How to Avoid the Caregiver-Alzheimer’s Battleground

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by Ray Burow |

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Familial caregivers are supposed to advocate for loved ones, but a person with dementia may sometimes view a carer as an enemy. Perhaps “enemy” is too strong of a word, but some caregiving days are permeated by one battle after another.

This gets old quickly for both parties. Who wants to wake up on a battleground every day? Not the caregiver, and certainly not the loved one, yet here we are. So, how can familial caregivers meet the physical needs of a loved one without enlisting in the same old battles?

Choose your battles

Figuratively speaking, some hills aren’t worth dying on. Caregivers must decide which issues are important and which can be let go. Taking daily medications, visiting the doctor or dentist for regular checkups, and personal hygiene are matters that can’t be ignored. However, a loved one may oppose them for various reasons.

The reason for opposition isn’t often clear. Someone with Alzheimer’s might not want to do something and stalwartly refuse. It can be helpful for caregivers to mull over the possible reasons for a negative response to taking meds or a shower, or keeping a doctor’s appointment, for example.

Knowing the reason may not change a thing about the battle, but it also might. At the least, an understanding of why a loved one refuses to comply may trigger a solution or a back-door approach to the situation.

Those of us who aren’t cognitively compromised take thinking and decision-making for granted, and at one time, our loved ones with dementia did, too. However, dementia has robbed them of the ability to ruminate and make sound decisions.

If that’s not terrible enough, the disease accomplishes this without the person knowing it. It’s a Catch-22 situation: Our loved ones with dementia don’t recognize their cognitive abilities are compromised because their cognitive abilities are compromised.

Recognizing the problem, caregivers take matters into their own hands. We do our best to make healthy, positive decisions for our loved ones, such as setting schedules and appointments, and even simple things like deciding when our loved ones will eat.

We know why we have to do it, but a spouse, parent, or friend with Alzheimer’s disease often will push back. They can’t verbalize why they push back, but it could have something to do with their loss of control. Every decision that personally affects them is relegated to the caregiver.

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Don’t clap back

It is absolutely useless to argue with someone with dementia. Don’t clap back with a negative response to their refusal to engage in an activity, but rather come back with a different approach. This will require creativity, but a second attempt later could have different results.

Not to be insensitive, but this is one of the few times that dementia might work in the caregiver’s favor. The loved one may not remember a first attempt at getting them to take medication or a shower, for example.

Keep it lighthearted and approach the request from a different angle the second time around, perhaps based on their original response. For instance, if your loved one said they would take a shower in a minute, give them a little time before returning to say something like, “Mom, a little while ago you said you’d like to take a shower, so I’m coming now to help you.” Suddenly, the decision to take a shower is up to her and not you. This strategy may seem manipulative, but it’s not.

Controlled choices

Caregivers can give loved ones a modicum of control over their own lives. Apply this tactic to other areas, too. Start talking about visiting the doctor before it’s time. Talk about the date and time, and ask questions like, “What time do you think we should leave for Dr. Jone’s office this afternoon?”

Don’t just pull out what your loved one will wear and say, “Wear this.” Pull several pieces of clothing from the closet and allow them to choose.

Providing controlled choices may limit confrontations so that the caregiver isn’t viewed as anything other than a loving advocate.


Note: Alzheimer’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Alzheimer’s News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to Alzheimer’s disease.


Brenda Muselius avatar

Brenda Muselius

You make some great points. I have heard variations on this theme from dementia experts.
My husband's response is very different, however.
He does not do well with choices-he cannot make decisions. Too much pressure
Much better for me to say -I think this would look good or I think we should leave at such a time.
And well he might not remember repetitive attempts, they do stimulate his amygdala and he has an adrenaline
surge. So in fact, it makes things worse and imprints on his mind that this is a risk/dangerous activity.
The approach and reapproach strategy does not work for him.
Dementia care requires an individual nuanced approach. I would encourage all caregivers to observe their loved ones and act according to their responses. It is definitely not one size fits all!



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