Caregiver of a 90 yo lady. She is demanding and manipulative. Any advice?

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Knowing her son is upstairs, she starts yelling when she doesn't get her way. She has small irritable bowel syndrome and, I am told, she has Sundowners syndrome. I am constantly getting her up to use the bedside commode, but 75% of the time, she will not use the bathroom. She starts shaking, and becomes confused, but when I ask her questions, she is alert and oriented. She starts yelling for her son to come down when I do not give her water, which makes her want to go constantly. I tried to sit down and explain to her that she needs to limit her fluid intake and by drinking fluids when she is trying to sleep, will only keep her up. I also tried to get her to sit up but the minute I get her up, she is yelling to get back in bed, vice versa. She is nice one minute, the next she is unbearable. I try to talk with her. I ask her if there is anything that is bothering her besides wanting to get up. She just shrugs and says she does not know. She then apologizes for her behavior but five minutes later she is doing the same thing again. I plead with her son to give her sleep aid, but he makes up all types of excuses why she does not need it. I tell him that she needs to sleep. She is agitated from lack of sleep and that she is fixated on getting up and down. I have no idea why he thinks that will make things worse. Her doctors prescribe sleep aid for her for a reason. If I cannot have her son work with me there is little I can do to calm her down. I end up waking him up to come down and talk with her because she will not listen to what I have to say. She starts to cry like I am hurting her when I am getting her up, but I am always careful. I get so frustrated I take time out in the dining area, but the minute I leave she is yelling again. I feel she is manipulating me into having her way which I end up doing. I get so tired from getting her up to the commode every 15-20 minutes. After a while, she starts to get weak and I am dealing with total weight and she is not light. She has fallen several times since I have been working with her. Thank God she has not broken anything yet. I have tried everything from talking with her to getting her up in the wheelchair so she can sit up, but she wants to get back in bed after being up for 5 minutes. The cycle of getting up begins again. I do not want to lose my job from frustration. I need some advice.
I work with her at night from 830pm to 530am. There would be periods of a week when she will sleep calmly and wake up only twice the whole night. Lately she has been up constantly. It is driving me nuts!! When I mention these things to her son, all he says is "I know, I know" and walk off frustrated. It seems like she does it because she knows her son is upstairs sleeping and she can get away with it by yelling for him. I am about to give up on her. I have been with her for 9 months now. The day shift worker says she does the same thing during the day and she has been with her over a year now.
She does become verbally and emotionally manipulative. When she sees my frustration she starts asking me if I am ok and starts apologizing. I tell her I am fine, I am just trying to figure out what she wants me to do. Like I mentioned, all she does at this point is shrug and says that she does not know. I do not want to injure myself or her, so I am in desperate need of some suggestions. I even tried calling the client coordinator and all I get is, "She has Sundowners and that she will get worse" HELP! I have taken care of clients with Dementia and Alzheimer's disease but they are always cooperative when distracted. So I know she knows what she is doing and will not stop once she gets started.
Anyone with suggestions?

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I remember when my kids were little and when my 92 year old nana lived with us, every once in a while, even in the middle of the night, I would give them a warm bath. I don't know if you can get her in and out of the tub, but sometimes changing their state is miraculous. Good luck, dear caregiver.
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Thank you for all your responses. I have talked to the son, but he is always making excuses for not giving her the sleep aid. I am trying to get him to be proactive with her in that area. She was behaving good last night, only up 4 times. She does have attends on, but she still insists on getting up because she does not want to wet them which is understandable. The thing with that is, I am not sure when she really needs to go and when she is unsure. She starts yelling after a while needing to get up. I will see if the son can talk to the doctor about the "sodium" check. He is so tight with budget, it seems. For example, she was having side pains when I first started working and her son started telling her that it was going to cost 4 grand just to take her through the ER. I was shocked! So, it is hard to work with him on matters that pertain to her well-being. It is frustrating and I do what I can even when she becomes unbearable. I wish I could take her somewhere, but I work late hours from 830pm to 530am. I even suggest to her that maybe sitting up in her W/C for an hour or so if she is restless, she will refuse right away. I run out of options at night. My last resort is to wake him up and have him talk to her. It does not help most of the time. So, I will talk with the supervisor and her son again. It is not like I am just wanting her to take the sleep aid, I want her to get the rest she needs. Yes, I end up just shaking my head when the son won't give it to her. I document, document, and document so that if she hurts herself, it will be due to her constant "getting up" and weak knees. Thank you for all your suggestions.
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Kalexa is right, electrolyte imbalance can throw things off. But don't encourage regular table salt. Use Morton's Lite Salt, which is a balance of sodium/potassium/magnesium.
As for sleep, if he doesn't like drugs ask if he would give her Nyquil. It works very well for a good night's rest.
Dark Cherry juice has melatonin, and tastes really good at bedtime, and is totally natural.
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Sometimes low sodium will cause crazy acting, worse at night. Urine infection and dehydration, all can cause this. Try to get son to agree to have labwork for urinalysis, sodium and revisit sleep medication with the MD. Sounds like you are doing all you can and it is a very difficult situation.
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A thought that comes to mind is that she seems to be playing a game. Have you considered taking a time out from the house. Perhaps to do an errand or ? (regain some sanity) Is the son capable of watching her while you are gone? I don't understand why you need the son's permission to give the sleeping med.
This situation sounds unbearable. What is in the patients best interest? Getting a good nite sleep or not. Try to be strong and give yourself a break away too.
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It sounds like you are a paid caregiver. So your hands are a bit tied. I would at the very least, suggest to the son that he have a conversation with Mom's doctor about the use of those sleep aids. If she has them and they help, for crying out loud use them. But you need him to be on board. Perhaps your coordinator needs to discuss that with the son as well.
If she really isn't using the commode as she thinks she must, i.e. not 'going', why is she not in Depends? At least it would cut down on the getting up and down all the time and worrying about lifting (for you) and falling (for her).
This is one of the hardest kinds of problems, you truly need son on your side. But I don't know if Mom has dementia or she's just being naughty. If she's naughty you need to treat her like a naughty child and refuse to be manipulated. Use the same skills you would use with your toddler. Truly sometimes, that really does work. Best of luck...caregivers are always in my prayers.
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well my mom is 90 and I take care of her. Yes they are manipulative and argumentative and my mom is that. Today she was very trying because nothing was going her way. Something went wrong in her apartment and she was crying and acting like a child. I simply told to stop it, because it wont work. You have to remembe sometimes they are in their second childhood and you are the parent. You
do loose patience I did today. When i came back to her apartment after shopping for her she was okay.
we are here with you. Pami
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