Our 77 year old mother, around stage 5, lives with my sister. While my sister works, Mom spends the day in her condo (still owns it) with her caregiver, Sally. We hired Sally because she had prior experience as a caregiver with a dementia patient. Sally's former patient was a 90 year old AD patient in a wheelchair; she had a relationship with her prior to caregiving. The former patient loved Sally and former patient's only son let Sally run most aspects of her life.

Our mother is physically healthy and aware of her environment. She does not believe she has Alzheimer's and resents that she must have 24 hour supervision. The first few months of this arrangement have been rough, but everyone seemed to be adjusting.

After 3 months, we thought the situation was running more smoothly. Today, though, Mom told us that Sally yells at her alot. My mother can be mean and yell herself, but we feel the caregiver should not be yelling at her. Mom cannot help what she does and she cannot "learn" to change her behavior.

We have a good relationship with a local Alzheimer's office support person. We have considered meeting with Sally and the support person for strategies in dealing with Mom.

What would you do? Thanks.

Can you put out some tape recorders or video tape to see what really goes on? Perhaps your mom is not telling the truth because she doesn't want to believe she's ill.

What's your gut feeling about this woman?

How reliable is your Mom? Would she lie about Sally (intentionally or not)? If you believe your Mom, I wouldn't give Sally a second chance. Sally doesn't have to be perfect, but yelling is unacceptable and there should be no reason that Sally should have to be told not to yell at your Mom. Sally should know that yelling at your Mom is not appropriate ever(unless your Mom was in some sort of immediate danger and Sally had to yell to get her attention.) I'd start looking for a new caregiver ASAP and as soon as the new caregiver arrives, I'd show Sally the door.

I would also suggest some sort of Nannycam or webcam with sound so you can see for yourself how the caregiver treats your Mom. If you doubt that Sally is actually yelling at your Mom, maybe try the camera prior to firing Sally. But, with any evidence of yelling, inattentiveness, or abuse, the caregiver should be fired, in my opinion.

Please meet with Sally and a mediator. Your Mom may be taking the situation out of context or telling you a story to try to gain independence from Sally. Unfortunately I have been dealing with a somewhat similar situation with my Mom for over 18 months. She resents any help and tells outrageous stories about her caregivers - from them dealing crack in the nursing home to them yelling at her.

It is all her, she takes things she sees on TV and mixes them up with reality and it all sounds so real when she tells it. our only recourse was to put her on Seroquel which leveled her emotions out and seems to have dampened the drama.

This is not easy, I was just thinking before I went online how much I wished that Mom was less aware. These holidays are going to be tough. Last year's were horrible.

I would suggest getting a voice-activated recorder and using it for a few days to see what's really happening when you're not there.

Sally might be yelling (clearly wrong, if she is) or she might not.

Your mom might be accurately reporting things, or she might not.

So get some data, then you'll know what to do, if anything.

And thinking everything's fine when it clearly isn't is a condition that's common in dementia.

It's called anosognosia. More here:

http://alzonline.phhp.ufl.edu/...ding/Anosognosia.pdf

How about installing a nanny-cam? That way you can really see what is going on. It may be that Sally is yelling, but perhaps she's not. My mom would tell me that her caregiver wanted her to run around naked, when all she was doing was encouraging her to take a bath . She ran the bathwater for her, gave her a towel, and left the room while mom took her bath.

"Caregiver is yelling at AD mother" as your topic makes me think you have no doubt that Sally is, in fact, yelling at your mom. If you do believe it, you must replace her. Even if your mom yelled first.

Always Learning More is right on about gut feelings. Your own gut (they call that intuition) and clues from your mom can give you much of the truth you need.

If you DON'T believe Sally is yelling, the meeting with Sally and the alz support person is a great idea!

If you're unsure and feel your mom is in no imminent danger, I love the idea of a voice acctivated recorder. Cheap, easy.

You gotta know one way or the other to know how to deal with it. Just always err on your mother's side.

My mother is independant, living in her own home next door, but needing homecare for an hour a day or so. My mother's recounting of a situation is not nearly always accurate, even though she is still overseeing her own bill payments, cooking her own food, etc, etc. Because I live in such close proximity, I can see the 'gaps' in her rationale/perceptions clearly. Our mothers sound similar in ability/stage.

I would do both--- voice activated recorder AND meet with Sally & mediator to discuss concerns, see if she needs extra support or more breaks, etc. My mother has called comments for which I was present "threats"; actually she accused me of making threats when I suggested that we could hire a companion to drive her on outings if family members were unavailable. It was not a threat, my tone was hurried because I was dealing with young children at my end of the phone line. She misread the hurry as a threat!

Your mom may be misreading the communication intent. It is important to find out because if Sally has been a good caregiver, you'd hate to lose her only to find yourself in such a situation again!

If Sally has yelled, I would give her another chance and make some changes, like less time on duty/another person to pick up a few hours, etc. Caregivers do have stress and need support. It sounds as though Sally has a very full week with your mom. Maybe there are options to reduce stress level IF she really did yell, or maybe she needs a week off or some such thing......

