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My daughter is a nursing student working as a caregiver for an elderly woman living in her daughter's home. She often witnesses the daughter (call her J) yelling at her mother, intimidating her, threatening to throw her out if she doesn't do/not do various things, not giving her mom her 6 am meds because she "didn't want to wake her," and leaving her in bed for extended periods. Today, the woman told my daughter she really wished she knew why J doesn't like her.
More experienced caregivers in the home have just told my daughter that "J gets like that" and to just ignore it. My daughter is having a hard time doing that, but doesn't want to quit, hoping she is a positive in the lady's life. She also hesitates to make a report, fearing that investigation will worsen the woman's situation. She is also hesitant to open the subject with J, who is apparently pretty intimidating, for the same reason - as well as wanting to keep her job.
I've offered all the ideas I can think of - can anyone offer some advice? I know that there is likely a lifetime of baggage that impacts the pair's current relationship. As an outsider, the situation looks like emotional abuse to me, as well as possible neglect.
For those who are wondering, I am aware that me posting rather than my daughter is odd. She just texted me on a break while at work, upset about the latest interaction, so I thought I'd get the ball rolling.

Thanks!

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I do think we need to tread lightly about what is abuse. Sometimes we can get caught up in a game of "Ain't it awful?" that can do more harm than good. We probably do things ourselves that could be seen as abuse. For example, I leave my mother alone for 2-3 hours at a time. Could this be seen as neglect? Should I make myself stay here 24/7 to avoid the appearance? Sometimes she asks me to pick up something at the store, but I know it is something to do with an obsession she is having, so I don't. Am I being mean or wise? I have yelled at her 2 or 3 times in the past year in response to her abuse of me. Is this being mean or is it being human? I'm normally a very passive person, so it takes a lot to push me to that point. My mother is mobile, so can get out of bed. She doesn't like to get up early and won't do it. Am I bad because I don't force her to get up early in the morning?

I know I'm not abusive or neglectful. I know I just have a difficult mother that I have no way of controlling. But she seems so sweet to everyone else, so if they took a single snapshot, it could make me look bad.

It may be that the daughter is tired and resentful and really shouldn't be a caregiver for her mother. But it could be something else entirely different. We can't tell by getting a snapshot of their lives. I would look longer and harder to see if the arrangement is beneficial or hurtful before I would cause potential damage.
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You say "I know that there is likely a lifetime of baggage that impacts the pair's current relationship". You don't say how long your daughter has worked for these people or if she sees and interacts with any other family members. It is possible that this kind of behavior is just par for the course in this family and the family dynamic is long established. Yelling, swearing etc can seem demeaning and hurtful and is difficult for outsiders to witness, but it could also seem perfectly normal to this family, the key I think is how the elderly woman reacts to it. Does she cringe and weep? Yell back? Totally ignore it/not seem to care?

As for not waking her for meds and letting her stay in bed all day, there are times when I have done the same with my mom, so again it all needs to be taken into context. If her needs are met most of the time a little flexibility is usually not going to be harmful.

I'm not saying your daughter should turn a blind eye to obvious abuse, but she is a brand new (idealistic?) young student nurse who perhaps has not had much life experience. The other caregivers seem to agree the caregiver daughter is pushy and can be unpleasant, but they don't seem to be concerned for the mom's well-being. Is there a school counsellor she could confide in and ask for advise?
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This is a tough call. As Cwillie points out, neither you or your daughter are able to determine what the family dynamics are, especially how the daughter and mother interact when they're alone, or what other issues are influential.

I think I would take a different approach. Your daughter can speak privately with "J", emphasize that she's a nursing student and is anxious to learn all she can, especially about a caregiver's family dynamics as well as the relationship between the elderly person and her/his caregivers. Make it a general statement and inquiry, and a quest for advice and counsel for a young novice from an experienced caregiver.

