The person refuses all help. How do I approach them?

My mother refuses everything: help with bathing, eating, medication. She says she's fine and doesn't need anyone, but she really does. I feel like I'm fighting her every day. How do I approach her without her shutting down?

Wanting to help someone who refuses all help is one of the deepest frustrations for a carer. Feeling like you're 'fighting' against someone you love is exhausting — and it doesn't mean you're failing.

Why it happens

The refusal is rarely against you. It's a defence of the autonomy, pride, and dignity of someone who feels control slipping away. Many people with dementia have anosognosia — they are unaware of their difficulties — so they 'really don't need' help, from their point of view. Fear, shame, and confusion also fuel the refusal.

Practical strategies

• Offer choices, not orders: 'Would you prefer to bathe before or after lunch?'
• Approach with calmness, without rushing, at a good time of day.
• Do things with them, not for them — preserve what they can still do.
• Use distraction and routine to make help feel natural and predictable.
• Sometimes, help from a professional or another family member is more accepted than yours.

What NOT to do

• Do not physically force or repeatedly insist — it increases resistance.
• Do not confront them with their failures ('you can't do this anymore').

When to seek professional help

If the refusal puts their health at risk (medication, food, hygiene), speak to your GP. Home support can be arranged through Social Security (300 502 502). Alzheimer Portugal can guide you on how to approach this.

'I stopped saying 'you have to'. I started saying 'can you help me?' and suddenly, she let me care for her.' — Anonymous Carer