When dealing with a loved one who is in denial of a certain level of care needs, you have to become creative, and enter into a short term plan that allows the loved one to make decisions on how to reach the goal of the care need. Ex. A loved one who agrees with needing some help, but not to the extent of which the family verbalizes to them. Instead of saying things like, "you can not do it yourself", "someone has to do it for you", eliminate descriptive words of inability, this can be done by allowing the caregiver to follow the lead of the loved one, at the pace and direction that seems to be allowing your loved one to actually do the task, even though the caregiver is performing the service. When the threat of independence is looming over the head of a person who has been independent this can cause friction, denial, and anger. Allowing participation in how, when, how often, and where is usually all the loved one needs to control to get the task done. They are aware that they need assistance, that is not in question, but removing them from participation all together is not what you want to do in a situation when there is denial in the level of care is needed.
This can minimize refusal of care, as well as increase mobility, physical and mental strengths. Most seniors whos cognitive process is still strong, but physical strengths has weakened should be allowed to control the care need process as much as possible as long as there is not a safety threat. Time consumption should not be a deterrent, an example, in showering. When the care provider takes full control a standard shower, skin moisturizing, and dressing can be completed within 45 minutes or less possibly, but with a cognitive independent, with minimum physical ability, the shower could take an hour or more.
A good assessment at the introduction of care services will determine the time frame of a service being provided for a loved one who is in denial of the level of care needs they should have, and that is how it should be done, and not by what is considered to be the norm. Reducing anyone who is in need of care services to a personal care needs is an attack on dignity. In and out services are never in good quality, it lacks compassion, and human interaction, and no one looks forward to any form humiliation, even when it is unintentional, so preventing this at all from happening is the best solution.