It can be challenging to care for a loved one with dementia when they won’t accept help. They may need your assistance more than ever, but they may refuse anything you offer, including food, medicine, and hygiene help. They might not want to go somewhere with you, whether it’s to visit the doctor, get groceries, or take a walk.
When your loved one with dementia won’t cooperate in receiving essential care like eating or taking medication, you need solutions. The following strategies and tips can help you understand their refusals and manage their care.
Why Dementia Patients Refuse Care
People with dementia can’t express themselves as clearly as they would have in the past because of cognitive changes and complex emotions, and there are several underlying reasons why they may refuse care.
Being in Denial
It can be difficult for someone to accept a dementia diagnosis or admit that it has gotten so advanced that they need help with activities of daily living (ADLs).
Losing Their Independence
After living independently for decades, imagine someone else making decisions about your care. This loss of control is often alarming and confusing for people with dementia. If a dementia patient refuses to go to the doctor, they may be worried that they aren’t in control of their health decisions.
Not Understanding the Situation
The cognitive decline that people with dementia experience means that they can’t grasp fine points or see the big picture. If they don’t know why they need food, medicine, or a caregiver, they might refuse anything unfamiliar or unappealing. A dementia patient refusing medication might want to assert control.
Fearing Change
People become emotionally attached to their homes. A dementia patient refusing to go into care may not want to leave the place they love, where everything is familiar.
Having Negative Thoughts About Care Facilities
There’s a stigma associated with nursing homes and memory care units. A dementia patient refusing to go into a care home may resist because they don’t want to live in a place they dislike.
Practical Strategies for Handling Refusal
If your loved one with dementia refuses care, you may become frustrated. Instead of expressing frustration, be empathetic and loving. Try these strategies.
Adopt a Calm Demeanor
When a dementia patient refuses to eat or take medication, calmly explain things using simple language and a kind tone. Don’t raise your voice or argue. Cognitive changes can prevent them from thinking logically, so reasoning won’t work.
Try to Understand Possible Reasons
Be patient, caring, and curious as you investigate the situation. If you can find out the reasons for your loved one’s refusal, it may be easier to change their mind. Maybe they don’t want to eat or drink because they’ve been choking on food, and changing what they eat might help. Maybe they’ve had trouble swallowing medication, and you could call the doctor to find out if pills can be crushed or capsules can be poured into applesauce.
Offer Choices that Preserve Dignity and Control
A dementia patient refusing to eat, drink, or take their medication may be trying to assert their control over the situation. You can help them feel more in control by offering two acceptable choices, then asking for their input. Do they want soup or pasta for lunch? Should they take their medicine before or after they brush their teeth? Limited choices allow them to make decisions, within reason.
Seek Guidance from Healthcare Providers
If a dementia patient refuses to go to doctor appointments, call your loved one’s healthcare provider for help. A doctor who specializes in treating dementia patients may be able to help, especially if it’s a new diagnosis. A professional might recommend that you use different words to describe something they’ve refused to do, or they may have other ideas that will work.
Introduce Care Services Slowly
A dementia patient refusing to go into care may fear the unknown. If memory care is on the horizon, consider in-home memory care services first. This can ease the transition for your loved one and allow them to stay in a familiar space while still receiving support. If more advanced or long-term memory care is needed, find out if your local facility offers trial visits. When your loved one hears that the move is temporary, they may agree with the plan more easily and then later realize the advantages of living in the facility.
Legal and Ethical Considerations for Dementia Patients Refusing Care
Can a person with dementia refuse medical treatment? Yes, as long as they still have the capacity to make informed healthcare decisions.
When someone is diagnosed with dementia, they and trusted loved ones should consult an elder law attorney to create legal documents called advance directives. Advance directives detail the person’s wishes for their future healthcare, such as whether or not they would want to have a feeding tube, have their life sustained with a breathing machine, or be resuscitated if their heart stops. These details can help others legally make healthcare decisions for them at a later time, if they eventually become unable to decide for themselves.
One option is describing future healthcare wishes in a living will. Another is to designate a person to be their healthcare proxy (i.e., power of attorney) who can make decisions on their behalf either right away or only when certain circumstances are met. Ethically, the person acting as the proxy is supposed to consider the person’s intentions, well-being, and best interests—not their own.
When the person doesn’t have an advance directive, you can consider applying for guardianship powers that would let you make decisions. But that can be a costly and lengthy legal process and can hurt relationships with loved ones if there’s disagreement.
Advance directives help people preserve their dignity and ensure that others act in their best interests.
What to Do When Refusal Puts a Loved One at Risk
A dementia patient refusing to eat or drink can quickly become frail or weak. Someone who won’t take medication could be risking worsening heart disease, impaired breathing, organ damage, or other complications, depending on the condition being treated.
Every time your loved one refuses to care for themselves, document the information in a journal, calendar, or home health record. Note the date and time, what you offered, and how your loved one refused it. You may need the information when you consult with doctors or attorneys.
If you’re concerned your loved one’s unwillingness to cooperate endangers their ability to be safe and thrive for the foreseeable future, consider consulting with their healthcare provider for a professional cognitive assessment. Healthcare teams can factor it in, along with other observations and information, to advise the best course of action.
Of course, when refusals put your loved one at immediate risk of harm, don’t hesitate to seek urgent care or professional help. Emergency responders and healthcare personnel are usually trained to support the safety and well-being of people with dementia.
Creating a Supportive and Safe Home Environment for Dementia Care
If your loved one with dementia refuses care and insists on staying in their home, you’ll need to create a home care plan and a safe environment. Technology and other home modifications can help support dementia care at home and ease some of the burden on caregivers.
Consider home modifications like these:
- Put safety locks on the stove and oven to prevent fire-related accidents.
- Use alarm systems on doors and windows to be alerted about possible wandering.
- Give your loved one a watch with a GPS tracker so you can find them if they go missing.
- Store medication in organized, labeled containers or use a timed dispenser.
- Make sure there’s good lighting throughout the home with switches that are easy to locate.
- Secure loose rugs and cords, declutter high-traffic areas, and keep the furniture arranged in a familiar way.
BrightStar Care® Offers Memory Care Support
Although it can be upsetting to watch a person with dementia refuse medication or other care, it isn’t uncommon. There are many ways that you can help keep your loved one with dementia healthy and safe, either on your own or with in-home support. BrightStar Care® can guide you on your care journey.
BrightStar Care caregivers provide compassionate, in-home support options for your loved one. If you’re looking for in-home care services for a loved one who needs memory care assistance, our experienced local care team members are ready to help. Find a location near you, contact us online or call (866) 618-7827 to learn more about how BrightStar Care offers A Higher Standard®.