Hi - it's a horrible feeling to think we have 'bad' daycare. I think I'd have the meeting no matter what. That way, Sally knows someone else is paying attention.
It could also mean it's time to pay closer attention to Mom's actions. Is she getting more paranoid? Anxious? Those certainly come with the turf and there are good med's for that. I'd also compare Mom's attitude on the days when the caregivers ISN'T there.
Have the meeting no matter what.

I could believe either way. You know as a caregiver how your nerves are often stretched thin. I have never yelled at my mom and I hope I never get to that point but I can see where someone who's not related could get to that point.

When mom was at the NH for a couple months of rehab, a worker was yelling at her roommate because she wouldn't take her teeth out. I asked her if she would talk to that lady in that tone if the lady's son were there.... she was shamed by my question, then I followed it with "If you EVER talk to my mother like that I WILL run you over with my truck." She was peaches and cream after that (as far as I know).
I should have turned her in but other than that incident I never noticed anything else. She was my mom's favorite worker because she bribed mom with chocolate to do what she wanted her to.

I would sit down and talk to the caregiver. It could go either way.

Cathy

Not to say your mother is lying, but at that stage, my mother would say all sorts of things that were not true to turn one of ua against the other. She may be trying to get rid of the caregiver. If the caregiver is really yelling at your mother, then she needs to go and not to care for anyone else with dementia.

I have to admit I raised my voice with my parents more than once, but when I yell, bring down the house. I can see maybe getting a little stern, but not yelling.

I went through the same issues over & over. It was a little of both. Yes the dementia my mom had aggravated the situation & she would exagerate. The aides would yell if it was something they didnt like. I did install monitors to hear ,my mom would start it & it upset the aide. I did my best to have patience with both of them being I didnt want to loose the aide & god forbid I sided with her. I would sit back & see how they could loose patience because I would too at times. That has been my complaint that it is hard to find people that really know how to care for them properly. It is like a child at school, keep that in mind. It is VERY HARD to find good help.

I would install a "Nanny cam" without Mom or Sally being made aware of it,,and video what actually is going on. This way you will have verbal and visual proof. If Sally is hollering at your Mom,,,I'd can Sally right on the spot! Its hard to get good help that is kind and gentle,,yet can handle the situatuions that arise with someone that has AD,,however,,,hollering is not on the list of how to handle things. Good luck

We had a so called friend move in to help take care of dad while I went to work. She would tell me all kinds of upsetting stories about his behavior. My dad has his moments when he can be pretty nasty, so I can say with some certainty that dad was nasty with her at times. But I didn't know my "friend" was yelling at and fighting with him until another friend overheard her more than once. I witnessed it a few times after this, and told her to get out.
I would make video or tape recordings to find out the real story, or if possible, ask a third party to monitor the caregiver.
You'll find out what is going on. Peace.

Without a doubt, this needs to be investigated by putting a recorder or cam in the house, or meeting with Sally and a mediator. This does have to be approached very carefully though - I know that my mother was extremely unreliable when it came to things like this. She would tell me she wasn't being fed at my brother's house (not at all true), and she told doctors that I yelled at her all the time (not true).

I wouldn't blow off what mom is saying, but I also wouldn't accuse Sally of this unless I had proof.

Sounds like you haven't talked to Sally. Get her side of the story. Since she's an experienced care-giver and was liked on her previous job, my guess is she wouldn't yell at mom. Unless it was under highly unusual circumstances. Make sure mom isn't fabricating her story. --Jim

I had the same issue with one of my mother's hired caregivers. At first we didn't know if we should believe my mother. We really liked this caregiver. My mother might not have been so clear with her speech, but at the time she pretty much knew what she was talking about. Her delusions were of things and people that were not real, not about real people. Then one day one of her neighbors called me aside to tell me that the caregiver was yelling at my mother and she didn't like the way this woman was dealing with my mother. We got rid of her immediately. We had her for about 8 days total. Often times it takes a couple of caregivers to find the right one. We were lucky because the next two (she had 24 hr home care so it was split between two) were fantastic. They became part of the family. I still keep in touch with them.

Try to find out for sure if this caregiver is really treating your mother poorly.

This is a tough situation and plse understand there are 2 sides to each story. We as caregivers to LOs tend to believe them, not hired help. Have you questioned Sally, too? Plse do so as you might find a different story that could be the truth.

This disease does confuse the patient, as in my mom's situaion. She would tell me so many things about her help at ALF, and after confirming to the main RN, it was not true. Mom was fibing in most of the cases. Just can't get her facts in order and like a little kid, tweek the story to fit her way.

Be coy and do give Sally a chance to confirm her side of the story.

Best to you!

I've noticed that sometimes my partner says or thinks self-critical things to herself, then "remembers" them as things I said to her.

That said, by all means use whatever recording or monitoring device necessary to check on the caregiver. If she's yelling, I'd fire her right away and get someone else because, in my opinion, you have enough on your hands without having to train a caregiver from scratch in better ways to deal with frustrating clients.

