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GuvnaBee Asked September 2016

What should I do when after almost one year with several different home attendants?

my ninety-two year old mum still does not ask them to do My Mum has Medicaid to pay for the Home Attendants, which she calls "Aids". ALso Medicare and pensions from being a teacher. She is ninety two now. The Guild net has provided her now three t=different vendors for these Home Attendants and evaluated her, posting "to-do" lists on refrigerator. Sometimes these Attendantd DO the "light housekeepeng", often times lately, they do not and Mum apparently does not ASK nor command them to do it! Amazing to me, since she was all over me as a boy to do chores, lol I understand she is not energetic like that now and has worsening dementia, and balance/walking issues due to lumbar degeneration according to her neurologist. it is like she is forgetting how to walk! And the Home Attendants do not make her walk with them, I think, if she resists, even though it is part of their "to-do" list daily to walk her up the block and back with the walker. H-E-L-P! I am at wit's end trying to suggest and asking Mum to be more supervisory on them. She has the indoor stairlift by the way, and could ride upstairs to check on them, but does not. Tonight there was a smoke alarm in the house, due to the fact that no Home Attendant of the eight or so has cleaned her oven since the Spring of this year! I remember the last one who did, but she suddenly quit in June. I am the oldest and only son and moving out of state soon for new employment and marriage. Getting DMM ans go between and leaving trusted one on the block to help officially. How to get these Home Attendands to be consistent, devoted, thorough and pro-active is my final summary question to the community here. Thank you.

GuvnaBee Sep 2016
@gladimhere, Two X TS = double trouble. I do not envy you, lol ThanQ

gladimhere Sep 2016
Guvnabee, you can't have a twisted sister! I have two of them and have called them that for probably three years now. LOL! Now I do not feel so alone.;-)

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Ron2375 Sep 2016
Since you are leaving the area another option for keeping tabs on your mother and her caregivers, whether she is at home or in a facility, is to hire a Geriatric Care Manager who can visit your mother and see the care she is or is not receiving and talk with the care givers, etc and then report back to you. A reality here is that if you leave the area you need someone who actually cares to look in on your mother often or more likely or not she will not be cared for well. If you do not have family close by to your mother could you consider moving your mother to the new area you are moving to and placing her in a facility there?

GuvnaBee Sep 2016
All are sage points here. To answer #gladimhere, I have only one sibling who is fifteen years my junio and who we call "TS" (Twisted Sister) as they have their own selfish alternative lifestyle agenda, I found was paying herself to do nothing when I returned to the house I was raised in four years ago, had convinced Mum to not include me on her Will Estate at all (since rectified, now I am POA, Proxy, Executor), and is an extreme feminist man-hater, etc. So, NO help there. The Assisted Living is a great idea, but convincing Mum to do it will likely be an emotional rollercoaster. Thank you for all of your comments on the Home Attendants. Yes, lists do tend to blend into the bacground scenery and I have too busy dealing with annoying workplace ploitics to update them. One reason I am changing careers and moving on before what's left of my life is gone. I am sixty. Kepp the love coming!

GivingItMyAll Sep 2016
To more accurately answer your question, I would suggest you find out from the agency exactly what the duties are of the home attendant. It could vary from agency to agency, so I would get that info and then prioritize. If the aide is interacting with Mom and doesn't have time to do something else on the list, is that ok eith you? Maybe a daily check off sheet would help you to understand what is done with the day. Mom lives with me, and many days when I finally get to bed at night, I will try to figure out exactly what DID I get done today? Maybe tomorrow I can mop the kitchen floor. Maybe tomorrow I can get caught up on the laundry. It's not that I'm lazy or not motivated. I'm busy. Everything with Mom takes at least twice as long to do as you think it should. So to recap, find out exactly what they are allowed to do, what their job duties are. Prioritize. Hire a cleaning service to do a more thorough cleaning once a month or so. Declutter the house. It will look cleaner as well as be easier to clean. Good luck with your new life!

cwillie Sep 2016
GivingItMyAll has it exactly right, if you want a housekeeper then hire one separately from the health aides, but even a cleaning woman is apt to balk at cleaning an oven, and to be honest the oven would have to be incredibly abused to start a fire from lack of cleaning.
Have you met with any of the aides personally to go over the list, do they even know it is there? I find that over time things like notes on the fridge just seem to blend into the background a be forgotten unless they are changed and gone over frequently.

