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Sorry but I don't agree that those with dementia don't know right from wrong - they may forget themselves and act out inappropriately but IMO that doesn't give them a free pass. If the client doesn't ever apologize and doesn't ever even try to behave, even briefly, and if the family doesn't apologize on their behalf and at least attempt to call them to task then it's all on them when the caregivers leave.
"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.
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Sarah3 Apr 2021
Excellent answer
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It reads to me that you are most upset by the lack of support from the client’s family. Whether or not some ‘correction’ would change the behavior, you are instead being told that your feelings about it don’t matter. My guess is that you are not getting much positive feedback, from the client or the family, and the money alone is not worth it. If this sounds at all correct, and the family is upset to lose you, perhaps you could talk to them about your treatment generally.
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You were right to cancel him as a client. My mother was abusive to her caregivers and they quit. I had talked to Mom about this and she said she wasn't doing anything wrong. So they quit. If they are not happy so be it. You have to take care of yourself and your sanity. So yes, I do agree.
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I understand how you feel.
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.
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my2cents Apr 2021
medicinelogic - You are correct. A family that has learned to accept the nastiness that come out of a dementia person's mouth, they are far ahead in the game. Far better to accept than to spend hours on end arguing with someone who is no longer living in reality
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Nah, I don't agree that the family should ask this dementia patient to be nice. It wouldn't do any good. Once a dementia patient gets a thought stuck in their head, it can't be chopped out of there with an axe. You can repeat yourself a million times and it won't stop them from asking the same question or doing the same thing again and again. That's the nature of the beast which you should be aware of as a professional caregiver. It goes with the territory.

That said, you shouldn't have to tolerate any behavior that upsets you. No job is worth suffering over, in my opinion. I used to work for a very ornery Alzheimer's patient many years ago & he was extremely abusive. I tolerated him for about a month and then said ENOUGH. I was done. I called the agency & quit that particular job and they said I'd stuck it out longer than any of the CGs they'd had on that job.

This man's family is going to have to accept the fact that they'll be going through caregivers quite a lot if their loved one is acting abusive. Just b/c he has dementia doesn't give him a free pass to be abusive. They may think it does, but it doesn't. They should try dealing with him for a few days themselves to see how it feels, and perhaps then they'd change their opinion, huh? :)

Good luck to you!
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No, with all possible respect for you and your very difficult profession, I don’t believe that asking anyone to “be nice” is very helpful.

If you state SPECIFICALLY the BEHAVIOR that you wish to change, and the client understands what has been said, there is a 50/50 chance that they may be able to respond and do what you’ve requested. “Hands in lap” is potentially a little more likely to get the result you want than “Be nice”.

In most types of dementia though, the client won’t understand or remember what has been asked of them, so the chance of changing behavior is not great.

You don’t EVER have to accept what a client SAYS, but you also can make a choice not to be offended by it. Whether he calls you a bean, or a bear, or a vulgarism doesn’t make you any of those. You are who you are, someone who wants to be helpful and kind to someone in need.

You seem to have made the best decision in your situation. Hope you can pick up a new client with a better vocabulary very soon!
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If you've been working with dementia patients for some time, then you know that just because a family asks their family member "to be nice," doesn't mean that they will remember. That is part of dementia. Wouldn't all of our lives be much easier if our LO's with dementia, would do exactly what what we tell them to do. It doesn't work that way though. You say that you can usually let clients verbal abuse "roll off your back." What was different about this client that you decided you couldn't with him? Just curious.
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.
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I think that not only are you justified, you were wise.   Has he ever been physically violent to you?   It wouldn't surprise me. 

If the family thinks verbal abuse is okay, to me that's a bad sign of what they would anticipate a caregiver to tolerate, and it wouldn't surprise me if it became worse.

Your mental health is important too.
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Well, both of you have valid points. If it is indeed dementia, then he can't help himself and chastising him will do no good.

That doesn't mean you're required to take it. Everyone has their limits, so you are certainly free to say you can't take it any longer.
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