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My client is in her 80s and capable of ADLs but her son hired me to care for her since she has Alzheimer's and she lives kind of unhealthy (eating snacks and sleeping all the time). So sometimes when she's napping she'll constantly tell me to leave and go home but she is not my boss, her son is. Then, she'll say that it's her house and I'm like a homeless person staying there. I'm not sure what to do in this situation. Advice is appreciated!

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Sounds like maybe you have some new "tricks" up your sleeve to try out. Some people say be tough - doesn't work. There is no way to reason with, argue with or force someone with dementia to comply, so you have to be "creative!"

Discussing this with her son, perhaps a change of time might help. Many times people with dementia can become more difficult later in the day (sun-downing.) If having at least one good meal in the day is part of the goal, perhaps mid-day would work better?

I know your frustration - mom was like this too! Still somewhat "capable" but needing some oversight/checking, but after a short while she refused to let the aides in. In the end we had to move her to MC for her own safety and well-being.
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To me it sounds like the client with ALZ is in an early phase, since she can still do ADLs and housekeeping but her son wants medication management and someone checking on her daily. Since she would most likely have more problems late in her day, that would explain the timing of the care giver's shift too.

I suggest being very honest with your client, saying things like: Your son wants to support you living as you wish in your home but he's concerned about you being here completely alone. So I'm here to ease your son's mind by helping with your medications and just being a daily check that you're okay. Your son would also like for me to do some things that might be easier with a second set of hands, like changing light bulbs or laundry. My agency requires a four hour shift and I cannot leave until my shift is over. I would prefer to have something to do, but if you don't have anything for me to do, is it okay if I sit at the kitchen table and read my book?
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How are things going, Cookiebear? Any better?
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Cookiebear Oct 2019
Yes, thank you all for your answers! I didnt expect to get this many responses, very helpful haha
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Why would you listen to an ALZ person. You can’t listen to anything they say.
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Isabelsdaughter Oct 2019
That is so true!
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The client doesn't get to decide as her brain is broken.
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Edit: I now see that the woman has Alzheimer's, so some of this may not apply...

Try to engage her in Grandmotherly types of things. Ask her "do you know how to crochet, sew knit, make this type of casserole, cookies or to make spaghetti sauce"? Tell her that your Grandma died when you were little, and you never learned her "special" recipes, or how to do those "old fashion" things, especially baking and such, and that you would really Love to.

Then once you got her in the mood, suggest to her how you two can start preparing for the holidays, or you can help her to get ready for Christmas, buy her gifts online, decorate, and wrap her gifts. Find ways to be needy and useful at the same time.

Once she learns to trust and depend on you, you will become indispensable to her, and hopefully you will come to enjoy working with her too!
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I have no idea what ADL is but does he have a Power of Attorney? If so, let him tell her in no uncertain terms to stop or else........ And you can say he is your boss, she should speak to him directly. And tell her yourself if she does not stop with her "nonsense", she will be removed and put into a facility. I have been through too much in my life and have been harmed by people with mental problems so my compassion for them is now gone. Be extremely tough and tell her like it is and if he starts in on you, just go into another room and ignore her after you tell her off. This may sound cruel and heartless but it works and it will save your sanity.
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Llamalover47 Oct 2019
Riley: Abbreviation for activities of daily living.
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I agree, talk to her son. He may even know some way to deal with her. If not, if she gets too unbearable, you can always quit.
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Just tell her what you here - I'm sorry, but I cannot leave because your son hired me and he's my boss. You need to talk to him....or.... I can ask him what he wants me to do. It's really about not engaging too much in the conversation with her other than something like I'll have to talk to your son.

If she's not in a really bad mood, tell her she cannot be alone all the time. Ask her if she would rather live at a 'home' or facility... just to see what she says, Probably the answer is going to be she just wants to be at home alone, so with that you can tell her that the son cannot leave her at home alone anymore.

If that doesn't work, you'll just have to ignore it and grow a little rhino hide! Best of luck.
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It sounds like you're there late afternoon until dinner time ?
frankly, this is the toughest part of the day
is there anyway you can suggest to son to maybe switch up and be there late morning, cover lunch and leave as she goes down for a nap ?

