The most recent caregiving challenge for me has been the necessity of administering a daily sponge bath to my mom. Both Mom and I resisted this transition! You'd think after 11 years as a caregiver, I would know that exhorting Mom to do a better job wasn't going to help, but I nevertheless tried this ineffective strategy for several weeks before it became apparent even to me that she had lost the ability and initiative to bathe independently. And then we had to get past Mom's resistance and resentment. That was the biggest hurdle for us, and was surmounted by my friendly but relentless insistence that bathing had been ordered for her by her doctor (I'm sure he would have ordered it if I'd asked him to...) and just had to be done (tinge of regret and empathy, firmness in my voice). For a couple of months she resisted my help but over time she adapted to my assisting her in this way. Things are much easier now, just a normal, not-too-time-consuming part of each day.
Every caregiving transition has been characterized by these steps:
1) Denial--I deny that Mom has lost ground and try ineffective strategies--or stick my head in the sand and pretend nothing is wrong (if I ignore the problem maybe it will go away).Some situations are intolerable and should not be endured over time. I would never recommend that a caregiver submit to violence or constant verbal abuse in the hope that the situation will somehow improve. But I do want to encourage caregivers, myself included, to always give a new challenge a little bit of time before giving up. When needed changes require the cooperation of a dementia patient, we must allow some time for those changes to occur.
2) Resistance--I resist having to do more caregiving work, and Mom resists my intrusion into areas that have previously been fully under her control.
3) Upset--characterized by a fairly tumultuous transition phase during which even calm and kind firmness on my part may be met with anger and resistance on Mom's part. During this phase I know it is ineffective to lose my temper, but I generally lose my temper anyhow. I also know it is fruitless to allow my my feelings to be hurt by the spiteful resentment of a dementia patient, but I generally get my feelings hurt anyhow.
4) Resolution--Mom and I both adapt. Dementia patients can learn new behaviors, but it takes many repetitions and gentle insistence on the part of the caregiver to establish effective new routines. These routines will eventually provide the security of familiarity for the care recipient.