A big part of what you pay for for AL is to have people to help.
My dad either has mistrust of staff members that he refuses to use them, and/or alienates them. He has yelled at many of them. Some of the experienced ones know how to tolerate that, but some staff don't and so they are avoiding him. THen, he likes that even less. Not to mention, he has not made a single friend among the residents, and actually has alienated a couple. But thats not my worry about not making friends. The worry is alienating and not trusting the staff of whose help he needs.
I see only two possible decent options:
1) Discuss the whole issue with management. The problem is , they may see this as an opportunity to say "maybe your dad is not a good fit here, and you want to look elsewhere". I don't have any better options in mind right now for ALs and a move would be very tough
2) I could just leave things be, leave him to his own devices and let the cards play out?
a 3rd option would be counter productive I think, which is to continue to prop him up with additional outside caregiver help (he already has own who comes 6 hours a week), and even worse, go in and help out more and more myself (the last thing I want to and have time to do, and it would stress me out even more).
He sounds depressed and agitated.
I would let the staff and management work this out.
Trust me, they have seen everything under the sun!
Stay away for a bit--don't make dad's dad behavior YOUR problem!
Perhaps they do feel dad is ready for a higher level of care. That happens all the time. IS he well enough to understand that his behavior is causing distress that he can control? It could be it's time for MC, which is not nearly as 'fun' as an ALF. You lose a lot of freedom in a MC facility.
Good Luck!
You could try to get the doctor to order something for depression anxiety . My father in law had no results with the antidepressant. My mother took something for anxiety. It helped her . She refused an antidepressant .
I was given 30 days to put my mother in MC if she didn’t shower . Mom had stopped doing her own occasional “ sink bath “ of pits and privates . And wasn’t changing her brief as often . Which was I guess keeping the odor to a tolerable level ??? She refused showers and her room smelled so bad it was coming out into the hallway. I told the facility that they were not being forceful enough with her with the showering from the get go and let her get away with it too long , so I expect them to now try to correct this. They wanted me to talk to Mom . I told them that my mother would not listen to me or take showers for me and THAT IS why she was in their facility . Ended up going down there and going in Mom’s room with the facility director who told my mother if she didn’t shower she could not live there anymore . The director thought if she told Mom in front of me that it might work , since I placed Mom . It did . My mother only trusted the Charge nurse , not the aides . So the charge nurse and an aide showered her . I looked for a new facility and was in the paperwork stage to get ready to move Mom because she was refusing to shower again and refusing help with incontinence. She died before the move .
My FIL wasn’t much better about showers , he would yell at the staff too . His attitude was he was paying the rent there so they couldn’t tell him what to do.
We had to push that facility to push him more as well . He started allowing showers . But refused help with incontinence care , and he didn’t do a good job on his own . He did not change often enough. His room stunk too but he always kept his door closed .
My mother and father in law were still able to have conversations , unlike the people in the MC units . The facilities they were in kept them in AL a long time . They both died before going to MC . Mom most likely had a heart attack . They found her dead in her chair . FIL died of Covid .
strugglin,
does Dad like the outside caregiver ? Is the outside caregiver doing his showers ?
What does Dad need help with that he’s refusing to let the staff help with ?
Yes, the outside caregiver comes in twice a week for bathing help. Its really the opposite for my dad as he has a strange sort of OCD, always has but its become worse with age and dementia. We first tried bathing with the AL's caregivers but he said their assistance was not adequate, and they were only allowed to spend 30 mins total , twice a week. So outside caregiver comes in and spends a total of 2-3 hours on the whole process! (AL gives some price discount since not using their help for bathing). So he sure is clean after that. He does like this caregiver and its the only person he approves of for bathing. To the point that, if that guy is off and the outside agency sends a substitute, my dad is not happy (but has no choice).
As of now, he can dress and do basic activities with "no help" but takes hours to get dressed and really could use help. Also, does not let the daily housekeepers make his bed any more (for reasons unclear to me), and is making his own bed, which is ok, but in doing that knocked his leg on the edge of a table the other day and got a wound.. So things like that. I assume he will deteriorate and need more help with things, so not taking the help from AL staff is not a good thing.
Well, I have decided to spend even more time in between visits now, will go in no more than once a week. Hopefully that will foster more of a need to depend on AL staff for things. If he calls and asks me to order something on amazon -fine I'll put such orders in etc. BUt no more long discussions about how he thinks the AL staff are "lousy" , and my opinion of what to do about it etc , circular meaningless discussions when I get into them.....
