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littlemisskitty Asked October 2017

Threatening phone call from the care company my grandma is with. Looking for ideas.

So I got a threatening phone call today from the company my grandma is with. She has been yelling at the helper to "leave her alone" and hitting her in the shower. I was told if it continues then she will be seen as refusing services and that will be turned into the state and other arrangements out of my control will have to be made since she's 88, with serious dementia and a ward of the state (or so they claimed). What is out there for calming agents for dementia? I made an appt with her doctor on Monday but was trying to get a feel of what to talk to him about and what options to mention to him that has worked for others in the past. Her doctor listens but honestly doesn't seem real knowledgeable about dementia and the helping agents out there. Is there any herbs or over the counter things that might work or perhaps a certain drug or two I should mention to him to try? I don't want to sedate her as she's still walking and talking and obviously strong enough to hit and beat up people. I have tried to shave her nails down to nothing to prevent nail marks on myself and others. I have tried to avoid the triggers and set routines. She has pain relief in the terms of nerve blockers and tylenol more often than she probably should but was told she wouldn't live long enough to see the effects. She's on one dose of motrin a night to help with that time. She's sleeping wonderfully and eating great, it's mostly the dressing and the showers that set her off. is there a drug that works for an hour or so and then wears off quickly so she's calm during the shower then back to herself able to walk and talk afterwards? Just looking for ideas. Thanks.

Lymie61 Nov 2017
I'm so happy to hear that it has been going better and in fact she is even taking a part in being helpful littlemisskitty. To me that's an indication of her feeling much more secure and in control, happier. It sure sounds like the regular aid is more of the problem. No doubt the sore as you say contributes and maybe the comfort stuff but sounds like a big difference in GM's behavior and enjoyment (for lack of a better word) as soon as she was gone. I would make clear notes about the differences including dates and times if possible then share them with the company for one along with a complaint about the phone call you received and perhaps threatening the same reporting they threatened you with if they aren't appropriately contrite and get a new regular person. Not sure I would even want her back in my home to give her another chance. You could also consider another company all together but that depends on how much you liked them prior to this phone call and the details that had yo choose them in the first place. There are so many variables with each case. Tuck those detailed notes away in a safe place though in case you need them in the future and maybe keep making notes about anything of even minor significance, it could be helpful in the future both for GM's care & medical stuff in the future and or should you get threatened again. Oh and I would ask the company about that "ward of the state" comment and then follow up and make sure everything is in order legally the way you think it is and want it to be. It's always better and easier to get those ducks in order when it isn't a "situation" or medical emergency. Keep up the great work, your GM must be a special person to have helped create the angel you are, a granddaughter with so much love and the two of you must have a special bond.

Talonsgrandma Oct 2017
I agree that it is not necessary for your grandma to have a shower every day. Just a quick wash up in the morning should be sufficient. Also, why put up with the aide who is causing problems? You do not have to have someone in your home who does not work well with your grandma. And I would definitely look for a geriatrician who has experience with dementia. We had no luck with our primary care or neurologists. By God's grace we were led to a wonderful geriatrician who is knowledgeable about dementia behaviors and medications.

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littlemisskitty Oct 2017
The last few days she's been pretty good but then again the regular girl wasn't here. She had her weekend off and last week was only here one day as she called out the other four and we had substitutes two of the days and the other three I handled her. She didn't yell or hit or anything and in fact was helpful. She's being treated for a pressure sore in the groin area which might be what is setting her off. She's now on antibiotics for it and I'm hoping that it was what was causing her fighting matches during the bathing time. If I was in pain while being bathed or wiped I wouldn't want my clothes off knowing that is what they were going to do to me. I could be going on hope that this isn't a new stage but hey I'll take a reprieve if nothing else.

She takes a bath usually everyday but I say that but most of the time help just doesn't come on a day or two of the week so those are the days she doesn't get showers but instead just gets her main rash areas washed by me with wipes. I picked up a wipe warmer for her wiping times and looking into getting a towel warmer but started using the dryer to warm up her towels to help. I have put a heater in the bathroom so it warms up the clothes and room nicely. I also have encouraged the substitutes to add a warm towel to the bath seat so she doesn't scream and get set off by sitting on it. I'm kind of wondering if that is what is setting her off. At night the heat turns turn a bit which makes the toilet seat colder for dressing her and then in the morning she's sitting on a regular bath seat that is hard and probably cold to the touch. I'm hoping by taking some of those link ideas and having grandma try them making the bathing experience more pleasing, then maybe it will go smoother.

Lymie61 Oct 2017
You might try area rehab facilities or care facilities as well as her doctors office and the nurses there to see if they have references either for other agencies that might travel to your area, I know you said this is the only one but if they are that bad maybe someone is starting to take u the slack or individuals that might come in on a private basis. But I'm with the others in saying she probably doesn't need a bath every day or even every other day. If left to her own devices to get ready for bed or get ready for the day what does she do? Might she do more for herself with ques or is she just beyond that?

GardenArtist Oct 2017
Check out these posts and suggestions:

https://www.agingcare.com/questions/best-way-to-bathe-an-elderly-person-who-complains-skin-hurts-219500.htm

One of Maggie's suggestions:

"She can be kept squeaky clean without a shower. If she's afraid, don't try to get her in the tub. Give her that gift of understanding. Don't listen to those who say her skin smells musty. What's that about anyway??

Give her thorough bird baths a few times a week. Pamper her with a pretty talc and generous rub of lotion on her probably dry skin, and call it a day."

