tugarjd Asked July 2011

My mother is struggling with dementia and keeps fighting with the aides in the nursing home. What can I do to get my mother to stop?

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Mother has been in the nursing home three weeks. She fights with the aides and nurses over everything...taking her insulin, medicine, showering, getting up in the morning, taking a nap, dressing, etc. The doctor was giving her Ativan, when needed, 1 mg., but she slept through meals, etc. So, he cut it back to .5 mg. in an injection form. She hasn't had this yet...waiting for the medicine to come in.

If mother wasn't fighting everything else would be really good. They keep her clean and dress her well. Her hair looks nice everyday.

I go twice a day and am pleased by what I am seeing. It isn't perfect, but it isn't too bad either.

If anyone has delt with this dementia and fighting, please help let me know if there is anything I can do. I've talked to her, but it doesn't stick in her brain.

Thanks so much.

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sumlerc Jul 2011
I agree with all the above. Like you said, if we put our selves in their place... but I just hope and pray that I will not be like my parents!! I love what DT wrote, gesh! doesn't that sound like my mom. Queene Anne, the Ultimate perfectionist, how dare they not have xyz on time! But to the distant family members she sweet ole granny. Yeah right!

My dad on the other hand, has no diagnosed dementia, he's just stubborn as heck, don't like being told what to do, even when he knows it's for his own good. He used to be quite the dresser, so he fusses with the staff because his shirt isn't tucked in right ( he's confined from bed to wheel chair!) he wants showers when and how he wants it done, I tell ya...this 96 yr old can make me LOOSE it with him! He's used to me but surrre tries to control everyone else around him. Fortunately, the NH staff knows how James is, and the deal gets done.

Anyway, your moms NH staff sounds like their familiar with this type of behavior so thank them, show appreciation towards them and thank our lucky stars for them.
Rest assured, this is not unusual behavior, hopefully Mom will adjust soon but if she doesn't....this is the new normal.
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gjh1022 Jul 2011
If mom has dementia...honey, it's not going to stick in her brain! Hopefully, she's in a place, where the professionals there know how to deal with this...that's one of the reasons she's there!
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Tori1925 Jul 2011
My parent has the same situation and is also up on and off all night pulling on the catheter and trying to get up to walk. What do you do? I think we will need to have 24/7 awake care. How can anyone afford to fairly pay someone to stay awake all night? How much will that cost? Any other ideas?
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vstefans Jul 2011
DT, sounds a little like my mom - the things she expected of people were NOT reasonable sometimes! It could get embarrassing, and some people would of course take a dislike to her and not want to help her! Professionals are supposed to see through all that sort of thing, but not all of them will. Cookies and candy might actually help - you could bring them and say they are from her, or that she really likes to give gifts even though she is pretty cranky - I forgt how I phrased it when I was advised to take a bribe to the staff to get an appointment we needed moved up, but for better or for worse, it DID work. .
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MariaS4life Jul 2011
Bakpakr thank you for your insight. Our family is in the process of deciding to take my mother-in-law to a Home soon or to an Assisted Living Facility. The information you provided is very helpful for both of those facilities. It is true that one of the most helpful things to do to get the patient's cooperation is to go slowly and speak with a friendly tone. My mother-in-law always gets a bit combative when its time for showering, eating or sleeping but I just have to go very slowly and talk to her with a soft voice. Sometimes, I just leave her alone for a few minutes and try again. I notice that sometimes the nurse aide, that comes to take care of her a few times a week, arrives in a rush and tries to rush her to take a bath and boy she really gets annoyed and combative! Sometimes I have to tell the aide to stop and I convince her myself to take a bath. The best ingredient is patience and calmness. A patient with dementia or Alzheimer (depending on the stage they are in) has no control of their behavior nor do they remember their actions. We just have to help them get trough this until the end.
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PLease talk to the doctor about depakote, its been a life saver for my mom and several at the daycare whom I have met their children. The sedatives will constipate her, make her sleep, and be unsteady on her feet so she can fall easily. Poor Mom , she is in a strange place alone and afraid ro top of it all .XOXO
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Hopeful2011 Jul 2011
I expressed some frustration over some of the above issues with my mother at her Rehab/Conv. and the charge nurse came up with some wonderful ideas!

1) She suggested that some members of the staff and I would meet with mom and explain that she is in the best possible place she can be now. Mom broke her back so is in a wheelchair, so has an alarm just in the middle of her shoulder blades that she is not able to reach. She has a bed alarm so she doesn't forget and try to get up by herself. She also has a roommate Doris who "tattles" if she sees my mother trying to do things w/o assistance (which she is prone to do).

