Are you Asking the Wrong Question?

In the last edition of The Dementia Newsletter, I wrote about what happens when we run into resistance to our care. We talked about how our care might be perceived and why it might be rejected. (You can read the original article here.)

As I’ve continued to ponder the subject of care refusal, I’ve come up with a distinction that may shine some light on why some interactions I’ve had with people with dementia have been successful, and why other interactions haven’t been.

So here’s my thesis: see what you think — when we run into a refusal of care, I think we tend to ask ourselves one of these two possible questions:

1. Why won’t they…?
2. Why would they…?

Perhaps this doesn’t seem like much of a distinction. However, I think that the sooner you start asking the second question, the sooner everything will get easier.

Here’s how I see it: the first question isn’t about helping your loved one. Not really. It’s about having a task to get done. #1 asks (whom?) for a solution to a hopeless problem, and in this phrasing of the question, your loved one is the problem. You’ve set them up in your mind as the obstacle. Why won’t they?

Question #1 is a dead end, a flag of surrender.

“Why would they?” on the other hand is bursting at the seams with possibilities. It asks you to find their “why," their purpose, in a given situation and use it to create positive outcomes. Instead of complaining to the heavens — “why won’t this turn out like I want it to?” — question #2 turns them into a partner and lets us to work toward a resolution together.

I’d like to tell a related story from my own history in senior housing: when I was starting my career in senior living, I gave general orientation tours to new employees at the community where my mom lives now (24 years later).

I would take them on a tour of the grounds, check out activities, meet the directors, locate the bathrooms and breakrooms, and so on. Then we went through the different levels of care and I explained what happened in each of them.

One day, as I left memory care with one of my groups, a resident came racing behind and went right out the door. My career flashed before my eyes! A caregiver came to my rescue, but there was a problem. She was asking, in essence, “why won’t you go back inside?”

“You can’t be out here. You need to go back in. Please just go back in the building. It’s not safe out here.”

The resident was getting agitated. It was not looking good.

But then, my hero! Right behind the first caregiver was a second one asking, essentially, “why would she go back inside?”

“Barb, the spaghetti is on the table and everyone’s waiting for you. Did you want to go join them?”

“Well, why didn’t you just say so?” Barb replied, and went back inside without another word.

Why would she go back inside? In that case, because she loved spaghetti. I can relate.

What do you think of this distinction? If you try reframing your care with this technique and want to share, I’d love to hear from you! Email ben.couch@elumened.com and let me know. I read every email personally.