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