Saturday, October 08, 2005

Caregiving: Dealing with Rebellion

We had a good session last week discussing how to handle situations in which the person we're caring for refuses to do what they need to do -- take medicine, do their therapy, etc. -- and some ways we can effectively deal with them.

We talked some about why the care receiver may be rebelling and strategies that may help. Here's a brief summary of what we talked about, both as a reminder for those of you who were present and for those who were not with us.


Often, the care receivers are trying to find something where they can demonstrate control because they sense that they have lost control of so much. Even when the way they can exercise control is harmful, having control over something is important to them. Refusing to take their medicine, for example, is a way of exerting control. Often they are also struggling with loss of self esteem from not being able/allowed to do things for themselves. Another common cause of these kinds of actions is loss of position -- feeling like they are being treated like a child.

Here are some strategies that can help:
  • Find another way to give them some control. "Would you like to take your medicine before you eat, or after you eat?" "Would you like to do your breathing treatment before Gunsmoke or after Gunsmoke?" "Would you prefer to walk around the block or walk in the mall?"

  • Talk about what's really going on. Have an adult-adult conversation about why they are making bad choices. Don't allow the situation to become a parent-child interaction where you're telling them what to do and why and letting them move into the rebellious child mode. Treat them as an equal in their caregiving decisions.

  • Help the care receiver take on as much responsibility as possible for his or her own care and well-being. Let the person you're caring for do as much for themselves as they possibly can, even if it takes a lot more time and effort. Let them dress themselves, bathe themselves, organize their day, etc. Our tendency is to want to do everything we can for them, but doing so results in loss of the satisfaction of being able to do for themselves. Anything we can do that helps maintain their dignity is a major contribution to their well-being.

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