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Last January, I hired a caregiver for my 92 year old mom with moderate - going into severe - vascular dementia. They hit it off and within 3 months mom really accepted R***. R*** was very good at what she did and had a routine down with mom that worked well. I also treated R*** like family. The better I treated her, the more I noticed the last few months she felt comfortable enough to flip on a dime and yell at me, throw things, and then sob for HOURS. I even took R*** to a doctor with my mother in tow in the backseat! (R*** canceled the appt for herself anyhow) - She has been giving me red flags left and right. And poor mom. It is hard for her to warm up to people and she literally loved Ruby and depended on her, trusted her presence. r*** began telling me she fantasizes about slitting her throat in the mirror and has determined how she will kill herself someday by jumping off a bridge. i always knew she was a little "off" but i thought she was just immature for the longest time, and she never, ever hurt mom. mom liked her a lot. knowing this, I should have fired her on the spot. But, no... in my bad judgement I told her she probably had a chemical imbalance and I would give her a vacation or whatever she needed.... I had never seen her hurt mom and mom could still tell me if R*** hit her or something. Mom never did. She loved being with her and finally trusted someone. So... I waited because I had nobody else, and 2 nights ago R*** began flipping out on me while my mother was asleep. I asked her to tone it down before she woke my mother and she kept yelling anyhow so I told her let's not do this anymore. I will find a replacement, just please don't leave me high and dry until I get one. she agreed. The next day, I took mom out for awhile to give her a break. She told me via text she would be back at 2. That was 10:30 AM. By 11:30 she wrote that "circumstances changed and I will not be returning. I left the key and the garage door opener on the baker's rack." That was it. Nothing else. It is like being the toll collector on a busy drawbridge and saying, "hey, see ya, good luck!" and throwing the door open and leaving the traffic piled up. I consider this abandonment. She did not come from an agency. she was a personal hire privately who gave me tons of great references, resume, the whole nine yards so I have no recourse but i feel very betrayed. It is a cardinal sin in the world of caregiving to desert a sick client that relies on you. I scrambled and got help the same evening coming in from an agency, so for the moment, things were okay. then the next morning after mom woke up to the new girl, I walk over after a bit - 2:00 pm to be exact. Mom is in her nightgown still. No wig on no make-up, crumbs on the kitchen tablecloth, mom is walking alone (this can't happen) through the house wearing her SHOES UNBUCKLED with her heels coming out. Bed isn't made... Now I don't want to complain because in reality, we are getting a different girl today at noontime. But the thing is, mom wants Ruby. She said she doesn't want a stranger in the house, and by having to bring in temps, they are all switching days and hours and everyone really is a stranger. i ended up writing a 3 page schedule or routine for mom for each one to read, but bottom line, mom won't cooperate with them. she was up until 9 last night (bedtime is 7) with her shoes on and fully dressed and argumentative. And for the first time ever, she said she was going to talk to dad about this (he's been dead since '09) and she will also have a word with her mother! Then she called me her cousin. I am her only child. She has never done that before. Her eyes looked "off" to me and I ended up having to give her a mood pill before bed just to settle her down. I told her we would talk about it in the morning. Well, now it's morning and the girl just texted she won't take her morning pills. I'm like, come on... this is getting crazy. I will find a perm for her here in the next couple of weeks, but obviously it will have to be someone really willing to earn her trust and understand dementia. I am a nervous wreck and at the end of my rope. If R*** could have just maturely said I am giving 2 weeks notice or whatever, I would have had a degree of respect left for her, but to literally desert mom in a sneaky tricky way like this... is unforgivable. I am glad she is gone. She turned out to be nothing like what she acted like for the first 8 months. But I had to call the doctor, figure out the pills, and get an expensive temp agency in there fast. I am stressed to the max right now and mom is rejecting everyone that comes in. Advice?

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Happens to a lot of us; on every other forum I've been on, we have the option to edit our posts and can delete out information we might later prefer not to have provided. But this forum doesn't allow us to edit our own posts.

I can certainly understand your frustration; you've been through a lot.

You can write to the admins here:

https://www.agingcare.com/contactus.aspx

You're in a similar situation to others, trying to do the best for your mother but meeting with opposition head on. It's a really tough position. There comes a point at which someone has to recognize that he/she has done all she can on a particular issue and needs to focus on her/himself before she/he becomes ill as well. I think you're at that decision point.

