Caregiver abandoned us 2 days ago. I hired temp help in the interim of finding new perm care in house. Mom is refusing to cooperate. Advice?
Last January, I hired a caregiver for my 92 year old mom with moderate - going into severe - vascular dementia. They hit it off and within 3 months mom really accepted R***. R*** was very good at what she did and had a routine down with mom that worked well. I also treated R*** like family. The better I treated her, the more I noticed the last few months she felt comfortable enough to flip on a dime and yell at me, throw things, and then sob for HOURS. I even took R*** to a doctor with my mother in tow in the backseat! (R*** canceled the appt for herself anyhow) - She has been giving me red flags left and right. And poor mom. It is hard for her to warm up to people and she literally loved Ruby and depended on her, trusted her presence. r*** began telling me she fantasizes about slitting her throat in the mirror and has determined how she will kill herself someday by jumping off a bridge. i always knew she was a little "off" but i thought she was just immature for the longest time, and she never, ever hurt mom. mom liked her a lot. knowing this, I should have fired her on the spot. But, no... in my bad judgement I told her she probably had a chemical imbalance and I would give her a vacation or whatever she needed.... I had never seen her hurt mom and mom could still tell me if R*** hit her or something. Mom never did. She loved being with her and finally trusted someone. So... I waited because I had nobody else, and 2 nights ago R*** began flipping out on me while my mother was asleep. I asked her to tone it down before she woke my mother and she kept yelling anyhow so I told her let's not do this anymore. I will find a replacement, just please don't leave me high and dry until I get one. she agreed. The next day, I took mom out for awhile to give her a break. She told me via text she would be back at 2. That was 10:30 AM. By 11:30 she wrote that "circumstances changed and I will not be returning. I left the key and the garage door opener on the baker's rack." That was it. Nothing else. It is like being the toll collector on a busy drawbridge and saying, "hey, see ya, good luck!" and throwing the door open and leaving the traffic piled up. I consider this abandonment. She did not come from an agency. she was a personal hire privately who gave me tons of great references, resume, the whole nine yards so I have no recourse but i feel very betrayed. It is a cardinal sin in the world of caregiving to desert a sick client that relies on you. I scrambled and got help the same evening coming in from an agency, so for the moment, things were okay. then the next morning after mom woke up to the new girl, I walk over after a bit - 2:00 pm to be exact. Mom is in her nightgown still. No wig on no make-up, crumbs on the kitchen tablecloth, mom is walking alone (this can't happen) through the house wearing her SHOES UNBUCKLED with her heels coming out. Bed isn't made... Now I don't want to complain because in reality, we are getting a different girl today at noontime. But the thing is, mom wants Ruby. She said she doesn't want a stranger in the house, and by having to bring in temps, they are all switching days and hours and everyone really is a stranger. i ended up writing a 3 page schedule or routine for mom for each one to read, but bottom line, mom won't cooperate with them. she was up until 9 last night (bedtime is 7) with her shoes on and fully dressed and argumentative. And for the first time ever, she said she was going to talk to dad about this (he's been dead since '09) and she will also have a word with her mother! Then she called me her cousin. I am her only child. She has never done that before. Her eyes looked "off" to me and I ended up having to give her a mood pill before bed just to settle her down. I told her we would talk about it in the morning. Well, now it's morning and the girl just texted she won't take her morning pills. I'm like, come on... this is getting crazy. I will find a perm for her here in the next couple of weeks, but obviously it will have to be someone really willing to earn her trust and understand dementia. I am a nervous wreck and at the end of my rope. If R*** could have just maturely said I am giving 2 weeks notice or whatever, I would have had a degree of respect left for her, but to literally desert mom in a sneaky tricky way like this... is unforgivable. I am glad she is gone. She turned out to be nothing like what she acted like for the first 8 months. But I had to call the doctor, figure out the pills, and get an expensive temp agency in there fast. I am stressed to the max right now and mom is rejecting everyone that comes in. Advice?
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Someone who fantasizes and discusses suicide (absent debilitating conditions such as ALS), is not perhaps immature but has serious mental issues.
It does no good whatsoever to analyze her behavior or be angry at her given the demonstrated emotional problems. You made a mistake in not addressing these when you first discovered them, that didn't happen. Just admit it and move on. Ruby probably has enough to deal with as it is and doesn't deserve criticism for abandoning you given that she's considering suicide.
I would try a therapeutic fib and tell your mother that Ruby has become very ill and had to be hospitalized indefinitely, and has been advised by her doctors that she'll never be healthy enough again to care for anyone else. That takes her out of the picture permanently.
