Family will not admit several issues wrong with wife including letting her know she has Alzheimer’s disease.
I have been working an 8 overnight 24/7 shift as well as trying to stay committed To my current Alzheimer’s Clients.
i would like some opinions about what I have experienced in the last 8 overnights.
I have always gotten along with my client. Because I have been with her for almost 3 years , we have gotten to know each other quite well, but based on all the information that I have obtained from the client, am I missing something? She is 78 and has to be walking all day long. That could be from severe anxiety issues due to the fact that when I first started, it was under the pretense that I was unaware that she had been diagnosed with Alzheimer’s Disease.
I have watched her for previous trips but it was not for as long and I just carried out my care provider duties.
This week because she knows me a lot better, to me it appears like she has some deep rooted Psychiatric Issues as well, based on her behavior.
Because this family has made a conscious choice to not remind her that she has Alzheimer’s Disease, she also has displayed an entire host of other issues:
The husband has told me that she had severe ADHD which is why when I am with her, she has to walk the entire time. He told me that all of these symptoms were there before the Alzheimer’s Disease but because she will not see any doctor regarding psychiatric issues that his hands are tied.
She has been very proud during the last 8 nights to tell me that she has an ego, that she is always right and always has to beat me to the car?
She seems to have a compulsive need to win. Also backed by the husband.
The children in their 40’s want nothing to do with their mother, and as I am looking at this through a different lense, I feel the entire family has put all of her respite care 20 hours a week as well as these extended vacations totally on me.
Yes , she does have classic symptoms of Alzheimer’s ton a
degree, I feel I have been made the scapegoat because she is really hard to deal with, meaning she cannot sit still and never talks about her disease as it is just absentmindedness.
Can someone please offer me some
thoughts on this issue)s)
Thank you
13 Answers
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Your letter got my attention because of my own experience with aids in my home hired to help my husband whom is diagnosed with Alzheimers. Half of the aids we have hired seem to think the job means arriving, sitting, leaving, getting paid. I want people to fully take care of my husband's needs during their shift as if I am not a part of his life. Whether it is meal prep, housekeeping, companionship, his laundry, etc. those chores are an aid's job during their shift. If it means losing sleep that is their job.
I think you may be burned out and may want to look for different employment.
As for telling patient about diagnosis, it is not your place to push that on her. I personally don't understand not informing someone of their diagnosis but that is family or a doctor's call. She may be living in willful denial to cope or the disease may prevent her from comprehending.
You're paid to care for her, as she is, for a period of time and that's it. If you feel like a "scapegoat" you can quit the job.
AD and dementia are so complicated that doctors and neurologists can't even figure out what's going on in the patient's mind half the time. And anosognosia is very common, as Geaton explained. My mother suffered from it, so "reminding" her of her dementia would've been a waste of breath.
You will not likely meet 2 patients with AD who act exactly the same. They all need to be treated differently based on their unique behaviors and symptoms. I would think your clients family have determined the best way to deal with her, based on 24/7 interaction and knowing her best. They need a break from her, which is why caregivers are hired. Go with the flow and keep her relaxed, that's my advice.
As Alvadeer says, these labels do nothing to help or comfort her. They may be useful for you, the family, and doctors, but not for her.
You are doing a great job listening to family AND to your client. Whether she has dementia, mental illness, or the quite common combo of the two is honestly irrelevant. You are there, and you are paid to be there, and it comes down to whether or not you can work with this client of not. Try to look at things as more "interesting" and with "curiosity" for what-will-work-for-my-client, not as trying to pin her with diagnosis and labeling. Those latter do nothing to help and comfort her.
No, they haven't put them on you, you excepted them. Next time tell them no. You can't care for her and have the energy for ur other clients. They need to hire someone else. Just a thought, ur not a live-in are you?
Also, she has memory impairment and can't retain the info of being told that she has ALZ. If you (or her family) told her, it'd have to be every single day. Like as in Groundhog's Day. Why do that to her (and you)? My MIL has memory impairment and we've decided to stop reminding her that her husband is passed away because this causes her to grieve over and over. When she asks for him we tell her a therapeutic fib. And with dementia, people are less able to bring themselves to a mental/emotional place of calm and peace because that part of their brain is broken or completely gone.
Her saying weird, narcissistic things to you: don't take those personally. She'd be saying that to anyone who spent as much time with her as you do. It's part of dementia. They say weird, awful, shocking things to just about anyone.
