Caregiving

I am responding to your example but the main idea can be applied to any behavior or choice a client makes.

Someone with a chronic health condition may stop eating for many reasons, perhaps food doesn't taste good to them anymore, eating causes gastric and digestive discomfort or pain, they don't see hope for a future (they develop depression), or they are expressing control over one aspect of their lives (albeit the control is working against their own health). It's important to properly assess the cause. If you are not qualified or experienced in that assesment, get someone involved who is. If the client is someone relatively intelligent, cogent and knowledgable, they know they should eat and (now that you've educated them) what and how they should eat over what they shouldn't.

The important thing to consider is how we can be influential with any client; we create a therapeutic relationship based on trust and mutual goals. It's imporant to build a relationship with them so that they see us as a confidante and supporter, rather than someone else who's criticizing them or telling them what to do. It's very difficult to do that if you become engaged in conflict/confrontation over behavior or choices they "should" make or if you are seen as judgmental or controlling.

Take the focus off of eating and extinguish the power struggle that could be developing. Listen to the client and their reasons for not eating without judgment. Empathize with them and agree that their reasons are valid. Give them permission to engage as they wish, but remind them of the outcomes that will likely transpire if they choose not to eat. Offer to help them overcome whatever reasons they have but don't push them. Encourage them by saying that often when people haven't eaten well for a while, their natural feeling of hunger can be blunted but will return if they can eat even when they don't feel like it.

When I worked in an inpatient psych unit, I often noticed intelligent, well educated people behave in somewhat juvenile and counter-productive ways when they were first admitted. They didn't like being told what to do, what to wear, when to do things, what they were going to participate in, or being observed whenever they did.

Rather than get into a power struggle with them, it was helpful to simply ask them what their goals were, top on the list was usually to get out of the inpatient unit. So I'd talk to them about what the expectations were for them to be discharged, the benefits that they would obtain by following the expectations (earned privileges, increased freedom) and the logical consequences if they did not meet expectations. Nothing was stated in a threatening way, just factual: "This choice will lead to this outcome. It's your choice. I'll respect your choice, but undestand I won't be able to prevent the logical consequences."

Lastly, don't judge your success as a caregiver based on whether or not they decide to eat. Their goals and needs may be different than yours. You are a success if you help THEM obtain THEIR goals. It is afterall THEIR healthcare and they have rights to make healthcare decisions.

Sometimes we cannot save people from their own choices. If we are acting in ways that are respectful and do not cause harm, that may be all we can do.