My mother is in moderate to late stage Alzheimer's. She has been receiving in-home care through BrightStar for a year and a half. Her usual aide that she had for about a year, left the company and since then, a variety of aides have come and gone and many times there are 2-3 aides coming within a week. My mom has always given some of the aides a hard time. She wants me to do all of the caregiving which I and my brother can't because we have to go to work. As time passes and the disease progresses, this is getting worse. Recently, a new aide started caring for her. My mother has developed a delusion that this woman is trying to take over her family and trying to get money (which we don't have any money or assets). She believes the aide is harmful to her. The aide does her job pretty well. She is experienced and I see no signs of her abusing my mother. I called BrightStar last night after a particularly hard day with my mother and told them how this isn't working out, hoping they would send someone new this morning even though I like the aide. They said they would talk to the aide and get back to me but didn't and the same aide came today. I feel sorry for her because she can't really even stay in my mother's room and my mother rejects her caregiving. The aide is currently just trying to find things around the house to do to be occupied and keeping her caregiving with my mother to a minimum. The problem is that I'm not even sure if a new aide would help. She has been rejecting of aides before although not always as bad as this. I don't know if I should just find a nursing home for her or try to manage the situation at home. If she goes into a nursing home, I don't want her placed somewhere far away because I need to be able to see her pretty regularly because I know she is very frightened about what is happening to her and I don't want her left somewhere alone with strangers most of the time struggling with this. Is there anyway to get someone like my mother to be more accommodating to aides? I live with her as does my brother and the stress from this is taking it's toll.
How is her mobility? Does she need a lot of other hands on care? Does she need skilled nursing care? I might consult with a professional assessment person. With the information that you, her caregivers and her doctor provide, it should be easier to decide what to do. Of course, I'd keep in mind that the agency who is sending caregivers to the home, may lean towards her staying at home, since they are getting business that way. Still, if it's too stressful for your mom, it may need to be changed.
I'd discuss it with the doctor, because the delusions that she is having must be very disturbing and distressing for her. I wonder if any medication for anxiety might help her relax and avoid this stress. I'd explore that.
Eventually, around the clock care in the home does become challenging. I'd consider if this might be a good time to make the transition. You can visit some of the facilities in your area. My LO was initially in a regular AL and that's not designed for significant dementia patients. She is now in Secure Memory Care and it's just right for her needs. I'm not sure how a nursing home would manage your mom's care. Would she be constantly trying to leave and/or resisting care? Maybe, others around here know how they handle that, but, I don't know. I would think that a place that is designed for significant dementia would be better trained and equipped to manage her care.
I hope you find some answers. Please let us know what you decide.
Honestly, if your mom is going to be difficult, you're NEVER going to find someone to work well with her. May be time to put her in a Memory Care facility. She'll hate it, and you, and everyone associated with it, likely, but she won't be at your home, making life difficult/impossible for you.
I don't see her becoming more pliable about the aides. It ISN'T the aides she doesn't like, it's what she knows about her own condition that's scaring her.
Changing out caregivers regularly is disturbing and hard on everyone. You can certainly keep trying, but do you really WANT to?
My mother is one serious fall away from being placed in a NH. An aide would make her life SO much better. I'm sure she'll never accept one. And she has only mild dementia, and a lot of physical issues.
Do come back and let us know what you decide!
Usually we need to wait for a very serious injury so the elder goes from the hospital, to rehab, to nursing home.
Thus, the quicker one can get a parent into senior living, and if the budget can afford it into Assisted Living/Memory Care the better. That way their mind can still learn the floor plan of the floor they are living on... still learn new faces of the Staff... and still learn to make new friends with the other residents. This worked very well with my Dad.
If I could get a DR to tell my mother she needed aides, she might listen. Emphasis on might.
You've already put your finger on it: the problem is the recent changes in personnel. Only solution to that is to avoid further changes and give it more time.
the cam can either be hidden or out in full view as a deterrent....check the laws in your state first.
My mom also is highly delusional. You can only do so much. Once she got the cancer diagnosis a year ago, I knew her dementia would get worse and it has. She is now highly anemic and incontinent and I know I did the right thing. Don't expect mom to change. Start visiting places and get a plan in place. I also work fulltime and realized my mom was needing more care and I needed to place her.
