Resistance to care in people with dementia: challenges, responsibilities and unmet need

Abstract

Resistance to care is common in people with dementia and can involve active resistance, such as shouting, or passive resistance, such as stiffening of muscles or refusing to open the mouth. Resistance occurs within a complex legal and ethical backdrop, where care staff must consider issues of consent, mental capacity, best interests and duty of care. Resistance also sits within powerful cultures of care, where care staff must resist task-orientated, dehumanising care that fails to acknowledge the personhood of people with dementia. Rather than accepting resistance as an expected part of dementia, care staff must look closer and with curiosity for underlying causes and unmet need. A biopsychosocial approach can be useful in uncovering these needs, and in allowing the structuring of a person-centred response.