If your mother doesn't believe that Ruby will not be coming back, use another therapeutic fib and write a letter from Ruby explaining that she has developed a serious illness, something medical that can't be cured, that she really enjoyed working with your mother...whatever...so your mother can recall those positive moments, cherish them, and be primed to move forward, eventually.
I assume you've spoke with a few agencies and explained the situation, as well as the fact that your mother wants Ruby, isn't cooperating, and needs someone with a great deal of skill to have the insights to handle her?
I think when a new person enters the home environment, it's best to just sit down, chat, get acquainted, and let your mother become used to this person before any actual "work" takes place. Find out about your new caregiver's backgrounds and interests, channel the conversation toward those interests so she can be enthusiastic.
And brief her on your mother's interests as well so she knows how to play to those. Maybe even buy something your mother had wanted, a bottle of perfume, special lotion, book...whatever...wrap it and have the caregiver present it to her as a present. There's always the possibility your mother will throw it on the floor in anger, or something like that, but she may also moderate her position after the caregiver has gone.
It isn't easy acclimating an elder to these changes; we discussed this in the Alzheimer's Creating Confident Caregivers class: older people are uncomfortable with changes, with new people. You have to find away to acclimate her to the caregiver, perhaps even pretend that the caregiver is visiting you, pretend it's a friendship, let your mother participate if she wants, but don't even mention the concept of caregiving until you mother begins to warm to the new person.
You'll get better feedback if you don't have 2 threads written on the same questions.
It did occur to me to ask whether you have any friends or your mother has friends from a church or other group that might pitch in to help until the situation has stabilized. I think even if the friends just come visit, it might help to provide that sense that she's with people she knows. They can just sit and talk to the both of you, or just her.
Go thru an agency that screens people. In the meantime, and probably minimally, use a temp agency. Reassess keeping mom at home.
Lord in heaven.
I totally understand your being so upset.... and hold no blame for you keeping her after you saw the red flags..... sometimes we let things ride because we are so overwhelmed by our life, that we don't realize until later, action should have been taken sooner.... no blame , no judgement....
And yes, mom may be upset for a little while, this is only temporary.... we never get to have perfect circumstances for our loved ones.... life has a way of getting in the way.... I am sending prayers that you get a good CG that appreciates that you give people chances, that you did care for your CG.....that is awesome in my experience of being quickly 'disposed of' at the families convenience... no warning, ect.... double edged sword...
It will work out..... it's ok for mom to be stubborn right now.... you are doing the absolute best that you can to remedy the situation.... have some faith in yourself that it will all work out for the best....hugs and prayers for you and mom.
There are some great ideas above on how to acclimate a new caregiver to your household. Introduction visits, kind comments, gifts, etc. are very nice, HOWEVER, I would keep in mind that trying to please a person with severe dementia is not easily done. Some patients are extremely difficult and no one may please them. Your mom may not be happy and content with another caregiver. But,that's okay. I would do my best and then just accommodate as best you can.
Nikki, it might be better to have three separate caregivers, each one taking an 8 hour shift... thus they get to go home and rest up for the next shift. And have another set of caregivers for the weekends to give the other gals some breathing room with weekends off. I assumed that Ruby never had any weekends off.
I realize that means a lot of different personalities for your Mom to learn, and if she can't maybe it is time for another level of care at a continuing care facility. Otherwise you will be going through this situation on a regular basis.
Concerning ruby. She was hired privately by me. I also want to say that for a year, she got plenty of respite time, cash bonuses, and was treated like family. She saw me often as I live across the street from mom, and basically if Ruby needed something, or had a complaint, I addressed it immediately. In a nutshell, if Ruby told me to jump, I asked, 'how high?' She KNEW she was valued and appreciated. There was more to Ruby than the manic depressive flip-outs she displayed 6 weeks ago... before that, there was no sign from her, ever. She was the perfect fit for mom, which is why I offered to pay to get her help; whatever she needed. further, she had no insurance because she did not want her name traceable by the IRS. She was running from a tax bill in excess of $20K, which I found out at the end. so, yes. I tried with Ruby, I more than accommodated; I treated her like gold because she was able to gain mom's trust and rapport; they went out to dinner on me, I sometimes joined for more conversation... I got her a skydiving ticket (she lived for skydiving) - to the tune of hundreds of dollars as a surprise. I feel - even now, that I was a great 'boss' to have because I treated her like blood. I did it because she took the time to paint mom's nails. Because she called her 'honey' and hugged her a lot. I always told her she was our angel and a gem. But the manic depressive illness that reared its ugly head finally exploded. No fault of mine; perhaps no fault of hers. We both decided ok this isn't going to work. but I asked, please let me find your replacement; don't bail. she promised not to, and the next day, she literally bailed. so please understand if I don't have an outpouring of sympathy today for her as my emotions are filled with settling mom down; who never got to even say goodbye to the one person she lived with and trusted. There was no excuse for that and since she was hired privately, there is no recourse.
