My parents are in their 80s and have limited mobility following health conditions. They are desperate to stay in their home and so they have a live in carer to help with all everyday tasks.
The issue is that they are both incredibly stubborn and have started being rude to the carer, complaining non stop that nothing is done in 'the right way' (even small things for example she doesn't fold clothes the way they like, they just expect her to know without having ever told her). It's gotten so bad that they've actually got through around 12 different carers, who either leave because they're being treated so rudely, or are told to leave by my parents. There doesn't seem to be any other options left. Please can anyone help offer some advice, I feel at a loose end! We've tried talking to them many times but they won't listen.
They have lived in a care home before and hated it so that doesn't seem to be an option.
My father was like that. kept firing the carers but then if he liked one he would give her more money, even tho its against the law here. and it became real hell for my sister to manage.
Home help must be aware, can you ask them to let you know the complaints or the firing and then go and have a right family fight regarding their total patheticness.
When Caregivers Are Abused-How to address anger and aggression from a loved one with dementia---by Marc Agronin, M.D.
Determine the cause of the abusive behavior
A geriatric psychiatrist or other clinician who has specific training in both mental health and neurocognitive disorders can help you understand why one is suddenly cruel or angry. 4 most likely causes can be summarized by four D's:
DENIAL, DEPRESSION, DELUSIONS, DISINHIBITION___________
Denial. Some people are oblivious to their cognitive changes and tend to get angry and erupt at anyone who suggests that they are impaired.
DEPRESSION_______________
Depression is extremely common in the setting of neurocognitive disorders, sometimes as a result of knowing the diagnosis but more commonly due to pathologic changes in brain structure and chemistry. Depression may manifest in irritability or anger instead of sadness, and is accompanied by symptoms such as insomnia, poor appetite and weight loss, lack of energy and interest, and physical aches and pains.
DELUSIONS________________
These are defined as false but fixed or deeply held beliefs, and more than half of people with Alzheimer's and other neurocognitive disorders tend to have them at some point. Delusions often involve paranoia (they might believe that someone is trying to harm or steal from them) or jealousy (accusing one's partner or spouse of having an affair, for instance). Delusional beliefs cannot be altered by logical reasoning or argument, and can lead to intense fear and anger.
DISINHIBITION_____________
Characterized by inappropriate, uncharacteristic or strange behaviors, disinhibition is seen in early stages of frontotemporal dementia and in later stages of Alzheimer's. In addition to verbally abusive or inappropriate comments, it may include behaviors that seem out of control, crude or embarrassing.
3. Treatment
Once the doctor has a hypothesis of what may be driving the verbal abuse, a relevant treatment plan can be devised. Denial is difficult to address but does not always require confronting the person with the diagnosis. Instead, the doctor needs to build a supportive relationship around issues that the afflicted person is concerned about, such as poor sleep or nervousness. Depression can be successfully treated with both antidepressant medication and various forms of talk therapy. Delusions often require antipsychotic medications, while disinhibition may respond to certain medications that temper the lack of brain control.
Leaving them with wrinkles or inappropriately folded clothes, as perceived by the person inflicted with dementia, may be the required action/response. In other words, just leave the clothes . . . and the caregiver go do something else ... or leave for 5-10 minutes if they are being screamed at/abused in any way. Letting a person know there are consequences of behavior (rude, screaming) = caregiver will leave may or may not result in lessening the behavior. As mentioned above, medication may be needed.
Unfortunately it will take an emergency to change their minds. I just pray it will not be a life-threatening one.
Nothing any harder than being a care giver 7/24. It has been 15 years with Alzheimer's and 40 years of other major health problems and hospitalizations. Prayer and others prayers, a few good Doc is where I give credit to my survival. I try to be grateful for what my husband can still do for himself but, I need to stay one step ahead with planning everything. and constant stress and trying to figure things out and wonder "what does this mean". My own health is suffering, but what about "for better for worse, richer, poorer, till death do us part". What about memory care when Doc suggest it, . It is not that easy and to figure out how to pay for everything. When I read about folks who have it harder, my heart goes out. The only thing that I know is that God is in control and I have more decisions to make and will do my best to get it right. Thank You for "listening"
My best to all!
Try finding one person. Strange people coming and going scared the h*ll out of them.
I am a caregiver, and have had 4 seniors I have cared for over the years . Most for over 6 years.
Peffect answer. I have done this and it works
Tell them , not an option, that if they do not accept the help that they need in the house you will have NO option but to find another "care home", Assisted Living place for them. And once there they will not be able to come back home. They can not live alone and care for themselves and you can not do it.
Sure they are not going to like having someone help them out but that is the way it has to be.
