Common Situations: Refusal to Participate
If the person refuses to participate,
• Make sure there is a structured flow to the day, not just the emptiness of custodial care.
• Be aware of other caregivers who might be coaxing, cajoling, or bribing the person to participate.
• Bring about minimal participation by doing activities with the person.
• Continue to dialogue.
• Emphasize valuing and elicit it during any movement toward the slightest participation.
The major challenge in this situation is to make valuing occur, even in settings that contradict it. Many caregivers work in almost hopeless situations: institutions where the mentally ill are herded like animals, nursing homes where the aged are left to fade away, homeless shelters where the poor are warehoused for an evening. Although we need to fight for social justice and establish decent places for people to live, work and play, many caregivers still need to create hope and feelings of companionship where there is none. Thus, if we work alone in a setting that seems to be the antithesis of valuing and engagement, we have a special and difficult role: to bring hope where only despair reigns.
We will often be ridiculed for our idealism and seeming naiveté. Yet we can express valuing and create feelings of companionship even in the midst of hopelessness. Our interactions are what matters. If the person in the most forsaken institutional ward runs from us and falls to the floor, we can keep on teaching the meaning of human engagement. If the person lashes out, spits, or screams at us, we can move toward him or her and continue to bring about engagement and give unconditional valuing. We are challenged to enable participation and establish feelings of solidarity regardless of the hellish reality in which we find those who are marginalized.
-John J. McGee, PhD
“In the beginning we must always be in the moment with two bits of knowledge focused on giving a feeling of being safe and loved. We should avoid lengthy case histories and cleanly typed plans. If need be, do these requirements. However, our task is to be in the moment; it is not to change anyone’s behavior, but to teach the person to feel safe with us and loved by us.
The present is a series of moments that tumble into the future. Yet, we should not worry about the future, only the present moment. The here-and-now becomes the future with each ticking second. Our encounters transpire in the moment and then transform the next moment.
Whether a mother, father, grandparent, or a person whom we are supporting, the most important variable is the moment, not the future, not a projected plan with outcomes, not behavioral change. No, it is our being present in this very moment and all the person sees, hears, touches, and feels in this mutual coming together. It is the tiniest amount of time, perhaps two or three seconds. Then, these moments are linked together with other moments and it is these moments that become new moments; it is the evolving chain of moments that creates our moral memory in us as well as a memory in the other person.
Caregiving’s simplification involves teaching caregivers to be in the moment:
- In bad moments this equates with forgiveness rather than control;
- In all the good moments this involves a series of accidental and intentional encounters throughout the day focused on safe and loved;
- The accidental encounters are merely brief moments of passing by and encompass a wave, a wink, a smile, a name, a thumbs up, maybe a hug if there is time, a whispering of “You are so good.”
- The intentional encounters are a bit more planned and involve a chunk of caregiving time—from a minute or two or a half hour or more. The time depends. It should be structured in the day with the only purpose being to give a memory that the person is safe when with us.
- The key is to stay in the moment. Joy is found in the moment.
Our task is simple, just being in the moment with the gift of helping the person to feel safe and loved:
- Not a moment before,
- Not a moment after,
- Just in the now.”
-John J. McGee, PhD
“As care givers, we need to be well grounded. Our hope is not in independence, but interdependence. Our primary task is not to control others or force others to be what we want them to be or do what we want them to do. It is to bring a deep unconditional love to those whom we serve. Our central purpose is not self-determination or self-reliance; it is a feeling of connectedness between those whom we serve and ourselves. Our central role is to express a profound sense of companionship and community. What we often think are our primary tasks will come in due course if those whom we serve feel safe, loved, loving and engaged.
We are community makers. Community is a gathering of gifts. Our gift in the act of care giving is the creation of companionship and the formation of community. Those whom we serve bring their mind-body-spirit, their dreams denied, and their hunger for love. They bring their troubles and sorrows, their life story, and their broken hearts. We are to bring a spirit of gentleness to mend their hearts.”
‘Mending Broken Hearts: Companionship and Community’