DEALING WITH BEHAVIORS SUCH AS STUBBORNNESS AND UNCOOPERATIVENESS 
CAREGIVER TIPS FOR THOSE WITH DEMENTIAS/ALZHEIMER’S
by Carol Ware Duff MSN, BS, RN
The person with dementia may be stubborn or uncooperative because of changes in the brain and an inability to control behaviors.
Reasons for Stubbornness and Uncooperativeness:
- Stubbornness can be at least partly caused by the disease even though the person may have always showed this personality trait.
- Forgetfulness may cause uncooperativeness. For example, if a person does not remember when he or she last took a shower, he or she may be insulted when told to take a shower. This is a perfectly clear reason to refuse to cooperate.
- Your loved one may not understand what is being said or requested and therefore unable to cooperate.
- He or she may think it is easier to refuse to comply than risk feeling foolish.
Remember:
- Negative attitudes can be part of the disease process, not a personal attack on you, the caregiver. Your loved one may be too confused to be able to insult you on purpose or to intend to hurt your feelings.
What are ways to cope with stubbornness and uncooperativeness?
- You can focus on a positive experience such as, “As soon as you take a shower, we can have ice cream.”
- Do not force your loved one to do anything since this could lead to aggression.
- Try again later, after using a distraction of something he or she finds pleasant. Perhaps you could offer a walk, watching a favorite television show, listening to music, or feeding the birds.
- Remain calm and do not allow your feelings to be hurt.
- Avoid arguments and power struggles and instead focus on a compromise that works. Always take the path of least resistance for you and your loved one.
- Listen to what is really being said; read between the lines.Remember that a statement such as, “I hate to bathe!” may really mean, “I feel horrible.”
There may be something else causing the uncooperativeness.
The following are some websites to provide you with more information about the behaviors of stubbornness and uncooperativeness.
AlzOnline: Caregiver Compass Reading Room: Caregiving challenges, Difficult behavior. http://alzonline.phhp.ufl.edu/en/topics
Caremark Resources Center: Alzheimer’s: Dealing with uncooperativeness. https://www.caremark.com/wps/portal/HEALTH_RESOURCES?topic=alzuncoop#s12
References:
Boyd, M. (2002). Psychiatric nursing: Contemporary practice (2nd edition). Philadelphia, PA: Lippincott.
Ignatavicius, D., & Workman, M. (2006). Medical surgical nursing:Critical thinking for collaborative care (5th edition). St. Louis, MO: Elsevier Saunders.
Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical nursing: Assessment and management of clinical problems (6th edition). St. Louis, MO: Mosby.
Mace, N., & Rabins, P. (2006). The 36-hour day: A family guide to caring for people with Alzheimer disease, other dementias, and memory loss in later life (4th edition). Baltimore, MD: The Johns Hopkins University Press.
Robinson, A., Spencer, B., & White, L. (2007). Understanding difficult behaviors: Some practical suggestions for coping with Alzheimer’s disease and related illnesses. Ypsilanti, MI: Eastern Michigan University.
Developed in 2008 by Carol Ware Duff, RN at the University of Toledo for the Caregiver Consultation Center.
Carol Duff graduated from Nursing School at Riverside White Cross in Columbus, Ohio.
She has a BA from Bowling Green University in History and Literature and a Masters of Science in Nursing as a Nurse Educator from the University of Toledo School of Nursing.
She has traveled extensively and has written on military history, veterans health issues and related subjects. She is the mother of several children and 11 cats and 1 guinea pig.
She can be reached via email at: Thehertz@aol.com
Carol graduated from Riverside White Cross School of Nursing in Columbus, Ohio and received her diploma as a registered nurse. She attended Bowling Green State University where she received a Bachelor of Arts Degree in History and Literature. She attended the University of Toledo, College of Nursing, and received a Master’s of Nursing Science Degree as an Educator.
She has traveled extensively, is a photographer, and writes on medical issues. Carol has three children RJ, Katherine, and Stephen – one daughter-in-law; Katie – two granddaughters; Isabella Marianna and Zoe Olivia – and one grandson, Alexander Paul. She also shares her life with her husband Gordon Duff, many cats, and two rescues.
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