Also, sometimes the rapport just isn't there. You might consider having your mom interview potential caregivers with you. If she herself chooses the one she likes best, that makes for an easier start. Of course you discuss the pros and cons of each, but in my experience if you interview three or four, it's easy to agree on the one who relates to your LO the best.

After you hire one, it's still best to have a monitoring device in place. I learned that the hard way (another post).

One more thing. If you do end up meeting with the current caregiver to discuss the situation, be alert for a "laugh of recognition" or a level of defensiveness that indicates guilt on her part. (Caregivers can't afford to be defensive; we all learn that the hard way!)

The caregiver we fired had been telling my partner she was a spoiled brat. When my partner brought that up in front of her, the caregiver gave a little snort that was a "laugh of recognition" so I knew she had really said it.

I agree wih Jim. If Sally did yell at Mom, maybe it was unusual circumstances, and she yelled without thinking because Mom was doing something dangerous or unsafe. If she did yell for other reasons, that is just wrong no matter what. Sally should be spoken with. Use a hidden recorder if you think it is necessary to see how your Mom and Sally interact when no one else is there.

I would not automatically believe Mom when it comes to her sayng someone yelled at her. People with Alz. can greatly misinterpret what and how things are said. And so can the rest of us.

My mom has told my sister that I yell at her. After searching conversations in my head and finding nothing I finally asked mom when I had yelled at her. She said oh you do it all the time when you want me to do something. I promise you I do not yell at her and only occasionally have to say something forcefully, i.e. Yes mom you HAVE to use your walker even if your hip feels fine. So I still don't have a clue what the "yelling" is. I guess anytime she doesn't want to do whatever I have suggested, it becomes that she was yelled at. Good luck in getting at the truth.

quote:

Originally posted by Always Learning More:
Can you put out some tape recorders or video tape to see what really goes on? Perhaps your mom is not telling the truth because she doesn't want to believe she's ill.

What's your gut feeling about this woman?

I agree with this. I know with AD, the patients can say things that aren't true because they believe it to be in their own minds. My mom has done that herself, so I would not be as apt to believe her until I heard or saw the facts for my self. Maybe a granny cam would help too?

Linda Sue,

There are some excellent suggestions here. I empathize with your situation as my own Mother tells me how my Dad yells at her and then tells Dad the same about me, which we both know is only true in her mind and is an unfortunate effect of her disease.

My only caution is that if you choose to set up any recording device, you investigate your states laws before doing so. Massachusetts prohibits any "secret" recording. I googled "laws recording devices massachusetts" and found this link:

http://www.citmedialaw.org/leg...usetts-recording-law

However, Georgia's laws are different:

http://www.citmedialaw.org/leg...eorgia-recording-law

Hate to have to throw something else out there, but just be sure that you have yourself covered legally.

Linda Sue

I took care of my MIL with FLD and my FIL with AD and now I am caretaking my husband 64 with AD. At no time in 4 years have I EVER raised my voice to them

I do believe though as others say - this yelling could be part of the AD dementia. Nanny recorder and if she is yelling, she is gone. I have no tolerance for senior abuse. And I would report her!!

Catherine Ann

Wow - I need to reply here - a hired caregiver should by no means be yelling at their person.

But that said, I have lately blown up at my mom - 4-letter words and all. I feel bad about it but I just reached my limit.

It's not something I'm proud of but this illness affects an entire family in different ways - for me, my patience level is not what I thought it was.

I agree with everyone - try a nanny-cam or something to prove that this is happenening.

Good luck and keep us posted

Kathy

Your mom may be confused but my mom had a care giver who did not understand the AD. She thought my mother was "nasty" and "difficult". Perhaps her previous client was at an advanced stage where there was less activity. I would try to get to the bottom of things and not assume mom is confused.

Nanny Cam, perfectly legal in most states, but there's an exception about recording speech. I think it's OK to watch them and listen to them "Live", but not recorded. I think we should all have them since our LO's with AD cannot stand up for themselves.

My bet is that Sally never really yelled at your Mom. She may have raised her voice trying to be understood. I know I used to do this with Mom...finally figured out it wasn't her hearing and talking louder didn't help. But, your Mom's best interest is more important than Sally's privacy, so better to know for sure. Your Moms perception of a situation may be a little off...not her fault...it's Alzheimer's and it sucks! It would be a shame to lose a good caregiver from a misunderstanding.

Felicia

quote:

Originally posted by Grassflower:
I would suggest getting a voice-activated recorder and using it for a few days to see what's really happening when you're not there.

Sally might be yelling (clearly wrong, if she is) or she might not.

Your mom might be accurately reporting things, or she might not.

So get some data, then you'll know what to do, if anything.

How much time do these record?

Depends on the model - for example, one of the Diasonics provides nearly 300 hours of unattended and completely silent (no clicks as it stops or starts) recording.

With these super-capacity models, you also want to get an enhanced battery supply so it stays charged longer.

Thank you for your advice! I will let you know how this goes.