Older adults often feel a loss of control over their lives. They are no longer able to do many of the things they once could and they may feel inadequate and frustrated. Being uncooperative is one way to get back a sense of control. You can help gain cooperation by:
Consider the capabilities of the care receiver. What is your family member still capable of doing his/her own or with little help? Knowing the abilities of your loved one can help us assess the activities and decisions in which he/she can still participate.
Include the person in the decision-making process. A sense of control can be enhanced by asking for your loved one’s participation in decisions ranging from meal choice to living arrangement. He/she can help you consider the available options and the positives and negatives of each choice. You can also learn more about your loved ones’ preferences. It is important not to offer choices that are not realistic. For example, if the person cannot drive safely, continuing to drive is not a choice he/she be offered. However, getting a ride from a caregiver, a friend, taxi service, or a bus might be a legitimate choice the person could make.
Be patient in allowing your loved one to accomplish the tasks they are capable of doing. Even accomplishing small tasks can be important to someone who has declining abilities. We might find ourselves rushing to button up our loved ones’ shirts or zipper their coats. Although we mean to be helpful, we can be taking away another task from them and another piece of dignity. Planning for a little extra time to allow them to accomplish a task can make them feel less dependent.
Be knowledgeable about how you can remove barriers to maintaining independence. Often little things can make a big difference in task accomplishment. For example, shirts with zippers rather than buttons can make it easier for people with arthritis to dress themselves. In addition to removing these small barriers, being aware of support services can help them stay in a less restrictive environment.
Five Creative Ways to Turn a No Into a Yes
How can you overcome your loved one’s constant refrain of “no?” Try these practical tips to gain cooperation and reduce your feelings of caregiver stress:
Be willing to compromise. If your loved one won’t shower, will he or she at least agree to a sponge bath? What about washing the hair? What about simply washing their hands before eating? Sometimes compromise leads directly to a “yes.”
Don’t be afraid to use bribery. Sometimes adult caregivers can view their elderly parents’ uncooperativeness as a type of temper tantrum,. Realize that this is not the case. Small children possess the ability to reason, which is why you don’t want to reward a tantrum. However, cognitive decline in seniors can lead to an inability to reason effectively. That’s why reward systems are okay when trying to elicit cooperation from an older adult. When you make a request, expect it will be met with resistance; try adding a reward to it. You may be surprised to discover how eager your loved one is to please you when they think they’re getting something out of it.
Use the “three tries” rule. Try three times in three different ways to turn a no into a yes. One, ask your loved one to do something. “Mom, let’s work on a jigsaw puzzle.” If she declines, wait awhile and then ask again with additional information from her life story. “Mom, can you help me with this jigsaw puzzle? I’m stuck, and you’ve always been good at this.” If she declines again, use physical touch and the offer of a reward for complying. Take her hand and look her in the eye. “Mom, can you help me with this jigsaw puzzle? You’ve always been so good at this. If we can get just three pieces into place, let’s reward ourselves with some ice cream."
Don’t take the “no” personally. Understand that “no” is not a rejection of you. In people experiencing cognitive decline, “no” may represent a loss of memory and the ability to use good judgements. Asking your parent to take a shower may seem like a perfectly reasonable request to you, but your loved one may be thinking, “I just took a shower earlier this morning. Why on Earth would I take one again? No!”
Make it easy to cooperate by offering choices. It’s easy to say “no” to requests that seem unilateral. “Eat your lunch right now. I went to a lot of work to prepare this delicious food.” It’s easier to say “yes” when you’re given a choice. “Would you like to eat lunch at 11:30 or at noon? Would you prefer tuna sandwiches or egg salad?”
Remember, a lack of cooperation is not the end of the world. It’s easy to get too invested in the power struggle that you lose sight of the overall goal. If you’re aiming for 100 percent cooperation and compliance from a stubborn parent or spouse, maybe you need to revise your expectations. The world will not end if someone refuses to shower today (or even two or three days). By setting reasonable expectations and using tricks to foster cooperation, you can reduce the stress you feel as a caregiver each time you hear the word “no.”