GivingItMyAll Sep 2016
Hate to be the bearer of bad news, but light housekeeping is wiping the crumbs off the counter, rinsing out the bathtub, sweeping the floor, changing the sheets. In no way is cleaning the oven in that classification. Sounds like you need to hire a cleaning service. Also, if the aide asks Mom to walk, or actually anything, and Mom says "no", then they cannot make her. All this that is going on now, will get progressively worse as the dementia and the spinal degeneration worsens. Besides, she is 92, cut her some slack. She's tired. In my opinion, she is likely ready for assisted living. I would be looking into that.

JessieBelle Sep 2016
GuvnaBee, it can be hard to accept the changes that go with dementia and getting older. We wonder why they don't do the things they did when they were younger and their mind was fine. They don't because the mind and body are not working in the same way. Your mother has dementia and her back is disintegrating. The lumbar problem is very painful. If she tells the aides that she hurts and does not want to walk, they cannot force her. Aides can help a person, but they cannot make a person do anything that they don't want to.

I think MsMadge and Babalou's suggestion of a facility is very good if no one is going to be around to supervise your mother's care. I don't know if I would trust a friendly neighbor to take on such a huge task as monitoring the situation. That could be quite a chore. Does your mother choose to stay at home? It makes more sense to move to a facility.

gladimhere Sep 2016
Your mom has dementia. She does not know what the attendants are supposed to do. There is a list, your mom doesnt remember it is there. You mom is not able to "command" them to do anything because she doesn't remember about the list. The caregivers may very well be busy just spending time with your mom. Baba is correct it sounds as if it is time for mom to move to a facility. Is there one appropriate that will be close to you in your new location? Are there other siblings that can help with anything?

Eyerishlass Sep 2016
Maybe the aides spend their time being with your mom and making sure she's OK as opposed to cleaning the house.

BarbBrooklyn Sep 2016
Guvna, i am with Ms. Madge on this. It's time to move your mom to a continuing care facility where there is supervision of her health and care.

MsMadge Sep 2016
My experience is they will do no more than the bare minimum and you need to keep an eye out but agency hired or not you could be left in the lurch if one misses a shift
Is it time to move mom to a care facility ?

Ron2375 Sep 2016
Sorry, I had a typo. I meant to say that if you mom does NOT get walking exercise her strength and balance will degrade rapidly and will be in significant danger of falling and hurting herself. BTW, have you made her house "elder safe" by removing throw rugs, adding rails, raised toilet seats, etc?

Ron2375 Sep 2016
Unfortunately many caregivers do not "care" and want to do as little as possible. If you have caregivers like this then the only way I know of is to have someone, family member or trusted friend, come by and visit on a regular basis but at different times so as to keep the caregivers on their "toes". I would also suggest complaining, with specific details, to the company the caregivers work for. If your mother does get walking exercise she will lose the ability to walk very quickly and then be at danger of falling and hurting herself when she does try to walk, or get out of bed by herself. I cared for my mother for almost six years and had to give up everything to do so. I was glad to do so as this provided her much better care than she would have received otherwise and her love and appreciation made it worth it. I think your mom is entering a dangerous stage where with muscle degeneration and increasing balance issues she needs exercise and someone to help her walk safely and soon she will need help getting out of bed/chair safely and getting to/from and on/off the toilet, etc. I would be concerned about what would happen if you leave and if there is no one, family member or friend, who keeps a close eye on her and knows what is happening day and night. Best wishes.

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