Refusing Care (or “Re-Accommodation”): Connecting The Dots from Airlines to Dementia Care

Refusing care and re-accommodation–did you ever think there was a link? It wasn’t an obvious connection to me, either. What about dementia and airlines? Or refusing care and being assaulted?

Dr Al Power (author of Dementia Beyond Drugs) notes the parallels between an older man dragged off a United flight–against his clearly expressed wishes–and what all too often happens when people living with dementia refuse a shower,  and asks, How does removing a person’s clothes or forcing her to shower against her will become okay if it happens within the confines of a nursing home?”

And just like that, the connection between airlines and bathing suddenly became as obvious to me as a lit-up runway.


Assault, or Self-Defense?

When people living with dementia refuse care (be it a shower, or anything else), they’re often labeled “difficult” and noted to “have behaviors.” What would you do if someone tried to take your clothes off against your will?

Do you think you should be treated as the victim of an assault, or labeled “difficult” and given anti-psychotic medication?

What if you tried to defend yourself? Should that action be called self-defense, or should it be noted in an official report that you assaulted your assailant? Or that you “have behaviors” and are a “danger to others”? How about you’re “stubborn” and “refuse care”?


How Refusing Care Gets Labeled

That’s the way it goes for people living with dementia: asserting their right to say “no,” be it verbally or non-verbally–and it is their right, just as much as it’s your right–gets them labeled. They “refuse care.” They’re “difficult.” They have “behaviors.”

In fact, they’re probably a “danger to others,” so they should be put on anti-psychotic medications post-haste.

See how crappy that argument is when we start looking at which person in the interaction is doing the assaulting and which is engaged in self-defense?

Well, yes, but they have dementia, you might think. They don’t understand what I’m trying to do. And you’re right: they do have dementia, and they don’t understand you. So that means it’s imperative we learn to understand what they’re communicating to us. It is our privilege and responsibility to ensure they are treated with respect, kindness, and love, no matter what.


What Happens Behind Closed Doors?

Unfortunately, American Airlines was in the news this week, too. In this episode, a flight attendant reduced a woman to tears, endangered a baby, and dared a man not directly involved to get into a physical altercation. All before takeoff. All while the pilot stood by, silently.

My first thought on seeing this story was that it’s pretty much the same as what I always say about choosing a memory care: be very aware of how you’re treated within the first 30 seconds of entering the community.

If you walk into a community and are ignored or treated rudely in the lobby, in front of God and everyone else who may pass by–you, who clearly are able to care for yourself–do you want to contemplate what happens out of sight at 10 pm on a weekend to someone who’s vulnerable and in need of assistance?


Try A Different Approach

As good as it feels letting off steam about problems, it’s even better when you find solutions, right? Bathing without A Battle is one of my all-time favorite resources. I could never find it on Amazon; turns out I was just looking in the wrong place. I was so excited when I found the website, I could hardly wait to share it with you!

The DVD is $60 and you can find it here. If I recall correctly, it runs about 60 minutes. My own 15-minute version is on my YouTube channel. If refusing care is something you’ve struggled with in your home or community, please take a look at these resources.

When we don’t know how to do something, but believe it must be done, we muddle through to the best of our ability at the time. Refusing care should never turn into a battle or be grounds for assault. When we know better, we can do better. These resources will help you do just that. 


Christy Turner is the founder of and has enjoyed the privilege of working with 1,123 people living with dementia and their families. Follow on Facebook, Google+, Instagram, Pinterest, Twitter, and YouTube. Content varies across platforms.