Resisting Care

People with dementia often resist care because they’re scared, confused, in pain, embarrassed, or don’t understand the need for help. Changing routine, feeling rushed, or being asked to do something they can no longer follow can trigger a “no.” Often, non-drug strategies work best.

Before you start (plan ahead)

Make sure basic needs are checked first: are they hungry, thirsty, in pain, uncomfortable, cold/hot, or need the bathroom? Address these first.

Choose a calm, familiar place and a time of day when the person is usually most cooperative.

Keep the environment quiet and remove distractions (TV, loud radio, clutter).

Set a positive mood. Smile, be pleasant and respectful. 

When resistance starts

Pause and breathe. Stop the task for a moment — escalating rarely helps.

Name the feeling, not the behavior. (“You seem upset. I’m here to help.”) Use a calm, low tone.

Offer a choice, give them agency. Instead of “I need to give you a bath,” try “Would you like a shower now or after lunch?” — choices reduce power struggles.

Use distraction and redirection. Talk about something pleasant, start a song, offer a beverage, or begin a different, gentle activity then return later.

Break tasks into tiny steps. Do one small action at a time, praise each step.

Try “do with” rather than “do to.” Offer to help together — e.g., “Let’s wash your hands together.” Allow them to do the steps they are able to do by themselves. 

If the person becomes aggressive or frightened, stop and ensure safety. Try again later or call for help. 

Words & tone that help (examples)

“I’m here with you.”

“Would you like to sit with me for a minute?”

“Which shirt would you like — blue or white?”

“I see you’re feeling sad—I’m sorry you’re upset. Let’s go get something to eat.”

Avoid arguing, quizzing memory, or contradicting.

Practical tricks for common tasks

Bathing: Keep both the bathroom and bath water warm. Consider time and frequency; try morning or daytime bathing if sundowning, and baths may not need to be daily and can be given less frequently. If full bath or shower consistently causes problems, consider a dry shampoo or sponge/towel bath.

*Eating: Offer familiar, favorite foods in small portions; Offer salty, sweet, and textured foods (in advanced dementia there is loss of taste and smell). Reduce distractions at mealtime. Eat together to model eating; allow extra time without rushing; use finger foods if utensils are challenging. Focus on comfort not quantity. 

Dressing: Lay out two outfits and let them pick; use clothing that’s easy to put on (elastic waists, velcro). Simplify the closet by removing seldom-worn items, and label the dressers.

Medications: Use pill organizers; combine with a daily routine (with morning coffee); offer praise and positive reinforcement; give with favorite beverages; give them agency in the process, such as pouring their own water; ask the clinician if less frequent dosage options exist for drugs taken multiple times daily. If refusal persists, contact the care team.

Incontinence: Approach calmly, maintain privacy by closing doors or using a blanket cover; explain each step in a reassuring tone; offer simple choices, follow a predictable routine, and use gentle guidance; encourage independence where possible, praise efforts, and use distraction or redirection if needed; make the bathroom safe and accessible with grab bars, raised seats, or absorbent products.

Transfers (moving): Use simple, clear instructions and allow time. Act out specific movements yourself while instructing. If physical help is needed, explain each step before you do it.

Mobility assistance devices (walkers, canes):
https://hottocare.helpjuice.com/en_US/challenging-behaviors-in-dementia/mobility-forgetting-or-refusing-mobility-assistance

*As dementia advances, it’s very common for appetite to decrease or for interest in food to fade. This is not a reflection of your care. Changes in the brain can affect hunger, taste, and the energy needed to eat. At this stage, the focus often shifts to comfort—offering favorite foods, small portions, and following their cues rather than pushing intake which will increase distress.

When to get professional help

Repeated refusals leading to medical decline (weight loss, infections, repeated falls).

New or worsening pain, hallucinations, major mood changes, or other dramatic change in status that is unusual for them.

Caregiver burnout (persistent exhaustion, depression, or dangerous stress)

Quick checklist for a visit or care moment

✅ Check pain, hunger, thirst, bathroom.

✅ Choose calm time & place.

✅ Give a simple choice.

✅ Use gentle distraction & small steps.

✅ Stop if distress increases; try again later.

✅ Tell the care team if refusals are frequent.

For more information & support (sources used for this handout)

Below are the pages used to create this handout. (Links open in a new tab.)

Alzheimer’s Association — Treatments for Behavior / dementia resources
https://www.alz.org/alzheimers-dementia/treatments/treatments-for-behavior
https://www.alz.org/help-support/resources
Alzheimer’s Association

Family Caregiver Alliance — Caregiving tips, behaviors, introducing home care
https://www.caregiver.org/resource/caregivers-guide-understanding-dementia-behaviors/
https://www.caregiver.org/resource/introducing-home-care-when-your-loved-one-says-no/
https://www.caregiver.org/
Family Caregiver Alliance

UCLA — Dementia training videos
https://www.uclahealth.org/medical-services/geriatrics/dementia/caregiver-education/caregiver-training-videos
(scroll down most of the way until “browse videos by behavior”)