Practical Ways for Family Caregivers to Reduce Conflict and Make Care Easier
Resistance is common when caring for a person living with dementia.
- Your husband refuses to shower.
- Your mother will not change her clothes.
- Your father pushes your hand away when you try to help with medications.
- A person who usually accepts help suddenly says: “Leave me alone.”
It can feel frustrating, exhausting, and sometimes personal.
But resistance is often communication.
The person may not understand what you are asking. They may be frightened, uncomfortable, embarrassed, tired, in pain, overwhelmed, or trying to maintain some control over what is happening to them.
Instead of asking only:
“How do I make them cooperate?”
Try asking:
“What might be making this difficult right now?”
That change in approach can make a big difference.
At a Glance
When a person with dementia resists care:
- Pause instead of pushing harder.
- Stay calm and use fewer words.
- Explain before you help.
- Offer one or two simple choices.
- Break the task into smaller steps.
- Look for pain, fear, fatigue, embarrassment, or confusion.
- Try again later when it is safe to wait.
- Change the approach if the current one is not working.
The goal is not to “win.”
The goal is to provide needed care while helping the person feel as safe, respected, and involved as possible.
Resistance May Have a Reason
A person with dementia may resist because they:
- Do not understand what you want them to do
- Do not recognize you or another caregiver
- Think they have already completed the task
- Feel rushed or overwhelmed
- Are frightened by what is happening
- Feel embarrassed about needing personal care
- Want to maintain independence
- Are tired, hungry, cold, or uncomfortable
- Are experiencing pain
- Are bothered by noise, bright lights, or too many people
- Cannot find the words to explain what is wrong
What looks like stubbornness may actually be the person’s attempt to communicate:
- “I don’t understand.”
- “I’m scared.”
- “That hurts.”
- “This is too much.”
- “I want some control.”
Start by Slowing Down
When resistance begins, caregivers often instinctively explain more, repeat themselves, or push harder to get the task done.
That can make the situation worse.
- Stop for a moment.
- Lower your voice.
- Reduce the number of words you are using.
Instead of:
“Come on, we have to get you dressed because your appointment is at 10:00 and we’re already running late.”
Try:
“It’s time to get dressed for your appointment.”
Then wait.
The person may need more time to understand and respond.
Explain Before You Help
Someone with dementia may be startled when another person suddenly reaches toward them, begins removing clothing, moves a walker, or tries to guide their body.
Tell the person what you are going to do first.
For example:
“I’m going to help you stand.”
Pause, then:
“Are you ready?”
Whenever possible:
Pause ? Explain ? Ask ? Help
Even when someone needs considerable assistance, these small steps can help preserve dignity and a sense of control.
Offer Simple Choices
Choices can reduce resistance because they allow the person to participate.
But too many choices can become confusing.
Instead of:
“What do you want to wear today?”
Try:
“Would you like the blue shirt or the green shirt?”
Instead of:
“You need to take a shower.”
Try:
“Would you like to shower before breakfast or afterward?”
The choice does not have to be about whether necessary care will occur. It can be about how, when, or in what order it happens.
Break the Task Into Smaller Steps
A task that seems simple to you may involve many steps for someone with dementia.
“Get ready for bed” might require the person to remember to:
- Go to the bathroom.
- Brush their teeth.
- Change clothes.
- Remove hearing aids.
- Get into bed.
Instead, guide one step at a time.
“Let’s go to the bathroom.”
Then:
“Here is your toothbrush.”
Then:
“Let’s put on your pajamas.”
One step is often easier than an entire sequence.
Do Not Argue About Reality
Correcting someone repeatedly usually does not make dementia disappear.
If your mother says she already showered when she has not, arguing about whether she is right may only increase frustration.
You can acknowledge what she is saying without agreeing with something that is untrue.
Try: “You don’t feel like you need one right now.”
Then redirect: “Let’s wash up a little before lunch.”
Sometimes a washcloth, sponge bath, clean clothing, or a later attempt may accomplish what is needed without creating a battle.
Try Again Later When You Can
Not every task has to happen immediately. If the person is safe and the task can wait, stopping may be more effective than continuing a confrontation.
- Take a break.
- Change the subject.
- Have a snack.
- Listen to music.
- Walk into another room.
- Try again in 15 minutes or later in the day.
With dementia, the same request that produces an angry “No!” at 9:00 may be accepted without difficulty at 9:30.
Change the Approach
When something repeatedly causes resistance, look at the routine itself.
Ask:
- Is the bathroom too cold?
- Is bathing happening at the wrong time of day?
- Is the water frightening?
- Is getting dressed taking too long?
- Is the person embarrassed by having someone help?
- Are instructions too complicated?
- Is the television creating too much distraction?
- Would familiar music help?
- Would a different caregiver have more success?
- Can the person do part of the task independently?
Sometimes the person does not need to change. The caregiving approach does.
Preserve Independence Where You Can
It is easy to begin doing everything for someone because it is faster. But being faster is not always better.
If the person can still wash their face, hold a toothbrush, pull up a zipper, choose a shirt, feed themselves, or walk safely with supervision, allow them to do it.
You may need to provide more time, cueing, setup, or assistance.
Doing what a person cannot do while allowing them to continue doing what they can do helps preserve skills, dignity, and independence.
When the Answer Still Has to Be No
Respecting a person’s preferences does not mean ignoring serious safety concerns.
There may be times when you cannot safely allow someone to:
- Drive
- Walk without needed assistance
- Take medications incorrectly
- Leave the house alone
- Use unsafe appliances
- Refuse urgently needed medical attention
You may not be able to eliminate resistance. Your job becomes finding the least confrontational and most respectful way to maintain safety.
That may require help from family members, physicians, home health professionals, dementia specialists, or other caregivers.
Watch for Sudden Changes
New or dramatically increased resistance should not automatically be blamed on dementia.
A sudden change in behavior can sometimes occur when a person is ill, uncomfortable, dehydrated, constipated, in pain, reacting to a medication, or experiencing another medical problem.
Contact the person’s healthcare professional when resistance or agitation is a significant change from usual behavior, particularly when accompanied by new confusion, weakness, fever, pain, changes in eating or drinking, unusual sleepiness, or other physical symptoms.
A Simple Caregiver Check
When resistance begins, ask yourself:
PAUSE
P — Pain or physical discomfort?
Could something hurt?
A — Afraid or anxious?
Does the person understand what is happening?
U — Unable to understand?
Am I using too many words or asking too much at once?
S — Sensory overload?
Is the environment noisy, rushed, cold, bright, or distracting?
E — Enough choice and control?
Can I let the person participate more?
You may not discover the exact reason every time.
You do not have to.
Sometimes changing your approach is enough.
Remember
Resistance is often a signal, not simply a behavior to stop.
- Slow down.
- Look for the reason.
- Use fewer words.
- Offer choices.
- Preserve independence.
- And when it is safe to do so, step away and try again.
A calmer approach will not prevent every difficult moment. Dementia can make caregiving unpredictable.
But reducing pressure and helping the person feel safe, respected, and involved can often make care easier for both of you.
By Zanda Hilger, LPC, Founder, Family Caregiver & Program Manager for Family Caregivers Online
We hope this information is helpful to you in the important work you do as a family caregiver.
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