And another good one:

https://www.agingcare.com/questions/get-mother-in-law-to-agree-to-an-assisted-bath-171932.htm?page=1

GardenArtist Oct 2017
How unfortunate that the caregiver retaliated. Do you think you'd want this person to continue to come, or would it be more appropriate to have someone else from the agency.

How often do you bathe your GM? I'm wondering if it's daily, and if so, I think you could bathe her less (or just the areas that need it and are more likely to reflect it if not kept clean).

Unfortunately, websites are just promotional and not always accurate. I've found that most of them feel they're superb, top notch, and create lovely grinning angelic like patients. In reality, that's not necessarily the situation. I've found a few in which misrepresentations have been posted, and some direct out and out lies.

Too bad those websites aren't monitored by the FTC and action taken for misrepresentations and false advertising.

Do search for other similar posts as BootShopGirl suggested. You might try to find one by Maggie Marshall; it was excellent in sharing tips on how to make the bathing event one which really makes a woman feel good - like going to a salon and being pampered.

I would try that as well; make the event something other than quick strip down and change, but rather an event that she looks forward to.

There are good suggestions from many posters; I just happened to remember Maggie's because of the way she turns what could be a tussle into something more like an indulgent spa session.

BootShopGirl Oct 2017
Look up help with getting an elder to bathe on this site. At the top of this page on the left hand corner are the bars. It will lead to to the search box. Type in getting an elder to bathe. The next page will show you answers on all the threads that mention this topic. I find great help doing that. Good luck! And Garden artist is right. She does not have to have a regular shower. Sponge baths are fine too. Even 1 swipe at a time lol!

littlemisskitty Oct 2017
My mother passed away 3 years ago from cancer and was POA at that time. She was at a lawyer's office with me when they updated the POA about 10 years ago and since I was present and helping by taking her to a few appointments, grandma gave me durable POA. Since my mother died, durable POA falls to me if I so choose and I did choose.

The agency is just threatening as far as I know. The helper we had, was being fussed at for taking too much time off so she threw out that she didn't really want to go there anymore since grandma had hit her in the face in the shower once. I have been brainstorming ideas of how to handle shower time. The problem is with sponge baths she refuses and kicks over water buckets before and caused messes that way. It's a work in progress. I was even joking with my sister who works so isn't involved in care but will sometimes listen to me as I bounce ideas off her, that there should be a two in one water/soap sprayer made for elderly. I was thinking just like the car sprayers that powerwash with soap and water built in, it's too bad something with lower pressure of course, isn't made to assist in bathing the elderly. I really think it's something to do with either the undressing part or the touching part. I struggle with undressing her at night but I'm fast and not trying to clean her or bath her at the same time. I can afford to pull off shirts and unbuckle bras fast then walk away when she's half naked giving her time to calm down then quickly put the nightgown over her head which calms her down the rest of the way to do her pants/underwear/shoes/socks etc.

I was just trying to figure out if there was anything out there that might help her get through an hour of dressing. I am kind of disappointed in the company ot be honest. It's the only one around here (I'm in a remote section of maine so no other companies exist) but on their webpage they claim they can handle any situation and deal with dementia and Alzheimer. I find it very hard to believe that no other patient that they have come across has ever been easily set off especially at bathtime and that they had nothing to offer me but a threat for a call to be put into the state. Anytime they have asked me to provide or do something, I have always done it so I'm disappointed as well that it has come to this. She's happy during the day just not during the two dress and undress times. Too bad she can't take a shower in her clothes and still be clean.

GardenArtist Oct 2017
First thing I think that has to be addressed is the presumption, which I've seen with home health care staff, that GM HAS to have a shower.

She doesn't; she can take sponge baths or use no rinse shampoos. They eliminate the danger of slipping, becoming too cold, undressing in front of a stranger, and more. And at some point they're just NOT that safe.

That's the first issue I would address. If the caregiver/aide isn't on board with that, raise the issue with the management, and calmly and politely suggest that you would anticipate that an experienced aide would be on board with this (or should have suggested it).

If you get the impression they're inflexible or are ready to call APS, you might consider beating them to the punch and terminating them for unsatisfactory care. That can establish that they're not the only ones with grievances; you have them too.

I find the threat of "turning someone in to the state" and "other arrangements beyond your control" to be entirely inappropriate for this situation. If your GM does have serious dementia, it might in fact be time to consider some other arrangement, but I find it so offensive when an agency (or anyone else) threatens with what seems to be an APS referral.

If your GM has been made a "ward of the state", who would be in a position to know this? Is your mother involved with GM's care? Is there a guardian or conservator? If proceedings were held, someone must know about this. I'd get to the bottom of this and find out if it's a legitimate issue or if the agency is just threatening.

If you're not getting much response from the doctor, find another one, a geriatric specialist who's treated patients with dementia.

You mention that she's been told she wouldn't live long enough to see the effect of certain meds. Has she been given a terminal Dx?

Motrin's just a pain killer; does she have other physical issues causing pain?

As to dressing, if she feels she can do it, why not let her try?

I've found that aides want to dress and bathe someone, but not with the idea of encouraging as much self help as possible. Some have attitudes that the elder is helpless, which isn't always the case. I see their role more as enablers to encourage as much self care as possible, rather than someone taking over those roles.

BootShopGirl Oct 2017
Sometimes ativan works. It's a calm down pill that has a shorter lasting effect. But it can also be bad for people that are a fall risk. You need to tell the doctor exactly what she is doing and that you received this phone call because the shower time is getting that bad.

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