best Cell Phone for Seniors With Dementia

If They Are Refusing Help With Personal Care

This is one area that can be really difficult to handle when you’re trying to care for someone who is living with dementia. The trouble here is that forcing someone to accept help with personal care (dressing, bathing, toileting, etc) can constitute abuse since you’re making them do something they don’t want to do and they may feel really uncomfortable. 

lonely elderly

However, by not taking care of them and allowing them to not keep up with personal hygiene needs this can constitute neglect, and even more it may put their health at risk even more than them refusing the care to begin with. 

It’s important, therefore, to understand exactly why they are refusing the care and how to talk to them about it. It will be important to find out about their personal preferences before they needed the help (IE did they prefer showers over taking a bath) so that, as a care giver, you can offer them options that are familiar to them and it may make them more likely to accept the help. 

Through figuring out what routines the patient is used to, and what their preferences are, any care giver can start to incorporate these things into caring for the patient. When there are familiar things to the patient surrounding them, they may feel a little more trusting. 

As you give them familiarity and routines, they will start to trust you and begin to accept the care you’re providing. 

You might like to read: Best Medical Alert System Canada

If They’re Refusing Medication

We know that there isn’t any medication that can stop dementia from progressing, but that doesn’t mean a patient with dementia isn’t on medication for other illnesses (like perhaps they have high cholesterol). 

elderly man refusing to take medicine

A patient with dementia may refuse to take their medication because they don’t actually know what it is you’re asking them to take or why they need to take it – and they feel like they don’t have control over their own medical decisions. 

It’s important to have a clear understanding and explanation of what each pill/medication is for, and why you’re giving it to them. They may need the explanation each time, and with each pill, so be prepared with some patience when it’s time for them to take the medication. 

If a patient with dementia doesn’t trust the care giver who is giving them the medication, they will be much less likely to take it. This is why building trusting relationships with care givers is crucial so that the patient knows they are being asked to do something by someone they know and therefore it’s unlikely they will refuse.

If They Are Refusing to Move Into Long-Term Care

There will come a point in the progression of the illness that someone with dementia just will not be able to take care of themselves without full-time care or help. 

Depending on the situation the patient is in, they may or may not be able to stay in their home with full-time care. Having a live-in care giver can become very expensive, and insurance doesn’t always cover the cost of the care. 

Alternatively, the patient with dementia may be faced with moving into a long-term care facility but this will be unknown to them and unfamiliar so they will probably be pretty resistant to it at first. 

If you have the time, and option to do so, you may want to take the patient on a few visits to the home they will be moving into or have the in home care giver come and visit for short periods of time while someone the patient knows and trusts is around. 

It will probably be a long process, and everyone involved will need to be patient. The person who is living with dementia will be very confused as to why there is someone new in their house or why they aren’t even in their home anymore. 

They won’t recall what happened or even know why they moved, which is why it’s going to be important to repeat to them what’s going on and be as patient with them as you can. 

If the patient is moving into long-term care, try to bring items from home that they will know and recognize to make the adjustment period just a little easier for them. 

Items like pictures of them with their loved ones or trinkets they had on shelves at home can make it seem much more familiar to them so the adjustment is easier and they feel more relaxed in their environment. 

You might like to read: Best Mattresses for Bedridden Patients

Final Thoughts 

Overall, for someone who is living with dementia or Alzheimer’s change is going to be very hard and it needs to be introduced slowly and with patience. 

daughter attending mother's needs

Your approach to asking someone with dementia to do something must be slow and patient, and try not to ask for too much at once from them. One change at a time, and make sure you are respecting their dignity and ability to make their own decisions as much as possible. 

If they are refusing help and care, this could be because they believe they are still completely independent and they can still care for themselves on their own. 

By respecting them, and allowing them to do the things they can do on their own (like getting dressed for example) they will more likely be willing to accept help with the things they can’t do. 

Patients with dementia don’t want to feel like they don’t have control over their own life or medical decisions, so don’t try to push too hard for them to do what you want. 

As long as the task or ask they’re refusing to do isn’t going to hurt them or someone else, it’s reasonable to try and have a conversation with them to understand why it is they don’t want to do this particular thing. 

By talking to the patient and trying to understand exactly why it is that they are refusing then you may be better able to communicate with them what it is you’re asking, and in a way that they will be more likely to work with you. 

It’s important to be patient when speaking with a person who is living with dementia – they are probably feeling overwhelmed and confused, and may not even recognize you (even if you’ve been in their life for a long time). So try to understand why it is they are refusing, and communicate with them in a way they can trust you and understand you.