When “no” is the default answer


July 9, 2022

If you are providing care for a loved one living with Alzheimer’s, it might seem that the word “no” has become a natural response to any question.
     “Ready for your shower?” “No.”
     “Are you hungry?” “No.”
     “Would you like to play a game?” “No.”
If you feel as if all you hear is “no”, here are a few approaches that just might help you turn a “no” into a “yes.”

A “no” response is pretty common when caring for someone living with Alzheimer’s. You’ll need a variety of approaches. If one doesn’t work, try another. So be open to learning and being flexible, and don’t take the “no” personally. You’ll also need to respect the “no”. Time may be short, but giving your loved one a little space may give them the chance to relax, and a calm environment is much more conducive to a “yes” response.

Offer Choices

Offering choices whenever possible gives your loved one back a little of the control they may feel they have lost. Present the task, “It’s almost lunchtime.” “Would you like your favorite soup today, or a chicken salad sandwich?”

Presentation Matters

How you present the question is also important. Five elements that I have found helpful include; smiling, greeting warmly, communicating thoroughly, remaining positive, and being patient. Here is a step-by-step example you might try if preparing to give a bath.

  1. Have a routine. Offer tasks like bathing at the same time/day of the week when possible.
  2. When you approach, smile and make good eye contact as you explain the task.
  3. Offer choices as you can. (Would you like a shower or a bath today? Would you like your bath now, or after the news? Do you want to try the new lavender soap, or your favorite rose scented soap?) Always give plenty of time for response and if too many questions seem to overwhelm your loved one, stick to those that require a simple yes/no response.
  4. If they respond “no”, respect that. Step back and try to redirect them away from the task at hand. Engage them in conversation about a favorite memory and give them time to relax. Then try again.
  5. Offer a favorite game, TV show, or snack once the task is complete. (“Mom, today is bath day. I bought some of your favorite Chocolate Ice cream. would you like to have some after we’re finished with your bath?”)

Non-verbal Communicaiton

We convey more through our non-verbal communications than the words we speak. Non-verbal communication includes tone of voice, body language, gestures, eye contact, facial expression, and proximity. These elements give deeper meaning and intention to your words. Tone includes the pitch, volume, and inflection of your voice. Eye contact suggests interest.

Always be sure that your verbal and non-verbal communication are sending the same message of positivity. Respect your loved one’s personal space, and allow them the dignity of providing as much of their own care as possible. Making and holding good eye contact will help you know your loved one is tracking with you.

What doesn’t work?

Respect and dignity of others should always be most important in caregiving. Negative approaches like those listed below can cause fear, anger, anxiety, frustration and a feeling that life is out of control, which leads to negative caregiving outcomes. Approaches that won’t help overcome the “no”:

  1. Arguing
  2. Intimidating
  3. Demanding
  4. Physical force
  5. Threats/guilt

Instead, try redirection. Change the subject or direction to draw your loved one from a negative to a positive. Using information that you know about your loved one, you can offer a favorite candy, start a conversation about a cherished memory, play a game they love, or break out in dance to their favorite music. Redirection is 1-part knowledge of your loved one, 1-part creativity, and 1-part common sense. Okay, redirection is bribery at its finest. I’m not ashamed to say that I’ve used it, I’ve loved it and I’ve gotten good results with it!

Adapted and reposted with permission from Caregiver.com, “Does Approach Matter?

We hope this information is helpful to you in the important work you do as a family caregiver.
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