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We are lucky enough to have in home care for Mom but the problem is she doesn’t remember that they are there, sitting in the other room. I wake up to multiple messages from her saying the aide left early or never showed up (which I know is not the case). What, if anything, can I do so that Mom knows there is always someone there to help her? By the way, she still argues with me constantly that she doesn’t need 24 hour care but all the messages I have from her clearly show otherwise. Any ideas on how to get her to stop arguing about that? She’s so angry that we are “making her” have someone there all the time but clearly it is the right call.

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MGGirl this is very difficult.

Your mother doesn't like to be intruded on. Yet she constantly texts you for help with - what sort of thing?

Two ideas:

1. The caregivers should knock on the door and go in on a schedule - once an hour, or whatever you think might be best tolerated. It sounds as though your mother will respond better to formal professionalism than friendly warmth? If so, advise the caregivers about that too.

2. You could forward the text to the caregiver. E.g. "I need help! They've just left me here by myself! What's happening???" Caregiver receives text. Caregiver knocks on the door and without mentioning the text appears as if by magic saying "can I get you anything, Mrs Smith? I'm right here if there's anything you need." N.b. neither you nor the caregiver should challenge your mother with reminders - you're right, she *can't* remember that the caregivers are in the next room, so don't burden her with trying to.

Also: is there a formal daily care plan? - a list of goals, activities, tasks to be accomplished.
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MGGirl Feb 2020
Those are really good ideas! Thank you so much - and to all the others who took time to reply. I will definitely use these. She most often calls me in the middle of the night because she has to go to the bathroom. I did ask the one aide to check on her hourly from now on but the other aide is live in on the weekend and must get 8 hrs sleep 5 uninterrupted. Ha - like mom is really going to remember and stick to that! But I did ask the live in to make sure she checks with mom before she (the aide) goes to sleep and when she wakes up. Hopefully, putting together a more detailed plan will help. Thanks again for your help!!
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Your Mom is in her bedroom all the time?
She needs to be ambulated to a chair in the other rooms, be sat down at the dining table for lunch, sit up (not in bed), etc. etc.

Caregiver should have her get up, she has to change her sheets.

I suggest the caregivers move Mom's phone to the dinner table.
If she gets mad enough, she will ambulate in there and call you.

Sorry, I did not re-read your Mom's abilities, if she can get up or not.

The caregivers need to make their presence known. Maybe if Mom gets angry enough, she will get up and take care of her own business instead of having everyone walk on eggshells around her.

Even an amoeba needs a little irritation to move around.
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MGGirl Feb 2020
It’s hard because mom isn’t ambulatory. She spends all her time in her recliner - sleeps there too - and she refuses to get in the hospital bed we got her. I’m afraid to move the phone in case she really needs it because she wouldn’t be able to just get up and get it. Thank you so much for taking the time to respond and for the good advice. I will ask the aides to make their presence more known.
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Make it a point to checkup on the Caregiver and find out what is going on. Talk to the Caregiver and let her know you have not hired her to sit in the other room and that she needs to interact with your Mother.
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Why can't the caregiver stay in the same room as mom?
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MGGirl Feb 2020
I have tried that a few times and mom had a complete meltdown every time. She does not want them in the room with her. Literally everything I try she has a problem with.
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Since she is able to send you messages, it's not like she is totally out of it in regard to communicating. Maybe get her a door bell and tell her it is a 'help' button like at the hospital. If she presses it the help will come.

Perhaps she is telling you the aid left early so you will fire them and get them out of her house since she is angry that you make her have someone there. It's very possible she knows someone is there, but thinks it is unnecessary.
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We had this with my mom too. She actually ordered the evening/nighttime person out of her room because she said she couldn’t sleep with someone staring at her (or breathing too loudly, or breathing period..you get the picture). So the aide would sit in the other room plus we had a baby monitor so she could listen for any issues, plus she would peek in at predetermined intervals.
that being said, mom would still call-sometimes all night long-help I need help there’s no one here with me.
things we tried:
leaving notes in critical areas (next to phone, in kitchen, etc) reminding her that there are people there she can ask for help. It might be even more helpful to put a sticky note on the phone itself so she sees it before she calls,
we also disconnected the phone next to her bed and “lied” and told her there was a Verizon issue-so she couldn’t call. The aide still had her phone plus the other phones were working just fine.
we also shut our own ringers at night so even if she called it wouldn’t wake us up. Sometimes we would just block her number overnight so the aide and anyone else could still get thru.
begging and pleading and arguing that we all needed our sleep otherwise we could lose our jobs got nowhere-so we had to become more “resourceful”.
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Woops!  Should've read other comments first.  Hope you find a solution.  She's wearing you out with the phone - that's a place to start. 
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If she's still arguing with you about the need for care, perhaps she's trying to sabotage the entire operation by throwing the aide under the bus.

