What are the factors associated with people with advanced dementia refusing assistance with personal care?

• Published in: International journal of geriatric psychiatry 2023-01, Vol.38 (1), p.e5857-n/a
• Main Authors: Backhouse, Tamara, Killett, Anne, Mioshi, Eneida, Khondoker, Mizanur
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; care home; Caregivers; Caregivers - psychology; Cross-Sectional Studies; Dementia; Dementia - psychology; Dementia - therapy; Dementia disorders; Embedding; family carer; Geriatric psychiatry; Humans; Personal grooming; refusals of care; resistance‐to‐care; Self Care; Statistical analysis; Training
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.5857

Background People with dementia sometimes refuse assistance with personal care activities such as washing or dressing. We aimed to investigate the factors associated with refusals of care in advanced dementia. Methods A cross‐sectional study using informant‐based measures. Participants were people with advanced dementia and their caregivers (family carers or care‐home staff) (n = 260, 130 dyads) in the UK. Mixed effects linear models were used to examine the effects of neuropsychiatric behaviours, ability with activities of daily living, professional input, co‐morbidities, psychotropic medications, environment modifications, and caregiver factors including type and training status on refusals of care. The Refusal of Care Informant Scale was used, range 1–13; higher scores indicate more refusal behaviours. Results Higher independence in activities of daily living was associated with less refusal behaviours (coefficient = −0.11, p