I'm a professional caregiver and work with a lot of clients with dementia. Some have been verbally abusive, but I usually can let it roll off or let them know what they said was unkind and they apologize. My current client is mean to all 3 caregivers and he lives with family that won't step in and correct him. Today he called me a name for touching him to assist with transfer. It upsets me because he does this at least once a day about something. He has a short fuse. His family feels that it's all Dementia and I should accept it. They feel it would do no good to ask him to stop. Today I dropped him as a client and the family isn't happy. I understand sometimes Dementia causes behavioral issues, but if the family could ask him to be nice it'd help. Don't you agree?
"Dad! That was mean, I don't accept that kind of language in this house"
turns to caregiver "I'm so sorry"
That is surely not too much to ask.
Dementia or no dementia, I will not tolerate him being ugly to her.
The family could have said something to the person who posted, apologizing for the client's rudeness , if nothing else. It's hard enough to find a kind, efficient, compassionate caregiver without allowing someone to just be hateful.
I can't agree that trying to correct the client's behaviour is the right approach. For one thing it's very unlikely to make the slightest difference. For another, this man is in his home, and within legal bounds can speak and act how he pleases - he doesn't have to be "nice" (and you don't have to put up with his not being nice).
We - I say we because I know my co-workers would also do this - try instead to identify and avoid triggers. Our managers warn us in advance if a client is likely to be rude, verbally abusive or inappropriate in language; if there's any risk of anything worse, we work in pairs and are instructed not to enter the property on our own.
And we do see quite a lot of "problem" clients - we can often spot them at a glance, from the three joy-inspiring words "Agency Hand-Back." In all seriousness I see the challenge as one of the advantages of the team I work for. We have three categories of client - Reablement (which is our actual mission, and the majority of our work); Urgent Care (crisis support, which can include end-of-life care, bereavement, life-changing events, caregiver breakdown etc); and the above named Agency Hand-Back, which tends to be a bit of a revolving door situation - we sort a client out, another local provider gets conned or schmoozed into taking him on, three months later back he bounces onto our rounds to universal rejoicing hem-hem, and round we go again.
But there is huge satisfaction to finding approaches that such people can tolerate and are happy with, so that they can then be provided with the support they need in a way that they'll accept.
One lady, who'd bitten my head off for an hour straight, finally said "is it you again tomorrow?" It should have been (it wasn't, as it turned out, which I regret but couldn't help), so I said "it may well be, yes." She said "I suppose I can put up with that." There was a pause. Then she added quietly "if you can put up with me."
I took this as a great compliment, but it also made me sad. This lady was - okay, she was a bit of a monster - but also in pain, not able to mobilise independently, lively-minded but bored, and sick to the back teeth of cack-handed strangers barging into her room and knocking all her books on the floor. YES she would have done better to let us move the books. YES the answer to not knocking over the photo frames might have been not to keep them on the window sill behind her incredibly heavy curtains. YES there are all sorts of handy storage units that would have been much more user-friendly than an 18th century oak press. But at the bottom of her sour temper and uninhibited rudeness was the real grievance that people didn't really try to get it right.
It's almost to late to bother about it, and I stick to my first answer which is that if you're not happy with an assignment you absolutely don't have to accept it; but you say this gentleman has a short fuse, and that today he called you a name (how bad a name? Anything actionable?) when you stepped in to support a transfer. Would you be interested in theory in returning to this family if you could resolve the issue?
"But there is huge satisfaction to finding approaches that such people can tolerate and are happy with, so that they can then be provided with the support they need in a way that they'll accept. "
You see the challenge, and how to overcome it.
However, if he treats the other two caregivers the same way, in my opinion that supports this behavior secondary to his dx of Dementia.
I would assume the family potentially has caregivers to provide respite from the verbal abuse they receive.
Honestly, I don’t feel he’s capable of understanding what he’s saying, let alone the affects it has on others.
In this case, I would agree it’s not possible to change his behavior by asking the family to tell him to be nice, to stop, etc.
If the family has accepted his behavior & knows not to take it personally that’s a big accomplishment secondary to their emotional attachments.
I think you need to hear what the family is telling you & believe it has 0 to do with you.
You didn’t mention what he said or why you took it personally? I don’t mean that to be disrespectful of your feelings or boundaries.
The family is being realistic by stating it won’t help. It would be wasted energy & going backwards if they believed talking to him like he’s lucid will result in change.
Caregivers like yourself are doing a tremendously tough job and you deserve respect. Even if the client themselves doesn’t change, it is still good for the family to speak up and let the caregiver know that their effort is appreciated.
Yes you have a right to pick and choose who you will have as clients, but if you're wanting just easy clients, then perhaps you need to stay clear of dementia patients as they can be quite unpredictable.
If this client does not meet your standards, you are right to drop him.
Don't doubt yourself.
You did the right thing
I hope you find a client that isn’t abusive in the future.
Perhaps you could ask questions that would give you a clue to their personality and hope the family doesn’t embellish the truth when they answer your questions.
My husband’s grandmother was a horribly mean woman. She didn’t even have dementia. She was that way her entire life!
She was so mean to my mother in law, her only child that her daughter would have never been interested in having her move into her home after her dad died. She insisted on staying in her large two story house.
She refused going into assisted living. She had loads of money!
So, my mother in law hired two women for daytime and two women for nighttime and paid them each double their normal salary just to keep them!
My mother in law said that it was worth every penny spent!
She still had tons of money left over after she died.
Maybe some people dealing with situations like this will have to end up hiring private care like my mother in law did an pay them lots extra!
See All Answers