It doesn't mean that you need to give up on caring for your mother. Just change your approach and tell her you've done all you can; you just don't know what to do any more because she isn't working with you. She might have a fit, become angry, provoke a situation, threaten, or who knows what. Then tell her that she knows you can't take care of her, what exactly is it she expects you to do for her? Then leave, go home, and let her think about it.

Dementia can prevent her from thinking clearly, so that might not be a solution. But if part of her actions are behavioral, she just might realize that she's not helping herself by being so uncooperative. With dementia, it's hard to tell - it's not easy to factor out the irrational activities.
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Well, maybe the admin could just delete it. Again, I was on a rant. I don't post a whole lot, at least I hadn't until recently, and I wasn't thinking. Last thing we need is a scam artist coming on the scene. how would I ask for the admin to delete this? I just wasn't thinking when I put the name. It wasn't intentional. i'm just exhausted this past week. It feels like it's been 3 months.... mom just WILL NOT accept anyone else, any other outside help, and somehow, in the name of everything holy, my period just started again, just like when I was young... same cramps, everything. I know my hormones are whacked out and I need to go see the doctor, but it came on literally the day after mom's world (and mine) fell apart... So, long story short, please admin, delete this post as 'names' weren't put on with deliberation.
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Nikki, my thoughts were that there's enough information on the site to figure out who the parties are. E.g., you have a photo of your mother (google has photo matching capabilities, so someone might figure out her real name, and even trace farther to determine where she lives).

From your profile, this can be gained: You're 49, your name might either be Paula or Nikki (so someone can search for your mother by photo, and a daughter named Nikki who lives across the street). And you both live in Palm Harbor, FL.

Ruby has mental issues; perhaps she's seen a clinic, but she would likely have a family, somewhere.

Your mother is a vulnerable person, even if she is feisty. Your post has already been picked up by Google, despite the fact that this is a secure site. Some skilled in Internet tracing could spend some time to locate you, your mother, contact you pretending to be a compassionate caregiver, and scam both you and your mother.

My concern is for the protection of all the vulnerable parties from online predators.
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Nikki, your mom already been diagnosed with Vascular Dementia, so I'm not sure I understand your comment about " obviously, dementia". The good news is that many geriatric psychiatrists are good at figuring out what meds, in what dosages work for elders with kind of behavioral symptoms your mom is exhibiting. Good luck!
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Seeing a person specializing in geriatric psychiatry does not automatically mean "dementia." Such people treat the entire range of symptoms and diagnoses as other psychiatrists, but for elderly patients.

You are right to be excited to have this option. It should be very helpful. But don't anticipate the conclusion before you hear it from the doctor.
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GardenArtist: Good catch!
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Gardenartist, I didn't think I gave her last name on here? But I understand. Sorry!
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Nikki, may I suggest that you not name specific caregivers on a public forum? I was concerned when the former caregiver who left abruptly was named and I see it's still being done. Not only are these people entitled to their privacy, but it's just safer not to mention people by specific name.
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update: Mom's temp caregiver, Marlene, called me tonight to tell me she is a contractor for visiting angels. she said that she sees how hard I'm trying with mom, and that if she leaves before our permanent caregiver arrives 1st week of Jan, mom will decline with another "strange face" and she won't do that to me. she told me she has the choice (not the agency) on how long she stays with mom, and that she will stay with her until Holly (new perm lady who is a long-time friend of family) gets into town and she will buffer her the first few days. I feel like Christmas came early right now. Now, if only mom will settle down.
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NYgirl, Xanax doesn't seem to touch her. Sunnygirl, I'm so overwhelmed just because I keep getting phone calls from the temp agency that mom won't let the caregiver help her and keeps saying "you need to leave"....
Anyhow, today went at 1:30 to dr. appointment. Deliberately withheld behavior meds to see how she'd act. holy cow. she performed (out performed) herself. She got to the point where she stated to the doctor, "I'll just get a gun and kill myself~" OH GREAT! Now the doctor says take her to the emergency room for a psych eval NOW.... and if you don't, I will have the police at her home at 5 to escort her. Now, 5 min later, mom doesn't even remember saying that. 20 min later in the waiting room at the hospital, she doesn't remember the doctor's visit at all. I'm thinking we are screwed they will Baker Act her - somehow by the Grace of God they didn't though. We were there SIX hours and finally she is on SEROQUEL 25 mg for 2 weeks until we can get to a geriatric psychiatrist for her, which I am actually excited about. We will see how she does on the Seroquel. She calmed down but was slurring her words a little 30 min after taking it... uh oh? I helped her to the bathroom to change her depends. She tried to put on a new pair OVER her pants... that's a first... but all I know is we have 2 weeks on Seroquel and in the meantime we see a person that will specialize in GERIATRIC PSYCHIATRY which obviously means Dementia. Just thank God. I'm fried and my period even started again today. I haven't had it for 2 years and am 49 years old...
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Your mom sounds like she is very anxious. I can't believe her doctor hasn't prescribed something she can take daily to keep her moods even. Things that you take as needed may work on some people, but normally you have to have the anxiety meltdown first, then, take the med. Plus, if you mom has falling issues, I'd be careful with the med they prescribe. Some of them don't cause dizziness or drowsiness.

