Christine M. Valentin, LCSW, LLC
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Good Cop, Bad Cop and Alzheimer's disease

11/16/2012

2 Comments

 
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Alzheimer's disease is a disease that affects millions of individuals and their families. Of the many behavioral symptoms associated with the disease, one of the most exhausting, stressful and emotional is dealing with a loved one's refusal to eat, bathe, attend doctor's appointments, etc. While it is normal to try to rationalize with your loved, for many families the attempt is often unsuccessful. 

One approach I often recommend to families is to look at the situation from a "Good cop, Bad cop" perspective. The essence of the "good cop, bad cop" approach is that the cop who is perceived as good is the one who will succeed in convincing the person to do as he/she wants, whereas the "bad cop" is unsuccessful. For many individuals with Alzheimer's disease the "bad cop" is usually the person who cares for them most - the primary caregiver. Why? Because he/she is most likely the one who is reminding their relative what they should or should not be doing. So, what should you do if you are the "bad cop?" 

1) Find a Trusted Relative - It is not uncommon for individuals with dementia to trust and abide someone who they see as 'good' and/or knowledgeable. Whether it is a grandchild, a next door neighbor or your cousin in another state - knowing who this person is and getting them on board to have a discussion with your loved one can be helpful.  

2) Consult The Physician - Many older adults, especially of certain cultural backgrounds, will often listen to anything his/her doctor says. In some cases, families have enlisted the help of their family physician and/or neurologist to get their loved one to begin taking medications, take showers, stop driving, etc. All that is usually needed is for the physician to "prescribe" a regiment or routine for your loved one.

3) Don't Undermine Their Intellectual Capability - Individuals with dementia should not be considered unintelligent. While they may be forgetful, it doesn't mean they don't understand what is going on. Therefore, try to refrain from talking about your loved one in their presence as if they are not there, especially if they are in the early stages of the disease. The last thing you want them to feel is like they no longer have control in decisions, no longer have a say in what happens and no longer have a purpose.  

While there are a lot of other factors that come into play when trying to get a loved one on board, in my experience, RESPECT is the biggest factor. Remember that your loved one is a grown adult who should be treated as such. To treat them any less will only result in more resistance and a lot more stress for everyone involved.

Do you have any tips you would like to share about the "Good Cop, Bad Cop" technique I described above? Has someone else had to step in to convince your loved one to do something? If so, who? Feel free to share below.



2 Comments
Nicole Scheidl link
12/3/2012 03:11:35 am

I think the underlying respect you have for the individual and giving them the space to have choice is really important. One approach is to give the individual a choice - do you want to have a bath now or after lunch? You've given them the choice as to when they are going to have a bath and made the underlying assumption that they will have a bath. Creating the space for as much individual decision-making as possible is key to supporting their human dignity.

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Christine M. Valentin link
12/3/2012 03:57:17 am

Hi Nicole,

Respect is a HUGE piece to making the situation work. Without most forms of intervention would be useless. Thank you for pointing that out and for commenting.

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    Christine M. Valentin 

    As a licensed clinical social worker, I help individuals caring for a loved one reduce feelings of anxiety, depression and stress.  This blog is meant to share with you, many of the suggestions I recommend to many family caregivers. Sign up to receive them directly.

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The Site does not provide psychotherapy advice. The Site is intended only for use by individuals in search of general information of interest pertaining to caregiving, stress and related topics. Content is not intended to replace or serve as substitute for professional consultation or service. Contained observations and opinions should not be misconstrued as specific counseling advice.
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