My Aunt is in assisted living. Last summer after she returned home from a fall, hip break, and surgery, I hired a visiting angel to be with her for the afternoon and evening as she has no self motivation and short term memory loss. It has been successful until recently. We had to change weekend caregivers and the bad weather has meant some angels couldn't come, and the agency seems to send a different person on the weekend days.
I live 60 miles away and can't be there to meet all the angels and keep an eye on things. I've been in touch by phone and go up there once a week.
Recently there was another fall. Nothing broken. But a mental decline again.
She did not go to rehab, but needs a wheelchair. The angels came all of her waking hours for a week, then we went back to the afternoon and evening shift.
Still lots of new faces. Last week doctor appts made it necessary for me to be there two days in a row. I was on the phone and heard arguing in the bathroom. The facility caregiver had treated my Aunt in a way that upset my aunt. I had just found this same caregiver had forgotten to take my aunt to lunch that day. I also knew my aunt had missed lunch the week before, and I had twice reminded the nurse that my aunt's care required that she be escorted to meals. After the bathroom incident I told them that caregiver was not to be paired with my aunt under any circumstances.
Aunt is upset now. She doesn't want to see anyone, let anyone in her room and won't even accept her favorite companion and caregiver.
My aunt needs someone with her but how do I stabilize this situation? How do I get there often enough to check on her.
How serious is it to move her? My stepfather only lasted two months after I moved him, his decline was dramatic and shocking. (He went from home to memory care).
Do I have to give up my job and my friends and move to where she is? (I could live in her house, which is empty).
I'm single and have no help. My aunt's weekday caregiver will stop and check on things when she is out and about. But clearly my aunt had been neglected and manhandled by a staff person for several weeks before I knew it. And the caregiver was fretting over the lunch issue and hadn't seen the other problems.
My Aunt can't tell me when things happen. But right now she is seriously feeling unsafe and combative. Even with her favorite caregiver. And even with me. I spent one day with her last week, and she was clingy and wanted lots of hugs. She told me over and over how much she loved me. She was just feeling safer and cared for. It broke my heart.
Is it time to move her to a memory facility? Do I hire someone to be with her all waking hours, but then who monitors them?
Can somebody help me think this through? Bless you.

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It is time for a higher level of care, Assisted Living is too much for her. She needs medication to quiet the combativeness. Talk to the staff at AL about proper placement, and talk to her MD about medication and whether or not it is time for Hospice. Do not give up your job, she will be combative with you and you will risk charges of abuse. Just make her comfortable with meds.
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My Aunt has a sensitivity to medication. Her doctor won't prescribe anything after changes in medication have resulted in falls. She is a consistently sweet and loving person, but the personality changes have come with the increase of caregivers, and the rough treatment by one facility staff member. She doesn't like so many strange faces and she cannot tolerate having all control taken from her. Her thinking is clear enough that she wants her requests to be taken seriously and the facility staff member was ignoring those requests. If no one is with her, she sleeps. Her physical condition is stable. She has no disease.
When her favorite caregiver can be there, she calms down and is fine.
I keep thinking I can rearrange things to stabilize her life, perhaps with just another agency and consistent staffing? She was fine when that was in place.
She has enough mental acuity to joke, laugh, and (mostly) follow a conversation. I don't get a sense it's time to give up. More that fine tuning is needed. Am I trying too hard?
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Find another doctor, I would recommend a good Neurologist who specializes in elderly with aggression issues. If you don't do this, the facility will boot her out for safety issues. If she is combative, she is going to get hurt. You need to accept the reality that she is not mentally well. If you really want to keep her out of a rubber room, get the proper meds.
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Twinflower I don't have great advice for you, I just wanted to say I'm sorry you and your aunt have to go through this. She's lucky to have you watching out for her. It's so hard when you see a frail loved one treated without the respect and care they deserve. Good luck in getting your aunt settled and feeling safe again.
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I am happy to say that Aunt is back to her sweet self. Once her favorite caregiver returned, we all sat down and talked about it. Aunt understands that we did not approve of how she was treated, or that she had to endure all the strange faces and that we fixed it. I found a weekend caregiver who can also fill in if needed and if Aunt likes her, that will help as much as it can, life being what it is. Aunt is learning to trust again and has calmed and is back to herself. I'm so grateful.
After talking to people and the nurses and administrator at the facility I came to understand things better. The aide was doing her job but there was no discernible clues that she was working with a person. No expressions of concern, no asking if aunt needed or wanted anything, no interaction at all. And especially disregarding aunt's requests. The aide did what she needed to do to take care of my aunt as quickly as possible and then leave regardless of what my aunt wanted or said. And she kept forgetting Aunt for meals, but when asked about that said " I remembered her for breakfast, I did that right!" Apparently that is not unusual, and the nurses and administrator were aware of that type of dynamic in their worker and found it expedient to simply move the aide to a different floor.
I heard stories of my Aunt being in tears and nobody seemed to see a red flag, which is really disappointing.
I remember my stepfather getting a label as combative and a danger to himself and others when he was in the hospital. Again, we are talking about a very mild, sweet man who never raised his voice or caused a bit of problems even with dementia. When I asked what happened, I learned they wanted him to go to bed, and instead of waiting for him, it was more expedient to grab him by the arms and force him. Much like what had happened to my Aunt. I realize everyone is busy. But force is so damaging and disrespectful. I don't understand how it is tolerated anywhere, yet it seems to be commonplace.
In any case, I wanted you to know that we got through this spell. I know there is another chapter in the story, but Aunt is happy and safer and I am much relieved.
I wish I was more computer literate. I feel so at sea where to find the comments and community so I can follow and offer support. Bless you all for taking the time to read and respond. I know minutes are precious. I will try to figure out this website enough to navigate a little better. I would like to give back a little as I have received so much help and support here. Blessings.
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