8 Steps to Overcome Refusal of Care: Step 5

Amanda Denny

Posted by Amanda Denny on November 2, 2018

In Step #4, we discussed the power of building upon one small thing that the client will accept help with so that we can gradually extend the length of our visits. We’ll now need to employ some degree of therapeutic storytelling, which is defined as the practice of deliberately deceiving a patient for reasons considered in their best interest.


Step #5: Get comfortable with therapeutic storytelling

Most of us are taught growing up that you should not lie, particularly to your parent or spouse. The big difference here is that usually when people lie, they are lying to protect themselves. With therapeutic storytelling, you’re lying to protect your client or loved one from their own poor decisions and dangerous behaviors caused by their dementia.

When we’re trying to initiate care, coming up with plausible reasons as to why we’re coming into someone’s home is critical to our success. Using explanations such as, “Your doctor asked that we stop by to take your blood pressure twice each day.” or “You had asked for some help with housekeeping and garden maintenance.” will usually produce a more favorable response than the absolute truth for our presence in the home.

When someone isn’t able to make good judgements or understand their own needs, telling them the real reason we’re there will likely only trigger agitation and create a setback in initiating care. Therapeutic storytelling works in situations where validating feelings, trying to reason and turning to logic all fail. Next time, we’ll learn how to use therapeutic storytelling to overcome a common objection to accepting care: paying for services.

This blog post is Part 5 of an 8-part series on how to
overcome refusal of care with someone who has dementia.

Topics: Dementia Home Care, Best Practice Dementia Care, Best Practice Approach