While you see your mom's situation across the street as ideal, I'm not sure how long that will work. You seem to be pretty overwhelmed about it.
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Hi Nikki. Ask her doctor about Xanax, which can help take the edge off. And because you can give it to her when needed, it may be the calming help she needs to accept new caregivers. If she's calm you'll feel better.
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Hi Everyone - ok to answer a lot of posts... my mom DOES look great. :) She looks 75 some days even younger. Sad thing is her brain is literally dying and her body is not getting the memo. she has wonderful genetics. She never smoke or drank, and was a cook that made 'real' food her whole life. so her body is great - her father lived to be 99! But her brain has the dementia/Alzheimers that has robbed her brother, and her mother (my grandma)... so it's not going to get better. That, I know.
Concerning ruby. She was hired privately by me. I also want to say that for a year, she got plenty of respite time, cash bonuses, and was treated like family. She saw me often as I live across the street from mom, and basically if Ruby needed something, or had a complaint, I addressed it immediately. In a nutshell, if Ruby told me to jump, I asked, 'how high?' She KNEW she was valued and appreciated. There was more to Ruby than the manic depressive flip-outs she displayed 6 weeks ago... before that, there was no sign from her, ever. She was the perfect fit for mom, which is why I offered to pay to get her help; whatever she needed. further, she had no insurance because she did not want her name traceable by the IRS. She was running from a tax bill in excess of $20K, which I found out at the end. so, yes. I tried with Ruby, I more than accommodated; I treated her like gold because she was able to gain mom's trust and rapport; they went out to dinner on me, I sometimes joined for more conversation... I got her a skydiving ticket (she lived for skydiving) - to the tune of hundreds of dollars as a surprise. I feel - even now, that I was a great 'boss' to have because I treated her like blood. I did it because she took the time to paint mom's nails. Because she called her 'honey' and hugged her a lot. I always told her she was our angel and a gem. But the manic depressive illness that reared its ugly head finally exploded. No fault of mine; perhaps no fault of hers. We both decided ok this isn't going to work. but I asked, please let me find your replacement; don't bail. she promised not to, and the next day, she literally bailed. so please understand if I don't have an outpouring of sympathy today for her as my emotions are filled with settling mom down; who never got to even say goodbye to the one person she lived with and trusted. There was no excuse for that and since she was hired privately, there is no recourse.
Now, one thing I want to mention is that my mother has always been neurotic. Truly a base personality trait of hers. I got an emergency appt today with her doctor to get an anxi ANXIETY med. I hope we don't need anti-psychotic, but at this point, I am a wreck because mom will see a new "stranger" every few days for about 2-3 weeks until our new perm caregiver comes in. I have interviewed and have someone extensively trained in this who will come and stay for good. (So they say) - I will treat them as I did Ruby. Time off with pay, all food paid for, all living expenses, use of the garage and the pool. I will treat them like family to the extent that they will get bonuses. But I cannot think of assisted living because in my personal case, my mother is across the street in a paid for house with a dog she obsesses over and loves, surrounded by her pretty things with me a stone's throw away. I can't see moving her to assisted living at this point anyway. She thrives when she is with someone she can bond with. It is just going to be a very hard 3-4 month road for everyone while we calm her suspicions. I have one foot in the grave over this and am still not understanding why her doctor, given all knowledge of mom's anxiety, hasn't given her something to deal with that yet. After today I will know more.
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We had a horrible time finding someone that my MIL trusted and liked. I'm just hoping that you contacted the company that sent the second girl and you complained about the care or NONcare that your mom received after Ruby left. After Ruby displayed her manic, off the wall comment of slitting her throat I would have called 911 and her company and gotten her away from your mom immediately! Even if I would have had to take off work for a week until they sent a safe, caring and competent caregiver. Your mom doesn't have to fall in love with someone just be taken care of and watched over. You can make sure her meds are taken but bed not made, NOT helpiing her walk!, and safety should be reported. Don't worry about Ruby leaving. She needed to. No telling what she would have done in another week with your mom. Hopefully she is getting some help now but that doesn't include you. A little nice story of Ruby is having some surgery or on vacation and will be back in a while doesn't hurt a thing. Let her think she is coming back until she finds the "next" Ruby. Good luck and God Bless....
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Let me tell you a good story. We had hired a caregiver for my mother whose work was 12 hour shifts at night for the person. I was completely shocked when she asked why do I use a computer. I wanted to say you are running a business yet you don't have no computer or a website or ssmartphone?
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You may half to trick her. Tell her it's a friend that's coming over, but you know it is the caregiver.
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After reading about Ruby I hope Ruby finds peace as being a full-time 24 hour a day [168 hours per week] live-in caregiver is very difficult work physically and emotionally, and then throw in dementia into the mix and there could easily be a melt-down. Anyone of us doing that work would break down after awhile.

