8 Steps to Overcome Refusal of Care: Step 3

You’ve tirelessly searched for the right caregiver and found one who is a great personality match for your client or loved one. Time and energy have been spent setting that caregiver up for success by arming them with helpful client insights around personal preferences, activities and triggers. Now it’s time to give your caregiver a compelling reason for being in their new client’s home that their client will accept (hint: we’re not going to introduce the caregiver as a caregiver).

Step #3: Make the Caregiver Not a Stranger

The third step in helping someone with dementia accept care is to make the caregiver not a stranger. Nobody wants a stranger in their house and clients who have dementia and anosognosia will almost always reject help from a new caregiver (after all, if the client doesn’t think they need help, why would they readily accept it in their home?). What does work is being creative with how we introduce the caregiver. Often times, low-risk, low-commitment situations will help the caregiver get their foot in the door. If the client will accept help with pet care or laundry to start, let’s begin with that! We can usually build on smaller tasks with larger aspects of care, but we need a solid starting point which will help the caregiver begin to develop rapport and establish trust.

Similar to most aspects of dementia care, our approach here will be individualized based upon what we know about the client. If the client has a chronic medical condition (aside from dementia) that they’re aware of, we might introduce the caregiver as a medical assistant sent by the doctor to check in on them. Once the caregiver has been welcomed into the client’s home, we use our knowledge of their personal life to start conversations about topics we know they enjoy. Each subsequent visit can be extended slightly if the caregiver can keep the conversation going in a positive manner. The relationship grows from there! Next time, we’ll do a deeper dive around gaining incremental commitment from a client once the first few visits have been successful.

This blog post is Part 3 of an 8-part series on how to
overcome refusal of care with someone who has dementia.