My Care Recipient Won't Cooperate!

Carolyn and her husband, Frank, are having a normal day, which means that they are both so mad at each other that they've spent the day in silence. Carolyn became so mad at Frank earlier in the day that, as soon as he turned his back, Carolyn stuck her tongue out at her mom.

In the moment, it felt great. She stuck her tongue out for a long time, even wiggling her hips (okay, her backside) to get a little bit of motion behind it, reinforcing exactly what she meant by sticking out her tongue. Yes, in the moment, it felt great.

But, a few hours later, the guilt has set in. Yech, she thought, when did it all become so childish?

Carolyn and Frank are engaged in a Battle of the Wills. Carolyn wants Frank to accept help; Frank has set his heels in the ground, he wont accept help and hes not budging. And, so now the days are spent in anger and frustration. And, they're both exhausted from it.

Caregiving is hard. And, it can become impossible if you and your care recipient engage in a Battle of the Wills a battle that no one can win.

Sometimes, uncooperative care recipients are just asserting their opinions. Listening to the gripes and complaints may improve your care recipient's disposition. And, if you listen to their gripes, you may learn some new approaches and solutions.

For instance, your care recipient gripes that her noon-time meal, delivered by Meals on Wheels, arrives cold every day. You may not want to hear this complaint; knowing that a Meals on Wheels volunteer delivers a noon-time meal to your care recipient lessens your guilt while you're at work. Thinking that your care recipient receives a cold meal just increases the guilt you feel! So, rather than acknowledging that your care recipient may have a justified complaint, you choose to downplay it: Oh, Mom, you expect too much. Or, Mom, it only costs $2.50. What do you expect?

Instead, try listening and accepting the gripe, then calling the agency to pass along the complaint. The agency probably can make some simple changes (perhaps a new volunteer forgets to include hot packs in the coolers that store the meals) that will greatly improve the experience your care recipient has with Meals on Wheels. What a benefit for both of you!

If a care recipient refuses help in the house, work to get a commitment to use in-home care on a trial basis. For instance, when your care recipient says: I will not have strangers in my house! You might try this approach:

Mom, I can understand your concerns about strangers in the house. I think you're wise to be skeptical that this will work. But, I also worry about you and want you to be safe at home. So, what if we try this: Lets try using a home health aide for a month. Ill be with you the first few times the aide comes. Well have her come three days a week for four hours. Ill make sure you have a notebook and pen so you can jot down notes about the aide and how its working out. Ill still call you every day, but well set aside Saturday mornings just to discuss the aide. So, Ill stop by to have coffee with you and well go over your notes. What do you say? Can we try this for a month and see how this works?

Its important to get a commitment on a trial basis because often its the springboard to a permanent commitment. And, its helpful to know that you respect your care recipients concerns and will listen to them. More importantly, if you take time to listen to your care recipients complaints, you may be able to nip small problems before they become huge problems (and huge barriers to a permanent commitment). If, when you have your Saturday morning meeting, your care recipient shares complaints that concern you, you can contact the home care agency immediately on Monday morning to resolve them.

When communicating with your care recipient, keep in mind these tips:

1. Listen for the meaning behind the words. Is your care recipient angry, sad, depressed? Love and fear are our two motivating emotions; most times, we act out of love or fear. Its easy to see actions from love. Actions from fear are trickier, though, because the fear can manifest itself in anger or guilt. And, those are very difficult emotions to deal with.

2. Once you've understood the message, then validate your care recipients feelings (Its absolutely understandable why you would so angry and upset, Mom. How can I help?). Validating means you've heard your care recipient and that's meeting a huge need. We all want to be heard.

3. Involve a third-party, a trusted professional or family friend, that can help mediate discussions with your care recipient. Physicians, lawyers and ministers or rabbis often can help smooth rough waters with your care recipient. And, bad news is often best delivered from a third-party, rather than from you.

4. You may feel that you wear a t-shirt with a bulls-eye, at which your care recipient is constantly taking aim. Take off the t-shirt! When discussions become verbally abusive, end the phone conversation, walk away, take a walk, escape to your room. Remember that the disease and illness (and sometimes the care recipients disposition and circumstances) are to blame not you.

5. Give back some control. Be sure your care recipient has some control over the decisions about care. Show gratitude with words and action: Give your care recipient a hug and say, Thank you for being such a trooper. Its great to be on the same team with you. Who knows what we can do together?

6. At times, managing an uncooperative care recipient comes down to this: We often have to change. And, if we change how we react, we can change our circumstances and perhaps even our relationship with our care recipient.

After all, the definition of insanity is to do the same thing over and over and expect different results. If we can change, we can change our frustration, anger and our guilt. And, who wouldn't want to get rid of those?