Nikki, it might be better to have three separate caregivers, each one taking an 8 hour shift... thus they get to go home and rest up for the next shift. And have another set of caregivers for the weekends to give the other gals some breathing room with weekends off. I assumed that Ruby never had any weekends off.

I realize that means a lot of different personalities for your Mom to learn, and if she can't maybe it is time for another level of care at a continuing care facility. Otherwise you will be going through this situation on a regular basis.
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I am hoping that people will someday learn more love and compassion towards people with suicidal depression and mental illness. I am pretty shocked by the things being said here, shocked at the lack of compassion for Ruby who gave great loving care for the mother until she couldn't hold herself together anymore, and then left so that she would NOT harm anyone else. No wonder suicidal people go through with it with this lack of compassion.
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The letter from Ruby that Nikki999 is a great idea. Maybe "Ruby" could be the one who is sending people to take care of your mother.
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To be honest with you, you are very lucky Ruby did not harm herself or your Mother in her current mental state. You dodged a bullet there. And for caution sake, I would change the locks on the house and get a new key. Someone as unbalanced as Ruby ("she fantasizes about slitting her throat in the mirror and has determined how she will kill herself someday by jumping off a bridge") may return to your Mom's house if she determines she "made a mistake and now needs a job/money" and will attempt to re-establish a relationship with you or your Mom. For piece of mind, I'd change the locks.
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I would move on from the former employee and say a prayer that you both got a way from that situation safely. I would take with me the lesson that comments about self harm are very serious and should always be taken as an emergency. People can harm others when they are thinking of harming themselves.

There are some great ideas above on how to acclimate a new caregiver to your household. Introduction visits, kind comments, gifts, etc. are very nice, HOWEVER, I would keep in mind that trying to please a person with severe dementia is not easily done. Some patients are extremely difficult and no one may please them. Your mom may not be happy and content with another caregiver. But,that's okay. I would do my best and then just accommodate as best you can.
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As a paid caregiver, I can tell you, that with all Ruby had going on, the most loving thing she could have done for your mom was leave... maybe it has thrown you and mom into an inconvenient tailspin.. and I feel bad for you about that. But somewhere in her illness, she understood she was causing harm..... and left...
I totally understand your being so upset.... and hold no blame for you keeping her after you saw the red flags..... sometimes we let things ride because we are so overwhelmed by our life, that we don't realize until later, action should have been taken sooner.... no blame , no judgement....
And yes, mom may be upset for a little while, this is only temporary.... we never get to have perfect circumstances for our loved ones.... life has a way of getting in the way.... I am sending prayers that you get a good CG that appreciates that you give people chances, that you did care for your CG.....that is awesome in my experience of being quickly 'disposed of' at the families convenience... no warning, ect.... double edged sword...

It will work out..... it's ok for mom to be stubborn right now.... you are doing the absolute best that you can to remedy the situation.... have some faith in yourself that it will all work out for the best....hugs and prayers for you and mom.
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Put your energy into finding a new caregiver. Plan to pay more. I don't even have to know what you were paying to KNOW that because anyone paying market rates would have fired her ass long ago. Your job is to care for and protect your mom. A two-week notice?? Are you kidding me?