If he becomes too unruly, too stubborn, and too disruptive to the staff and residents they can evict him. Then you will have to find a new place for him to go.
You can have a talk with your father and level with him. Tell him straight that the AL is the last option for him because after that it's a nursing home or memory care facility.
Let him know plainly that if he is rude and makes 'trouble' for the residents and staff he will be medicated or put in a nursing home. See if this helps.
If it doesn't then you'll have to medicate or have him moved.
It has been a nightmare, I hope your LO understands they need to adjust or adjustments will be made for them.
I edited a lot after you read my post. You might want to reread it .
I also asked if your Dad’s outside caregiver does his showers. And what does he need help with that he refusing to allow the facility staff to help .
Definately do not go in yourself and do more things for your Dad . That is counterproductive .
"
My father in law has dementia , still hides in his room except for meals , is nasty to the staff etc . It’s been 19 months . He kept asking us to move him , we took him on many tours , he didn’t like any of them because he kept wanting to go to independent living but he can not."
This is totally my dad! 6 months into his AL.
I would be asked if I could 'have a word' by the Nurse-in-Charge when visiting rehab.
Refusal to shower, refusal ro change clothing, refusal to talk to any Psychologist.
Like a 4yo No No No!
I attempted to muster my patientce & tolerence to ask a bunch of Whys.
Didn't NEED a shower (yet could not remember the last one).
Didn't NEED clothing changed (despite obvious smell & stains).
Didn't WANT to talk to anyone (yet didn't understand who this person was).
I realised cognition was worse that I had realised. Cognition + stress + anxiety.
An informal meeting came up with these solutuons to trial.
- Staff struck a compromise to shower on certain days. This would be SET & was written on the wall. No buts. Good cop, bad cop routine. Bad cop got that shower done. Good cop laid on the compliments afterwards (you smell lovely now ☺️).
- Clothing would be changed on shower days. Swapped out of sight to avoid tantrums.
- Psychologist arranged to visit.
She introduced herself with a quiet & calm manner, stating she had just come to say hello & ask how my LO was. Worked. A little trust gained.. Then some opening up about how SCARED she was. What had happened? Why she was there? When could she go home?
People in fear often lash out.
Allowing choice & control became the antidote to fear & loss of control.
Eg Must shower on set days. But choice of available (clean) outfit.
In time, adjustment was made to the regualr routine. Offering choice & allowing control where possible has worked to a (mostly) tolerable level.
I hope you too can get there.
I'm speculating, but, ironically, it may be that: since my dad is avoiding asking help from the staff, and some staff avoiding him, and hes trying to do as much as he can himself and utilize the outside caregiver, management may be perfectly happy with this. We are paying rent without using much of their services/ labor costs! If his yelling and stuff causes more issues or the staff complain about that - then I think that could be different (eg dining room staff, he does go for meals).
Truth is that you are likely looking at a need to move out of AL into MC and I would be honest to tell this senior that is what he is looking at.
Sit him down and tell him that rudeness to those he is DEPENDENT on now will get him thrown into MC where he will be medicated, like it or not, and sharing a room with someone nastier than he is.
Lay down the law.
Now, if this doesn't work, then you ARE looking at MC and at medications, just as I indicated in the threat above. So much depends upon his ability now to understand and act on your advice.
And when you get the call from Admins there--well, you will be expecting it. Let them know that, and ask for their help and cooperation. Speak to MD re a trial of low dose anti depressants which often works.
Interestingly enough, medical marijuana is now used in MANY facilities. One in Austin recently working with a friend's mom who became completely non verbal. Guess what? It's WORKING and her mood is much better as well. l Guess it's called "Baby Boomers hit the Elder Care Communities?
he has been adamantly against any antidepressants or anxiety meds. But I have a feeling that eventually , one way or another , that may need to be forced on him.
People with dementia lose the ability to bring themselves to a place of acceptance and peace because of their declining ability to use reason and logic. They also lose empathy for others, they lose their sense of time and connection to their own bodies (reading its signals), the develop paranoia, so they need external help in the form of meds and an understanding, compassionate staff.
The admins and staff can only do so much since your LO is losing his ability to learn and adapt. It's not fair to ask this of him when he organically can no longer do it.