Make a list of the things that they need help with, get their input on this as well
Have them explain how they want things done (within reason) and present this to the caregivers. (I had to laugh at this when I read about folding clothes right...my husband never folded towels, he said he couldn't fold them the way I wanted them folded. I told him as long as they fit on the shelf I did not care how they were folded. Funnier yet..I had moved in with him, he had lived in the house his whole life as he had ben born on the front porch! NO excuse for not knowing how to fold towels!)
No one wants to admit they are in need of help. To do so is giving up a big part of your independence and that is difficult. We fight for independence from the time we are born and to give up some of that is hard.
Tell them if this does not work out there will not be an option 2 it will be moving to a facility where they can be cared for.
So explain, if THAT'S want they want, then keep doing what they're doing, because that is the eventuality of what will happen.
IF you try to reason with them, in all sincerity, and they're not able to "get it", then it's time to realize that they are incapable of making decisions in their own best interest, and you must do what you must do, sooner rather than later - - that is, NOW...
Certainly 12 is a high number of quitters- are their other factors besides the grouchy behavior? Low pay? Unreasonable requests? Infrequent pay? General unkindness? Impossible schedules/long hours? Are the former employees qualified or trained to perform the requested tasks? Contact those who quit to see if they are willing to provide an “exit interview” to reduce future turnover.
Perhaps a tweak (higher pay) will make the difference. The certified CNAs who worked with my parents and grandparents were trained to be understanding regarding negative geriatric behaviors.
Maybe hiring 2 to “tag team” is a solution for unusual or demanding schedules.
If you or a sibling can become more involved as a point person, future problems can be mitigated.
No one would want family heirlooms destroyed because of her weight. She was super obese. I bet a home scale doesn’t even register high enough for a person as large as she was.
Furniture has a weight limit.
People a long time ago were smaller. Look at stadium seats from long ago. They were smaller. Antiques are the same. It isn’t a personal attack.
It’s sad that she has this problem but maybe she will seek help. I hope so. She showed up at my house with super sized fast food meals. Food addiction is an issue for some people.
Even if she were thin I would say the same thing. She wasn’t doing a satisfactory job for a frail elderly woman with Parkinson’s disease. The agency thanked me for being honest about her performance and sent a wonderful replacement so it all worked out.
Well, nothing else to say about the matter. Enjoy your evening.
Mind you, for the G_ in question, that was pretty mild. I was also on the receiving end of "you don't get any prettier, do you?" "do what you want, you stupid cow" and a few unprintable expletives. The key thing about this particular client, though, was that we all of us - and some of my co-workers heard much, much worse from him - really cared about this man's wellbeing. Usually, if you spoke civilly to him he was civil in return; but there were days when his miserable life made him desperate and foul-mouthed. I can't truly blame him for anything he said.
There was a long-running battle about food. It was our job to make sure that if he didn't eat a meal, he at least had food to hand that he could help himself to. G did not agree: "I SAID, I'M NOT HUNGRY!!!" I watched one sweet girl, who can't be more than 24 years old, carefully arrange a plate full of G's known preferred snacks in the kitchen; then just as we were about to leave and lock up, she darted into his room, popped the plate on his table and ran like the wind.
So - the OP's parents may be hard to please, but it is a rare client who stands out for intolerable rudeness. I'd be interested to know exactly how many caregivers have resigned in protest, and how many have been let go.
You advice is always spot on.
I love your responses to this one.
Wash the floor, no problem 😊
I had a tough talk with him, telling him he was risking Mom's health and safety by not having help come in. And that I was not going to quit my well-paying job to be their caregiver, not happening!
We hired an agency who sent a worker on 3 times a day. Some they liked, some they hated. Mom did the same thing, complaining to me that they didn’t do things the way she wanted. I told her she was their employer and it was up to her to give them directions, they aren’t mind readers!
Also, my parents were not accustomed to having an employee and were pretty uncomfortable with giving directions. Maybe you could sit down with your parents and get a list of issues that bother them. Then review that list with the next caregiver and discuss it with everyone concerned to agree on what is most important.
Mom wanted the carer to scrub her kitchen floor on her hands and knees the way mom always "used to," I told her no one would do that anymore, I didn’t do that myself and certainly wouldn’t do it for her.
You might ask them what they hated about the facility. And for each thing they hated, is it better with Ms Caretaker doing it for you in your own home? Would you want to be talked to the way you talk to Ms Caretaker? No. It is rude and she doesn't deserve it. So. . . do you want to live at home with caretakers helping you out - or - do you want to return to the facility? You have a choice.
I would also do some kind of covert observation - get a camera that you can see what's going on. It seems a little odd that they were able to run off 12 caregivers. Most people in that field are used to some pretty mouthy patients. There could be some real over the top abuse from your parents. Definitely figure that out before assuming you've only had some weaklings that can't handle some clothes folding criticism.
They probably have a lot of fear and anxiety since they are dependent on others for their care. Please talk to their doctor. They may benefit from antianxiety medications as well as strict routines - easier to get both well-monitored in a residential facility.