Maybe it would help if you educated yourself more on ALZ so that you can have a better understand of what's going on and what's to come. You can also learn strategies to help have more productive and peaceful engagement with your clients. Teepa Snow has lots of videos on YouTube that I found very helpful.
If you are hired for 7 hours you do what you have to do in those 7 hours for that client. (By client I mean the person you are caring for)
You are hired by the client's family member. Be that a spouse, child, other relative or the POA or Guardian. You do what you are instructed to do by them within the confines of caring for the client.
Telling a client that has Alzheimer's or Vascular Dementia is pretty much useless. Most of the time they will "forget" the diagnosis. You can tell them everyday and possibly upset them everyday, why put them through that?
Constant walking is pretty common. As are many other OCD tendencies.
Do you document what you do and what you observe? If not you should be that can show a significant rate of decline. This can be taken to the doctor for review. You may be spending more time with the client than the family and you may notice things they do not.
If this person is getting difficult to care for and "manage" without being medicated or treated for anxiety it might be time for you to tell the family something like this:
"Ms. H's" care has reached a point where I no longer feel that I am doing the best that I can for her. I will stay on until you find another caregiver that will better meet her needs. But I think you need to get that in place by (date)."
If you are burnt in general being with this woman , then leave and find a new client . There are plenty of clients to be had and not enough caregivers . Good Luck .
"Because this family has made a conscious choice to not remind her that she has Alzheimer’s Disease, she also has displayed an entire host of other issues"
I cannot get my head around this comment.
To me, this reads like you have reasoned the woman's behaviour has been caused by her family not disclosing a diagnosis? This does not make logical sense to me. Like if she knew she could stop??
(If the woman had pain using her arm & you reminded her it had been fractured, in a cast & was healing - this would make sense. She could stop using her arm. Brain conditions are very different).
That comment also reads as rather judgemental to me.
"I feel the entire family has put all of her respite care 20 hours a week as well as these extended vacations totally on me."
Do you have resentment about this?
Be honest with yourself.
Do you want this job?
Are you in over your training or experience?
It's up to you if you want to reduce your hours or change to other clients isn't it?
I would add;
1. A doctor or other professional diagnoses medical conditions, including psychiatric, ADHD, Alzheimer's Disease or other forms of dementia.
2. It is not professional or helpful for a caregiver/support worker to speculate or jump to labels.
3. It is not a worker's role to ever inform a person they care for of their diagnosis. Not tell then, not remind them. This is not their place.
4. Even if dianosed with Alz, it is not useful to discuss the diagnosis with the person.
5. It would benefit yourself & your clients to find the professional boundaries you seek. There may be many resources available in your area, maybe aging or disability organisations or training programes.
End of reply part 1.
I had a great Jack Russell once. Supposed to be my daughters dog. 🙄
Off it went to a famous in the area trainer. When it was time to pick the dog up, it was pulling and not behaving as I had envisioned. The trainer said. “She’s a Jack Russell. That’s what you wanted … right?”
Not to compare your client with a rowdy dog but she is who she is in-spite of her high jacked brain or maybe because of her highjacked brain?
You just have to decide if you want the job or not. You know of course that telling someone all their problems doesn’t make the problems go away. Especially when the problem is Alzheimer’s.
You have been with her three years and so the Alzheimer’s has advanced. Her husband is not yet willing to force the issue on medication and is accustomed to her personality. At some point perhaps he will decide she needs memory care. It’s okay for you to focus on quieter clients. Three years is a long time. She is his wife. For you, a client. You have different choices than the family does and she may be acting out on some level as she has been left behind. Perhaps next trip ask for extra help?
cuz I had one for 16 yrs (JR Shorty) and could never break her of that habit, even with pro trainers.
When you say you are the scapegoat, is someone blaming you for her symptoms?
I’m sorry the family is constantly leaving her while they go on vacation… you are house sitting with 78 year old Jane. Jane is happy to be home but walks… my family member did that too.. it’s sad. It’s almost like they are trying to run/walk away from this disease… one morning his wife called telling me he took off with her wallet… she was more worried about the wallet. I printed up a picture of him and showed it to a couple near his house. They in turn, took the picture and found a policeman in the park. That got the ball rolling… everyone was out looking for him. Police called the wife… she gets mad at me for calling the police… technically, it wasn’t I who called.. enough of that… people with brain diseases react differently.. yiu really need to look out when they don’t know what to use… a fork
or spoon. My answer is getting too long and off track..sorry .
yiu have other patients..how are they and their families?