Assuming that the aide is there when she's supposed to be, and doing the work she's supposed to be doing, it may be best for you to have a call bell system.

My mother's bedroom is on the opposite end of the house from my major work area (kitchen and laundry), and as her voice got weaker, I often couldn't hear her calling. I got a system with three buttons: one for her bed, one for her wheelchair and one for her recliner. I have the base station volume turned to maximum so that I can hear the alarm from anywhere in the house (and I can even hear it outside, if the doors and windows are open and I'm close enough).

My only problem is getting Mom to actually use the button ALL the time. We've had the system for three years, and she still calls to me with a faint "Yoooohooo!" or "Hellooooo?" when she wants/needs something - or she'll just sit in her chair, sigh heavily and say, "Gee, I wish I could have some cookies...oh well, never mind...nobody listens to me..." and I have to keep telling her to RING THE BELL. (I can't post a sign or whiteboard on the wall to remind her, because she's blind.)
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I'm a Certified personal care aide working for a good agency for 4yrs and so I've cared for dozens of clients with durations ranging from just one shift to as much as two yrs. You didn't say in your question why the caregiver remains in the next room. I ask because in my experiences I've never situated myself in another room and out of the sight-line of the client. I would think it would be all the more necessary to remain where a client could easily see the caregiver if a client was anxious about being what she perceived to be "alone." The caregivers should be meeting all of her needs for ensuring she has fresh fluids at all times, that she is comfortable including with the temperature, that she is receiving frequent snacks, beverages and meals, that all of her toileting needs are met, her surroundings are clean and neat, that she is safe from falling and other accidents, and that she feels acknowledged and like someone truly cares about her as a person. None of this can happen if a caregiver is camped out in another room.
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Caregiverhelp11 Feb 2020
I totally agree with what you said. I hired a couple of different caregivers for my Mom when she was at home and one was great, the other just sat in the other room reading the newspaper or watching tv. I keep her very long.
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Sounds like you need to speak with the help.
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This seems to be an employment issue.
Tell the caregiver(s) they are f i r e d .
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I think it’s the caregivers responsibility to provide care. What the heck are they doing there out of sight of their ward?

They need to have a comfortable place near your mom where they can interact with her so that may be what is missing.

Or maybe mom should have a comfortable spot where the caretakers are and get some relief from being isolated.

It makes no sense to be paying someone who is out of sight, out of mind. Are they not even mindful of your mother’s calls to you? That’s also the point for being there, to enable you to do what you need free of worry about your mom. Instead they’ve created a new point for arguing.

Good luck,

charlotte
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If your caregiver usually sits in the same spot, perhaps you could put a mirror so that your mother can see the carer's reflection in the mirror when she is in bed. It may not work, but it could be a cheap option to try.

Mirrors that reflect other rooms or the outside are actually quite helpful in making people feel not so shut in on their own.
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My mom did that "I don't need anyone here in my house" thing. Then when she accepted having help and stopped complaining about it, she would still call me, even while looking straight at the care giver. The final in-home caregiver was special. She would clean and cook for 20 minutes at a time, then sit and talk with my mom for 20 minutes and make sure she had everything she needed, then continue to do chores. 20 minutes at each chore, then back to my mom. She never sat in the other room. It was what I did too on the days I was the care giver and all evenings. My son and grandson as well. She still called me sometimes, but not as much. The notes on doors and by the phone were ignored for the most part, or she would call and ask me to explain the notes. Now in assisted living she doesn't call at all because she's forgotten how to use a phone. Strange to say, but I miss it a little bit. Mostly, though, I have time to finish thoughts and activities without interruptions. I'm afraid to say that this may go on for some time with your mom. Leaving notes, giving her attention, ringing bells, whatever, she will most likely still call you.
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What has helped us with some of that is a large white board with reminders on it. You could put
MOM-if you need anything there is a house helper in the other room, just call out and they will be here. (Or get her a bell to ring)
Your house help people are here to:
1.
2.
3.
(list out their responsibilities)
If you feel ill, let them know and they’ll help you or call me.
if you run out of things tell them and they’ll get a list together for me.