Now, one thing I want to mention is that my mother has always been neurotic. Truly a base personality trait of hers. I got an emergency appt today with her doctor to get an anxi ANXIETY med. I hope we don't need anti-psychotic, but at this point, I am a wreck because mom will see a new "stranger" every few days for about 2-3 weeks until our new perm caregiver comes in. I have interviewed and have someone extensively trained in this who will come and stay for good. (So they say) - I will treat them as I did Ruby. Time off with pay, all food paid for, all living expenses, use of the garage and the pool. I will treat them like family to the extent that they will get bonuses. But I cannot think of assisted living because in my personal case, my mother is across the street in a paid for house with a dog she obsesses over and loves, surrounded by her pretty things with me a stone's throw away. I can't see moving her to assisted living at this point anyway. She thrives when she is with someone she can bond with. It is just going to be a very hard 3-4 month road for everyone while we calm her suspicions. I have one foot in the grave over this and am still not understanding why her doctor, given all knowledge of mom's anxiety, hasn't given her something to deal with that yet. After today I will know more.
While you see your mom's situation across the street as ideal, I'm not sure how long that will work. You seem to be pretty overwhelmed about it.
Anyhow, today went at 1:30 to dr. appointment. Deliberately withheld behavior meds to see how she'd act. holy cow. she performed (out performed) herself. She got to the point where she stated to the doctor, "I'll just get a gun and kill myself~" OH GREAT! Now the doctor says take her to the emergency room for a psych eval NOW.... and if you don't, I will have the police at her home at 5 to escort her. Now, 5 min later, mom doesn't even remember saying that. 20 min later in the waiting room at the hospital, she doesn't remember the doctor's visit at all. I'm thinking we are screwed they will Baker Act her - somehow by the Grace of God they didn't though. We were there SIX hours and finally she is on SEROQUEL 25 mg for 2 weeks until we can get to a geriatric psychiatrist for her, which I am actually excited about. We will see how she does on the Seroquel. She calmed down but was slurring her words a little 30 min after taking it... uh oh? I helped her to the bathroom to change her depends. She tried to put on a new pair OVER her pants... that's a first... but all I know is we have 2 weeks on Seroquel and in the meantime we see a person that will specialize in GERIATRIC PSYCHIATRY which obviously means Dementia. Just thank God. I'm fried and my period even started again today. I haven't had it for 2 years and am 49 years old...
You are right to be excited to have this option. It should be very helpful. But don't anticipate the conclusion before you hear it from the doctor.
From your profile, this can be gained: You're 49, your name might either be Paula or Nikki (so someone can search for your mother by photo, and a daughter named Nikki who lives across the street). And you both live in Palm Harbor, FL.
Ruby has mental issues; perhaps she's seen a clinic, but she would likely have a family, somewhere.
Your mother is a vulnerable person, even if she is feisty. Your post has already been picked up by Google, despite the fact that this is a secure site. Some skilled in Internet tracing could spend some time to locate you, your mother, contact you pretending to be a compassionate caregiver, and scam both you and your mother.
My concern is for the protection of all the vulnerable parties from online predators.
I can certainly understand your frustration; you've been through a lot.
You can write to the admins here:
https://www.agingcare.com/contactus.aspx
You're in a similar situation to others, trying to do the best for your mother but meeting with opposition head on. It's a really tough position. There comes a point at which someone has to recognize that he/she has done all she can on a particular issue and needs to focus on her/himself before she/he becomes ill as well. I think you're at that decision point.
It doesn't mean that you need to give up on caring for your mother. Just change your approach and tell her you've done all you can; you just don't know what to do any more because she isn't working with you. She might have a fit, become angry, provoke a situation, threaten, or who knows what. Then tell her that she knows you can't take care of her, what exactly is it she expects you to do for her? Then leave, go home, and let her think about it.
Dementia can prevent her from thinking clearly, so that might not be a solution. But if part of her actions are behavioral, she just might realize that she's not helping herself by being so uncooperative. With dementia, it's hard to tell - it's not easy to factor out the irrational activities.