they get tired, cranky and sundown in the afternoon

if you can connect with her earlier in the day then it might help and she may even take up a little activity with you that she'll begin to look forward to - puzzle, short walk weather permitting etc
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talk to the Son, maybe the two of you can come p with a plan
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Suggestion: Have the caregiver tell Mom “thanks for being so considerate. Unfortunately, my ride won’t be here until [whatever time she’s agreed to be there] so I wonder if I might just wait quietly in here [some room that will not disturb Mom’s privacy] until they arrive? Meanwhile, if there’s anything I can help with as long as I’m here, please let me know.” I tried this with a woman whose son had insisted she have a caregiver. She complained, I kept showing up with a smile, and before long she asked me to make her bread pudding. I admitted I didn’t know how and that was the magic moment for her. She was now my teacher (and a very demanding one she was, of course). I learned to make bread pudding, and she got an active role in our relationship. Before long I was “learning” how to wipe off a counter correctly, how to clean a bathroom correctly, how to help her with exercises correctly, and even how to read to her correctly. As long as I loved her curmudgeonly self just as it was, we got along. Pretty soon I was the only caregiver she tolerated and I was also her son’s hero. May have been a fluke, but give it a shot if you can get the caregiver to agree to this role of “student”.
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my2cents Oct 2019
Great way to handle the situation, lindabf!
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I don't know what your training level is with dementia and als, but you may want to reach out to your local Senior Services and ask if there are any programs for a caregiver of a patient with dementia or if they can direct you to some. Where I live there is and it helped me tremendously. I learned to understand the behavior and it made things less stressful for both. It is still a tough road to tread. Maybe you can, as suggested above, leave the area when she goes into her rant. When you return try to redirect her into some fun kind of thing. Check with her son what she used to like to do. Simple easy things. I have learned from visiting the nursing home that if dementia patients are not kept busy they get all kinds of strange behaviors. Did she like cooking? Maybe she can help you cook the rice, peel the potatoes, fold towels, anything easy that she can do with out frustration.. My brother was a musician - I bring easy music sheets and have him name the notes or symbols. He spends hours doing this and loves it. I also have him draw music out of music sheets.
I hope some of these suggestions can help you. There is a lot of good advice in this forum. Patience is also key. Best of luck to you and all involved.
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cookie, it’s the exact same with my mother - same reasons I send someone, same responses from mom. :0 I’ve been sending people since April and it’s a constant struggle of ‘what are they doing there.’ Mom wants them to touch nothing and do nothing. But if I don’t send anyone then it’s me going to check on her every day instead of every other day. Are you working on a 4-hour minimum? I totally get why providers need to do that, but it can be an imposition on the client to have someone there so long. I haven’t found a solution to it yet! My ideal would be someone that lives very close by and could go for 1.5/2 hours in the morning and then in the evening, but haven’t been able to find that.

To what extent have you been able to bond with her, and let her know that it could be really nice to make friends?
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Cookiebear Oct 2019
I work from 4:30-8:30 :)
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Morning , unless her son has power of atty over his mom you are violating her rights .. until she is declared unfit by the power of atty she can put you out .. now if he is power of atty then you can help her and deal with the decline of the dementia
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Relax, Her on most Likely is POA and Then Some, Hun, Of Mommy Dearest. You Stay.xx
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disgustedtoo Oct 2019
translate that into English please?
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Have the son's number on speed dial, every time she starts up call him and hand her the phone, let her talk to him about it. Enough calls and that will end.
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Thank you guys for your answers! :)
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My husband’s grandpa fired his caregiver every day. Typical for some elderly to do so. He couldn’t be left alone. My in laws hired live in help at his home and he told them to go home daily.

The caregiver was warned about his behavior and she ignored it and went about her business. It’s unfortunate these things happen but kind of goes with the territory.

I wouldn’t expect any personality changes from him this late in the game. He is most likely set in his ways.

I wish you well and hope things go as smoothly as possible.
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Sometimes we just have to let it go. I think that she can eat what she wants, getting her meds is important maybe. Maybe she doesn't need anything. If she is 85 and has Alzheimer's then trying to change her lifestyle is an exercise in futility, as you are discovering.

Have you talked to her son and asked if he has any ideas how to deal with mom?

I would ask about maybe going outside for a bit to try and reset her time. Such a difficult situation to be in.
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gdaughter Oct 2019
YEah, this client is a total PIA. Just like my mom. And yet, you're needed for safety. One day when we tried an aide, I was walking out with the aide and she was behind me a couple feet and as we left the room mom was in, she heard mom say "Get LOST." We both giggled but didn't know which of us it was meant for. Maybe the son needs to watch mom with cameras being set up, and just make sure someone like a neighbor or someone will pop it to make sure the meds are taken, if they are essential. Maybe they could be taken at a different time of day. The problem from the son's perspective is probably wanting to do his best to keep mom safe, and the agency is probably saying he can't have service for less than 4 hour shifts.
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I would tell her after you take care of xyz you will head out. Then get busy taking care of those items.

Try to stay busy and out of her way while she is wanting you to leave.

Talk to your employer about this and ask them if they want you to say anything specific.
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Cookiebear Sep 2019
Thing is, there isnt much for me to take care of. My regular duties are to cook rice and make sure she eats her meals as well as making sure she takes her meds which is 10mins before I head out. She honestly doesnt even want me touching anything so there is no excuse for me to do anything in her house. She also doesnt want to eat dinner so I'm not sure what to do about that either even though it's part of my daily duties
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