Go thru an agency that screens people. In the meantime, and probably minimally, use a temp agency. Reassess keeping mom at home.

Lord in heaven.
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Wouldn't it be great if a good cup of coffee could solve all our problems? We've used two different agencies over the past five years. The very first caregiver was outstanding and we were lucky enough to have her for a year. The very last caregiver was very good and mom adores her, we had her almost a year and even though mom is in a NH now we still have Star once a week for five hours to be a "companion" - she takes mom out to lunch, gives her pedicures etc. In between these two angels were about a dozen barely competent, "better than nothing" helpers. We used the first agency for four years, the second for one. I wish I had changed agencies a lot earlier as the professional approach of the second was considerably better - which made everything better! So my advice - if you are set on keeping mom at home, just keep looking for the right person. It's very hard to continually go through new people but when you find the right caregiver it can make all the difference. When someone isn't working out make the call and ask for a new caregiver. My biggest mistake in that whole process was setteleing - thinking "they'll get better" or "they just need more time". Good luck!
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BTW, your mother looks better at 92 than I look at 71!
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Expect a lot more answers toward mid afternoon and after dinner. That's when the forum really gets active.

It did occur to me to ask whether you have any friends or your mother has friends from a church or other group that might pitch in to help until the situation has stabilized. I think even if the friends just come visit, it might help to provide that sense that she's with people she knows. They can just sit and talk to the both of you, or just her.
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Nikki, I see you posted on this same issue twice. That splits up the answers and prevents posters from reading what others have written, which often helps those who post later to see what's been written, enhance, comment, or in other ways address it.

You'll get better feedback if you don't have 2 threads written on the same questions.
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BTW, Ruby might have been crying for help with her comments on suicide.
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Step back for a minute and set aside the abandonment issues. Ruby obviously had severe mental problems. You admit you saw instances of this and other than take her to a doctor didn't realize the complexity of her mental disturbance.

Someone who fantasizes and discusses suicide (absent debilitating conditions such as ALS), is not perhaps immature but has serious mental issues.

It does no good whatsoever to analyze her behavior or be angry at her given the demonstrated emotional problems. You made a mistake in not addressing these when you first discovered them, that didn't happen. Just admit it and move on. Ruby probably has enough to deal with as it is and doesn't deserve criticism for abandoning you given that she's considering suicide.

I would try a therapeutic fib and tell your mother that Ruby has become very ill and had to be hospitalized indefinitely, and has been advised by her doctors that she'll never be healthy enough again to care for anyone else. That takes her out of the picture permanently.

If your mother doesn't believe that Ruby will not be coming back, use another therapeutic fib and write a letter from Ruby explaining that she has developed a serious illness, something medical that can't be cured, that she really enjoyed working with your mother...whatever...so your mother can recall those positive moments, cherish them, and be primed to move forward, eventually.

I assume you've spoke with a few agencies and explained the situation, as well as the fact that your mother wants Ruby, isn't cooperating, and needs someone with a great deal of skill to have the insights to handle her?

I think when a new person enters the home environment, it's best to just sit down, chat, get acquainted, and let your mother become used to this person before any actual "work" takes place. Find out about your new caregiver's backgrounds and interests, channel the conversation toward those interests so she can be enthusiastic.

And brief her on your mother's interests as well so she knows how to play to those. Maybe even buy something your mother had wanted, a bottle of perfume, special lotion, book...whatever...wrap it and have the caregiver present it to her as a present. There's always the possibility your mother will throw it on the floor in anger, or something like that, but she may also moderate her position after the caregiver has gone.

It isn't easy acclimating an elder to these changes; we discussed this in the Alzheimer's Creating Confident Caregivers class: older people are uncomfortable with changes, with new people. You have to find away to acclimate her to the caregiver, perhaps even pretend that the caregiver is visiting you, pretend it's a friendship, let your mother participate if she wants, but don't even mention the concept of caregiving until you mother begins to warm to the new person.
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Not slitting mom's throat!!! Her OWN throat. She had episodes of mania that she kept hidden for 9 months... I just need to know how to handle getting mom to accept licensed help - esp if there are a couple of different people relieving each other's shifts. Mom won't have anyone else! I told her R*** had problems and she said, "No... she just needs a cup of coffee..." UGH!
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