Good luck.
You don't "get" an Alzheimer's patient to do anything. There is no way to reason with someone who can't reason. My mom was like that in Stage 5 Alzheimer's. You can talk until you're out of breath and nothing will change. The only way is to wait it out.
My Mom's in Stage 6 now and there are a whole new set of symptoms but she has given up fighting the caregivers at the memory care facility.
Being a Dementia caregiver is harder than any other job on the planet. If she won't accept the help and you can't do it all, it may be time to investigate other options.
1) require a caregiver who has a good deal of experience caring for Alzheimers patients.
2) gain personnel consistency
3) make caregivers presence palatable.
1) Our first caregiver stayed over a year and was wonderful. Had all the requirements I requested. She understood how to work with patients with dementia. She was adept at redirection and did not tell Mom what to do, but led her with questions and conversation to the desired conclusion. When Alicia became ill and had to leave, we experience multiple caregivers (due to issues with the caregiver). The agency was no longer considering the requirements previously agreed upon. Thus I had people come with absolutely no dementia experience - it made a world of difference. They did not have a clue how differently her mind processed things, so they were ineffectual in being able to gain compliance and create a partnership in doing things.
2) consistency is very important. Ideally have one caregiver, but if necessary two caregivers. If two, one takes three days in a row and the other takes two days in a row. How would you feel if strangers were in your house everyday? With consistency of caregivers she may never remember their name, but with enough repetition she may recognize their soul when she sees them. Mom did not know I was her daughter or her caregivers name, but through consistency she knew are souls and she was happy to see us, even though she had no idea how we fit in her life.
3) My mother did not believe that she needed a caregiver. After two years as sole caregiver I told my mother I was bringing in a maid to help out. Since you need someone daily this may be harder for you. Get creative - you are having a helper come in. The person will be doing housework, lite gardening, repair work, organizing your files and is to help mother with anything she needs to have done. Notice that last one - she is not a caregiver, but if your mother needs her to do something, she is to follow your mother's direction - mother is the one in control (so it appears).
Since mine wasn't every day, "maid" worked. After a few days Alicia was doing less housework and more interaction with mother. She brought dominoes on the third day and asked if mom wanted to play dominos with her during her lunch break (from day one she made lunch for herself and mom which started the personal relationship). That lunch was a long lunch and things began to morph into caregiving only. Alicia was wonderful, she would take momma to lunch, drive around so they could talk about what they saw (safe conversation, no memory required) and then stop at Braum's for a Sunday before coming home.
This is what worked for me, I wish you the best.
If mom is not on anti-psychotic meds then they may help but it is not an easy process either
Even now that mom is in a memory care facility I have private agency caregivers with her - it is very hard to maintain stability and mom is very particular about whom she likes and lets help her
Try to research the various types of care facilities to explore your options - the last thing you want is to be in a crises and trying to arrange placement in haste
Also, ask her doctor for a medication check. Make sure everything is in balance (blood sugar, urine, etc)
A good geriatric psychiatrist or neurologist is experienced at adding a blend of different medications to help patients and their families.
Mum's doctor added a dissolvable anti-psychotic medication (I was horrified when I looked it up online and found out what it was really for) - but - IT WORKED! She become more contented, pleasanter, sociable. I called it the miracle drug. What a difference it made in day to day life for her, for us, for her caretakers. (she was already on 2 medications for Alzheimer's and one low dose antidepressant when the anti-psychotic rx was added).
For most dementia patients, in general, it is good to do a full medication review about every 3 to 6 months.
It might not change her mind about having aides in the house, but it will generally make her more amenable to cooperating with you and your 'housekeepers', and she will be a more contented person, because constant distress over situations they feel they have no control over really exacerbates the situations and can escalate their distress/responses/reactions.
I am not saying to medicate someone into a 'stupor', but rather to find a balance of treatments (rx, otc, naturopathic, homeopathic, music, flowers, hobbies, back rubs, hand and foot massages, aroma therapy, etc) to improve their quality of life and their disposition/outlook.
It's trying to change a contentious outlook / environment to a contented one.