Perhaps J will be flattered that her opinion is valued and be more candid in sharing her experiences and position. And it might even be the only compliment she gets for her labors.
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There is a fine line between what is the normal family dynamic and what is abuse. If you call APS they will certainly investigate. Most likely they will determine that she has a safe home with adequate medical care and food. The mom will never tell an APS worker that she is being abused by her daughter because the alternative is to go to a nursing home. Without that happening there are no obvious signs of abuse or danger to the mom. APS will have no reason to monitor her status.
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Senior Advisor and Jessie very compassionately and insightfully described the pros and cons of becoming involved in abuse allegations and the determination if abuse really exists.

I suspect many of us caregivers have at one time or another become exasperated and said things we later regretted. It happens. It's a tough job. No one knows how tough if they're not viewing it from the caregiver's perspective, and that includes people who see the care from a clinical perspective.

Those who aren't caregivers haven't been up all day caring for someone, nor have they been up all night in an ER waiting room and then a hospital room when conditions arise that could have been handled earlier if an elder person hadn't been uncomfortable, frightened, or unwilling to get help.

It is to the nursing student's credit that she's concerned, but things are not always as they seem to be, and it's not easy to get beyond appearances to determine what the real situation is. That's why I suggested she try to become more friendly to J to get more information before acting.

And sometimes intervention can backfire; if APS determines there's no abuse, the trust between the nursing student, J, and her mother have been permanently damaged.
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I believe everyone is being very kind. I think the general thought is to make sure something is really wrong before taking authoritative action. She may even choose to talk to her supervisor to see what she thinks. If there is abuse, someone should move on it. If it isn't, then the woman may lose her home and support for no good reason and the daughter could also be harmed by making home and care available to her mother.

I read over the link with abuses that were on the site that Jude gave. These included calling people "dear" or making them do things they didn't want to do. So making them bathe or eat would be emotional abuse. I do think that list needs reworking, because some things that are counted as emotional abuse in one area are also listed as neglect in others if they aren't done. Should we make them bathe or not? Should we keep encouraging them to eat or not? Should we let them eat ice cream and cookies only or give them nutritious meals? It depends on which abuse section you're reading at the moment. :)

Fortunately, most of us know when we are doing something we shouldn't. If someone isn't able to stop it, then they need to stop being involved in care.

On a lighter note, when I read the emotional abuse part, almost every one of the things are something my mother does to me every day. Should I report her for elder abuse? I mean, after all I am over 60. I guess since she is 88 she can do it to me, but I can't do it to her.
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All of you on the bandwagon to call in the authorities scare me for your jump to judgment without really knowing any facts or all of the situation. We don't know enough to be advising reporting and starting a hell storm for this family. This young student nurse has supervisors that are the best source of information for her. I hate that our society has taken to such extremes when jumping to judgments and making accusations. Also the rest of the support staff seem to be telling her to not worry for a reason. They have information that we do not. Maybe our little student nurse could benefit from asking them to explain to her how they have come to that decision and learn some valuable insight. After all she is there to learn, and asking the questions is part of the learning process. I don't see where anyone has been cruel on here, but advising anyone to jump to reporting without any real information is just careless. It also leads to frivolous reports being filed and social workers being over taxed when there is real abuse for them to address. Mandatory reporting is real, but this young nurse needs the more seasoned to help her take a look at the situation before she is causing a situation that could backfire on her and her credibility. She is building her career now and some things will follow you your entire career if not careful.
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For Heaven's sake, she should make the call to APS. She is witnessing a crime in progress. RN's are mandated to report abuse, didn't they teach her that yet?
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Always easy to make a judgement call from the outside looking in. To outsiders my mom is a sweet old lady. I know better. Stay neutral. J's got a life to live, so does the mom. Do your job and stop playing counselor(unless there is a physical reason)
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Wow, this post has really generated a lot of interest and interesting viewpoints. In reading all the posts after mine, I think the daughter should share her concerns with her supervisor, who presumably has more experience, and allowl that individual to decide how to address the situation.

A student nurse shouldn't feel as though she's put on the spot. And presumably the care organization has a chain of command.

The supervisor can consult with others on the team such as those who've advised the student nurse, and can draw her own conclusions. That's part of being a supervisor.

The student nurse isn't put on the spot for either causing trouble or ignoring abuse. And actually, as a student, she shouldn't have to make that call in the first place.
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