How to Deal with Resistance to Care

July 1, 2024
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For healthcare professionals, especially those that work with elderly individuals or those with dementia, resistance to care is something that you may encounter on a daily basis. Understanding why someone might be resistant to care and how to deal with it are important skills to have for all types of healthcare workers so, in this article, we’ll look at why resistance to care might happen, what it means and what you can do to help support a patient who is resistant to care.

What is Resistance to Care?

Resistance to care is when somebody refuses healthcare assistance, whether that’s by pulling away from their nurse, trying to leave the room, refusing to take medicine or becoming annoyed or aggressive when you try to help them. It is a common behaviour amongst people in later life or those with dementia or Alzheimer’s, especially when it comes to personal care.

Resistance to care is most common in healthcare settings but it can also happen at home. For example, a wife with early stages of dementia may be resistant to the extra help offered by her husband, or an elderly grandfather may act aggressively when his son suggests he hires a cleaner to help take care of the house.

In a healthcare setting, resistance to care might take the form of refusing to take medicine, refusing to eat, pulling out equipment or tubes, wandering out of their ward or leaving the healthcare facility completely.

Patient being resistant to care from a professional

Why Might Someone Be Resistive to Care?

Resistance to care usually happens because the person doesn’t understand why they need help, is afraid of the new situation or feels uncomfortable, whether physically or psychologically.

Resistance to care is particularly common with hands-on, personal care tasks, such as washing and bathing, toilering, administering medicines and feeding – especially if the person feels undignified because of the situation.

Amongst people in later life, fear of losing their independence can be a key reason why they resist care. Everyone wants to be autonomous and no one wants to rely on someone to take care of them, especially if it involves personal care tasks. Accepting help from a healthcare professional can feel offensive to older people, as if they’re ‘giving in’ to ageing, harmful to their pride or, more often than not, an interference.

For those living with dementia, resistance to care is often due to a lack of understanding about what’s happening to them. The person may be aware that they’re struggling with simple tasks but unaware of how significantly it actually impacts their daily life. They may believe they can do more than they’re able to in reality and get irritated when people try to help. This is sometimes referred to as ‘lack of insight’, because the person with dementia cannot recognise they need assistance with tasks and will therefore refuse to accept any help given to them.

Patient refusing to drink water given to them by a carer

How to Deal with Resistance to Care

When someone is resisting care, it can sometimes feel like an uphill battle. You want to act in the best interests of the patient and do all you can to help them, yet they’re behaving combatively and it’s hard to maintain positivity. With the right techniques, however, you can deal with resistance to care in a compassionate and constructive way.

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Communication skills are essential to help any patient that is resisting care. Our Communication Skills in Health and Social Care Course will teach you about the different barriers to communication and how to overcome them, as well as how to respond to conflict appropriately and efficiently.

To handle resistance to care, try the following tips:

  • Encourage the person to do as much as they can by themselves before you step in to help.
  • Involve the person in the conversation about their care – avoid making decisions on their behalf if they have the capacity to choose themselves. Always strive for person-centred care.
  • Put objects, activities, food and medicines within sight of the person, so they can do things themselves and see what’s going to happen next.
  • Be consistent as much as possible, so the person knows what to expect and your care becomes just another part of their daily routine.
  • For a person refusing to eat, tailor food and drink to the individual where possible, offering them choices you know they prefer and will be more likely to accept, such as adjusting portion sizes, chopping or not chopping foods up, putting gravy in a jug rather than on the plate, etc.
  • Avoid arguing with the person if they’re refusing to eat, drink or take medicine. Instead, politely ask that they eat/drink/medicate, leave the item near to them, then walk away.
  • Listen to complaints from the person and don’t be dismissive, even if their grumble seems very minor to you.
  • If the person is resistant to washing or bathing, make the experience more appealing to them using aromas and bath products they like, improving cleanliness of the bathroom and using their favourite music.
  • For a person refusing medication, be patient, positive and polite. Explain why the medication is necessary, politely remind them to take it, then leave the medicine within sight of the person whilst you get on with something else. Never force a person to take medication or threaten them with consequences.
  • Always maintain the dignity of the person you’re providing personal care for by staying out of their personal space as much as possible, giving them privacy where you can, keeping them covered and allowing them to do as much of the care as they can on their own.
  • Compliment and praise the person once they’ve allowed you to assist them with something – positive words go a long way in gaining your trust.

For the person in later life or the person with dementia, refusing help can be a matter of pride. They may be in denial that they can no longer live independently and be resistant to care for a long time before they admit that extra help is needed. No matter their situation, it’s essential that you always involve the person in the conversation and act in their best interests. Always be patient, compassionate and positive – even when this feels challenging.

Resistance to care can be hard work, for both the person resisting and the person trying to offer care. What’s important to recognise is that the person resisting care isn’t trying to be difficult or combative – they are simply reacting to their lack of understanding, discomfort or confusion about the situation. As a healthcare professional, you can help by understanding why a person may be resistive to care, then supporting them with compassion and kindness to overcome their barriers.

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