What's the best way to deal with combative behavior?

Yojerry asked...

What is the best way to get my mother, who has Alzheimer's, to cooperate when she is being combative?

Expert Answer

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.

Alzheimer patients are often confused and become oppositional when a loved one, or a professional caregiver, attempts to provide direct care. The caregiver is 'well-meaning' but the patient does not understand this and thus, may behave in a 'defensive' manner that ranges from saying 'no' to expressing anger. Sometimes, this behavior is perceived to be 'combative' when it really is a way the patient can communicate that he or she is not ready for this care. It might be when medication is being administered or a bath is given....or even a meal is served. The best strategy at that time is to 'retreat' and try to perform the task again in a little while. You may need to do this a few times before the patient will 'cooperate'. By understanding the patient's 'preferred time schedule' you also may foster cooperation rather than opposition; if a bath at night works better than in the morning, do it then. The key is understanding that you cannot usually cajole or negotiate with an Alzheimer's patient. Instead, you need to modify your methods of providing direct care.