also list upcoming appointments and activities for the day/week.
this helped my FIL a lot. We even have reminders of MIL’s care/condition.
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Sadexecutor Feb 2020
I like your idea. Nothing else has helped my mother. My mother is in an assisted living facility. They only check on her once in awhile because she does not have many health problems other than dementia. She remembers nothing 2 minutes after its said. She has been there since October and still does not remember that she should be wearing a necklace buzzer for help and there are several other buzzer strings in every room. I think that putting up a dry erase board on her wall would be an excellent idea.
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If she has cognitive decline or dementia (Which would explain why she can't remember caregivers are there in the house.), then, you won't be able to get her to remember, understand, be aware, etc. of some things. It just won't happen. So, you learn to work with it, tolerate, redirect, manage it day by day. I would examine few things to see if the matter can be helped though.

First, when she calls and says that the caregivers left, is she scared, confused, anxious? Because, sometimes, with dementia, their mind is changing and things can be scary. They need constant support and reassurance that things are okay. So, having someone nearby for comfort can be good. I'd discuss this concern with the caregivers. They should be trained in working with people with dementia. And, they should not be leaving her alone in a room. She could fall, ingest something harmful, get sick, leave the house, etc. So, if they are properly trained, they'd know how to properly supervise and comfort her. I'd put it in writing as to what is expected of them.

I'd also discuss it with her doctor to see if she needs meds for anxiety. My LO took a small dose daily med for anxiety and depression. It helped her worry less.

Sometimes, the complaining about not needing help will pass with time. But, if not, it's just something to be tolerated. I don't know of any way to make a person with dementia get it. Reality is just not something they can handle much of the time and they may never agree that they need help, no matter how dire the situation.

Oh, I'd also make sure that the caregivers are NOT leaving early, like she says. lol
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First..you can not get her to stop arguing about this or anything. Just tell her that they are there to help when you need it.
Second.
Why are the caregivers sitting in another room? If they are supposed to help her they should be with her. If she is sleeping someone should be checking on her every once in a while so when she awakes they can get her up. If she is sitting in her room, they should be checking on her and trying to engage her as much as possible. They should be talking to her, popping in to check on her, encouraging her to come to the kitchen for tea or coffee a bit of a snack.
It sounds like you need to have a talk with the caregivers. Make the house an active one make a bit of noise, run the vacuum, the laundry make sure mom knows they are there.
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Have you spoken to her doctor? If caregivers are there and she keeps claiming they aren’t, something is off. They need to make her aware of their presence.

Have as assessment of your mother’s medical situation done as soon as possible. Why guess at a situation?

If you find some sort of dementia then she will need more care. It is often less costly to live in a facility rather than pay for round the clock care at home.
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You can't get a dementia patient to stop arguing............never gonna happen. Period. So stop trying. It's a waste of time & energy.

I suggest you have the care givers stay in the same room with your mother. Either that, or have them go into the room she's in every 10 minutes to see to her needs and as a reminder they're still there, and that she's not alone. Have them ask her what she needs, if she's hungry, needs to use the bathroom/have a Depends change, etc. Make sure they're bringing her fresh water and/or beverages as well since the elderly get dehydrated in a NY minute.

If the in-home help does not work out, then it is time to look into Memory Care homes for your mother. It's actually a less expensive alternative to round the clock in home care and also gets you to stop listening to all the arguing and complaining. Plus, she'll get plenty of activities to keep her amused and others to interact with every day, in addition to hot meals & snacks.

Wishing you the very best of luck.
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Have you had her evaluated for dementia? If she has dementia, you will not be able to reason with her.

She actually may be ready for memory care.
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