I came across such a seemingly hopeless situation from a reader of one of my favorite blogs “Alzheimer’s Reading Room” and the writers (Bob DeMarco) brilliant response from his own experience with his mom.
“I’m Ready To Quit”
I have tried everything to get my mom to brush or rinse. Maybe if it was a stranger relationship like in a nursing home but at home with me she refuses. Her normal response to any kind of request no matter how it is put to her is “who are you to tell me what to do” and then “I already did that” and then refusing to do it. She is completely confused and afraid of the vibration of an electric toothbrush. That was a major disaster. She does not understand any longer how to swish something in her mouth and immediately swallows it, even toothpaste. I’ve tried “helping” her by guiding the brush like one post and she hit me, got very angry at me, yelling at me “I can do it, leave me alone“. “All you ever do is tell me what to do, leave me alone.” Now, She refuses to brush her teeth period!
From the mouth of Bob DeMarco
If only I had a nickel for every time I heard “I Give Up.” I had the same problem with getting my mother to brush her teeth. And she did say, “who are you to tell me what to do”, “you’re not the boss of me”, “leave me alone”, “kiss my ass”, “I already brushed my teeth”. Over and over she said these words.
Lets examine the responses.Who are YOU, “tell ME”, “leave ME”, and “YOU” “ME”.
My point? The dreaded word YOU is not conducive to effective Alzheimer’s caregiving. When you argue with someone did you ever notice the conversation is often dominated by the word “YOU”. The word “YOU” can be combative.
What are some alternatives to engage someone with Alzheimer’s, and get them to do something that is needed and necessary? Let’s stick to the topic — brushing. Instead of the above maybe we respond with:
“Mom, WE need to brush OUR teeth. Mom, why don’t WE brush OUR teeth together. Mom, I want to be sure that OUR teeth stay nice and healthy, why don’t WE brush our teeth.” I might suggest here that you use the kitchen sink. Get out two toothbrushes and two tubes of toothpaste. I suggest you get your Alzheimer’s patient strategically set, standing right in front of their toothbrush and toothpaste which is sitting strategically right next to the sink. Turn on the water. Pick up your brush, and start brushing. You are now demonstrating what to do. And, you are doing it — brushing your teeth.
Don’t say a word. Brush. Spit. Brush.
Finally, make a short comment. “This feels good. I don’t want to end up in the dentist chair, this is why I am brushing.” Keep brushing, spitting, and smiling in between. Don’t say a word.
Put down your brush. Pick up their brush. Put some toothpaste on the brush. Hand the brush over. Don’t say a word. Do it while smiling and without talking. Remember, some Alzheimer’s patients can only do one thing at a time. They can’t multi-task like you and me. This means they can’t talk and brush their teeth at the same time.
If they still don’t brush, or if they say something negative, move the brush a little bit so they can see it, and don’t say a word. Smile. Relax. Smile. Finally, say,”its up to you”. And walk away.
Let me advise you. The more you talk, cajole, or push the less chance that it is going to happen. Sooner or later you’ll learn, in Alzheimer’s World, fewer words get you more. Now this technique might work the very first time, or it might take 19 days. You must be patient, and you must remain positive. Please remember, if you make it like you are trying to pull teeth, you’ll get what you don’t want.
Keep in mind: This person has been brushing their teeth for a long time. However, no one was standing around telling them what they had to do or all the bad things that were going to happen if they didn’t brush.
What About Bob?