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HE A LTH • Spring 2021 19 I t's not easy to take care of another adult, especially while managing other responsibilities and, ideally, taking good care of yourself, too. Stress comes at you from many directions. There's one source of stress that often takes caregivers by surprise—a loved one's resistance to their help and suggestions. Although noncompliance and active defiance probably aren't reactions you expect, they're not unusual at all. A person who's having a physical or cognitive decline may: • Push away their family and friends • Ignore medical advice • Continue to do things that are no longer safe • Say hurtful or inappropriate things This resistance may make it harder to provide necessary care or safety measures. Your loved one's response may also bring up feelings you wish you weren't having: anger, impatience, guilt, confusion, frustration, depression. Try to see their side It may seem that everything would be much better if your loved one would cooperate. But the difficult behavior you see may actually be your loved one's attempt to maintain a sense of autonomy. Whether physical or cognitive, decline can be accompanied by a strong sense of loss for the person experiencing it. As the ability to do things independently declines and dependence increases, frustration can grow. Don't dote too much Your loved one's resistance may also be an effort not to be a "burden." One woman I worked with has cognitive loss but understands how her situation is affecting those around her. She is angry and frustrated because she can't escape being reliant on them. Her family's response is to dote on her, and the woman sees that as confirmation that she is a burden. In similar situations, it can help to pull back a little and let other family, friends or professionals do some of the work of caregiving—so you can keep the relationship healthier. Make decisions together Even if you're not able to strike a perfect balance, trying to understand the emotional conf lict your loved one is experiencing— while also being practical and effective in managing their care—can go a long way toward calming the situation. I regularly encounter families who say, "We want mom to go to an adult day health center five days a week." Yet when I ask whether their mom also wants that, I often learn that no one has asked her. When she finds out that they haven't consulted her, she becomes resistant to the idea of going to a center at all. Families aren't usually leaving mom out of the decision process intentionally. They're trying to find efficient and effective solutions for difficult situations. While some decisions must be made quickly, the person receiving care should still have a voice— even if their thinking is not as ordered, and even if their desire is unrealistic. The more decisions you take away from them the more they're going to feel like they are losing control and are no longer being treated as an adult. Enlist the help of friends and family If your attempts to talk leaves your loved one feeling angry or resistant, it may be time to look at the situation from a different angle. Sometimes a person rejects a caregiver's advice, but will accept that same advice from a different source. Is there someone else your loved one may listen to? A friend? Neighbor? Relative? Someone with a calming demeanor can help set and maintain the tone for an important conversation between you and your loved one. Talk to health care providers You can also ask a doctor, physical therapist, pharmacist or other health care professional to speak to your loved one or recommend an approach for managing your particular situation. Health issues and medical treatments may also affect behavior and attitude. Check with your loved one's health care providers to see if that could be the case. If your loved one is displaying aggression or is physically abusive, contact his or her provider immediately. Remember you're not alone Although it doesn't always feel like it, there's a village of people around you who can help you care for your loved one. Reach out to them for help. n Emily Lemire, M.S.W., is Manager of Social Work for Fallon Health's Summit ElderCare program in Lowell. She also contributes to Fallon's Caregiver Connection blog (fallonhealth.org/caregiver-blog), which features information and resources for caregivers of older adults. She can be reached at emily.lemire@fallonhealth.org. SENIOR PLANNING GUIDE SPE C I A L SP ON S OR E D SE C T ION What to do when your loved one resists help By Emily Lemire, M.S.W.

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