2) The charge nurse at mom's Vacaville, CA Conv./Rehab also suggested that we purchase a binder with a letter assuring my mom that we love her and want the best for her. It also mentions the talk we had with the staff at our meeting about the family members and staff feeling that this is the best possible scenario for my mother at this time. At the end of August the letter states that my mom will be re-evaluated. The charge nurse makes an effort to include the rest of the staff so we are on the same page as far as what we say to my mother. The charge nurse has a copy of my letter so she can refer to it and can also show my mother the binder. Also included in the binder: a couple of pages with her favorite pictures, and an "update letter" for her relatives and friends again stating that my mother is in the best possible place at this time of her life and giving the phone number where they can reach her. Today I had a Pedicure lady come to mom's facility to take care of her toes. My mom was pleasant during our visit, but when we returned to her room, my mother's belongings were on her bed and she said she was ready to go home NOW. I needed to be firm & pleasant with her; to disengage from the conversation and redirect it. I gave her a hug, a kiss, some of her fav magazines and the homemade chocolate chip cookies I brought to her. I told her I loved her and would see her on Sunday. I used to "go through it emotionally when I needed to do this"--now, as I see that there is no other option--it makes it easier. If you can find staff that are willing to support you and are behind you and can encourage you and give their input--you are a blessed person! I need to remind myself that my mother is cognitively impaired. Unless a miracle happens she will always be that way, and she may worsen as the days go by... We take each day at a time and I try to make the most of every opportunity. Hats off to you who has a heart to do the best for your mother--hang in there:! I hope the above helps you.
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I would try lavish use of the phrase Thank you and please. overdo it. by the nursing staff. even if it does not make sense. (Like thank you for missing my jaw...little joke). Look for openings to say thank you. Have the other nurses say "you're welcome." Get that gratitude attitude started some where. Use PLEASE a lot. If your mother does say thank you or please, then lavish, "thank you for saying thank you..." and "You're welcome, Mrs. Smith" ...start using stickers if any success with "You're awesome:" "WOW"...stars. If you get that far, let your mom choose to give a star to the aid. The aids can give stars to each other. At first it might seem totally looney tunes ...but even the aids giving stars (battle scars) to each other creates an attitude of gratitude.

This has worked with Mom, even got her to more wonderful plateau in her life participating...she often says thank you spontaneously now. She did not say thank you in over nine years.

If you have a jokester type caregiver there who can kid alot, you can try a smiling... NO NO NO NO NO??? Hey, how bout YES YES YES YES YES?? hopefully that makes them laugh...and you can go to the next step. Do not look for total up and dressed and out to eat and back for a sponge bath. There are dozens of steps, each with opportunity for combativeness. This same caregiver was rubbing mom's cold arm, and mom was being a grouch. She instinctively tickled one spot on her upper arm and mom smiled. that is the sort of thing you know from trying dozens of "didn't work" maneuvers. Please share your techniques. These little tricks are what we have to really work with on the ground. Suggestions like "approach them from the front, get on eye level, don't argue.." look nice on a list...but we are dealing with raw behavior here, more like a wild dog or cat. Instincts kick in.
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dlmpam2010 Jul 2011
I live in a different state from my Mother's nursing home. My sister lives near her. I call her every day and tell her silly stuff to keep her laughing while on the phone. She has been diagnosed with dementia and is LOUDLY and PHYSICALLY abusive to the staff at the care center. The ridiculous stories that I mostly make up....about her great-grandchildren, myself, my spouse, my friends, etc., give her something to laugh about when we are on the phone or I am visiting, but the inevitable fact that she is 93 years old and going downhill daily is ever present. The staff is superb, and I tell them that constantly. She also takes Ativan, but I don't know the strength. I never ask her questions to test her memory--instead I phrase my sentences to GIVE her the information regarding the story that I'm making up and constantly pretend that I do not remember things. She enjoys our visits, but the quality of our phone calls is decreasing. Her sleeping time has increased so much that it is difficult to find her alert enough to speak (or just listen) on the phone.
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CaraMia Jul 2011
Sometimes I am at the nursing home when aides are helping my mother to get out of bed, or back in bed and hear her telling the aides, "No, no," or telling them to stop the foolishness that they are doing when they try to adjust her position in her wheelchair. When that happens, I keep speaking softly letting my mother know that she's ok, and that the aides are just helping her, that they always look out for her, and how nice they are to her. It may not help much, but yours is a voice that can be reassuring to your mother when she is going through such changes. Other than that, as everyone has said, if that is your mother's disposition right now, there is nothing you can really do to change it. Keep praising those who help her while you are in her presence if they are truly being caring and helpful to your Mom. If they are too rough or too quick, politely let them know that you think that if they slow down a little and talk to her a little more, they will help to ease your mother's anxiety.
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