There is always a patient that says no to every question a nurse asks of them.
Whether they would like something to eat.
Or if they would like to have a shower.
The answer is always no.
Nurses have a tendency to categorise patients who do this as aggressive or disruptive.
But it is not only nurses who experience this type of behaviours from patents with cognitive impairment who require assistance with activities of daily living.
Other health care workers and caregivers experience this behaviour as well.
Resistiveness to care is a term that has been used to describe these behaviours.
Up until now there has been no consistent way of defining exactly what it is.
Three researchers have attempted to define resistiveness to care –
“Resistiveness to care was defined from the perspective of the caregiver or care provider and considered to be deliberate acts invoked from the caregiving encounter that were either verbal or physical and were thought to be meaningful responses of the care recipients to their perceived environment, such as a threat, or disability and were means of communicating needs, conflict, rejection, or an unwilling acceptance of an interaction between a caregiver and a care recipient. Factors contributing to resistiveness to care included distorted understanding (such as cognitive impairments and immature cognitive development), dependence on another for care (such as physical or psychological limitations), anxiety, apprehension or unmet physical or psychosocial needs. The resulting effects of resistiveness to care included interrupted care, use of force, physical restraints or pharmacological restrains to provide the care, increase in distress, and discomfort for both caregiver and care recipient as well as increased disruptive behavior (sic) manifestations of the care recipient toward the care giving experience if resistiveness to care was not addressed when it occurs during the care giving interaction.”
Until a definition is agreed to, research into this important area of nursing as experienced by nurses and patients together will falter.
To learn more about resistiveness to care,