My husband, who has dementia, is refusing to do anything for himself- how do I handle this?

5 answers | Last updated: Sep 14, 2017
A fellow caregiver asked...

My husband at age 65 was diagnosed with early stage of dementia. That was almost 2 years ago. He is home and now the latest is he doesn't want to do anything for himself. He is a big guy and his answer to everything is "I can't". He is a diabetic, has asthma and has a problem walking. I am 63 and have become very angry. How do I handle this?

Expert Answers

Helene Bergman, LMSW, is a certified geriatric care manager (C-ASWCM) and owner of Elder Care Alternatives, a professional geriatric care management business in New York City. She consults with nursing homes and daycare programs to develop specialized programs for Alzheimer's patients.

Dementia caregivers like yourself often express that understanding their spouses' progressive behavior changes can be challenging. They often are confused whether a change like a spouse refusing to help himself reflects that he can no longer perform that specific task or that his reluctance is intentional and a call for attention. Whatever the cause, these episodes can cause caregiver anger and frustration.

Nurturing independence for persons with dementia is important but it is equally necessary to know what capabilities your husband retains so your expectations are realistic. His response of "I can't" infers he was asked to do something or was given a suggestions to perform an act. His resistance could mean he didn't understand the communication or his inability to organize the steps to initiate action. This is very common to frontal lobe dementia as well as moderate stages of other dementias. Performing familiar acts like ambulating or taking ones pills require organized thinking.

Sometimes using a more tactile and less verbal approach can be helpful. Thus, if you want him to go outside with you, you would offer his outer garment to him to trigger the action. If you want him to get dressed, you would prepare his clothes and then assist as needed. If the task is more complex, you would need to break it down into more manageable steps to see what he can do autonomously.

Understanding your husband's present stage of dementia might lessen your frustration. A good article to read is the description of the Clinical Stages of Alzheimer's Disease {>Alzheimer's Symptoms}. If there is a local Alzheimer's Support Group for younger spouses like yourself, you could hear how others manage a wide range of dementia behaviors.

Community Answers

Janetm answered...

I have been working with my husband since he was diagnosed in 2004 with dementia. I have experienced those incidents of I can't or I won't and have found that if I present the desire/request with a happy/fun/positive manner that he responds in that same way. If I am upset or anxious he "shuts down" his positive responses. He rarely now sees any of those anxious or tense moments from me and the days progress in a much lighter tone. People that know him say that they are amazed at how happy he always appears to be. Stay positive with the patient, request of them only one thing at a time, note the length of time it takes to process what you have asked of them and proceed as needed. If you have to ask the question again do not get discouraged. It is all part of the day.

A fellow caregiver answered...

Thanks for your reply. The I can't and I won't is mostly when he wakes up in the morning. He refuses sometimes to get up. He is a diabetic and the longer it takes him to get up the lower his readings are. I try to make light of everything but sometimes it is very difficult. Even when we go to doctor's visits, which is the only time he will leave the house, it refuses to listen to me on how to get out of the wheel chair and get in the car. He creates sometimes a scene, which has become very embarrassing to me. Then later in the evening, I will tell him what happens and he doesn't remember any of it. Right now, I am in the process of arranging for someone to come with me and assist in getting him in and out of the house and the same in the doctor's office. Sometimes I feel that I am losing it.

Miamiabu answered...

I'm not there yet.

Louise krekic answered...

It wont help you to get angry. He needs proper nutrients and especially trace minerals. His health is shot and dementia could be the result of bad lifestyle and nutrition. Have he had his heart checked ? Dementia is sometimes a sign that heart blood vessels are diseased and starting to get plugged. He needs to be stimulated to exercise and eat super healthy and his mind kept busy. Does he like some mental stimulation games or crossowrd puzzles ?