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My siblings and I live out of the area, so we have one sister who has been bearing the primary responsibility for caring for aging Mother. My sister is/has been trying to get cooperation between our Mom and the staff who provide care for her in her home. She (Mom) has a tendency to 'sabotage' attempts to help her with bathing/self care by getting dressed prior to the arrival of the care provider or claiming that someone else (our sister) is going to take care of it for her. Is there a good resource or checklist we could provide to the care provider to ensure this as well as other tasks are done, regardless of the contrary efforts or our Mom?

Thank you

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Ah, yes, the old sabotage routines. My mother's main sabotage was while we were trying to set up the care. "Oh, no, I don't need a nurse to set up my pills. I can remember to take them myself." (Ha!) "My daughters clean my apartment, so I don't need cleaning help." (When we come, Ma, we'd rather play Cribbage with you than scrub your toilet.) And so on. It is not so bad now that the services are in place, though there is still some of the "oh, no, you don't have to do that" to the service providers.

I think the most helpful approach is a talk with each care provider. Especially now that you have a little experience with the situation you should be able to provide some helpful hints. "Even if Mom is dressed when you arrive, and even if she tells you a family member is going to help her, we are counting on you to help her shower." Share all you know about her sabotage attempts. Make sure this doesn't come across as criticism of the service provider. It is just information they need to know about your mother's behavior so that they can do their job mroe effectively.

We have some professional caregivers on the forums. I hope they'll provide some input from their perspective.
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Enter one professional caregiver! Ha. Wow. This is so tender, and touchy. The thing I find the hardest is when the elderly client resists me being there. But my main tool is humor. I like lists from my clients' family or in the case of my Dementia client, the live-in caregiver. In this situation, yes, please tell the caregiver what you're dealing with. I've had a client who explained why a shower wasn't necessary, etc. If I were working in the situation you describe above, I would use the kids by name as my reason for insisting on the shower. "Susan said to tell you she is really sorry, but won't be able to help you with the shower today. That's why I'm here!" If you get the info to a good caregiver quietly, she can incorporate what you've said into what she says to your mom. Ask for the caregiver's help. We are absolutely born helpers. It's in our little caregiving blood. Here's the deal. The caregiver has to find the balance between gentle care and firmness. If the caregiver hesitates or waffles, your mom has a little chink in the armor and can drive right into it. My technique with "Rose" is to look right into her eyes and smile and tell her what I'm going to do. She responds to this. I think sometimes the elderly just need to feel that their caregiver knows what she's doing! Sounds overly simple, but I really think it's true. So, sit your caregiver staff down, and level with them. Get them on your team. Then trust them to handle it. If they can't - well ... replace them! Are there rewards the caregiver can promise your mom? I know it sounds funny, but my Cream of Wheat motivates Rose. She has fairly severe Dementia but certain things "stick". I'm the one who makes exceptional Cream of Wheat and with whom she laughs a lot. So - what does your mom love? Tip your caregiver off and, without being condescending, have her offer this as a payoff. "After your shower we're having cinnamon toast and tea!"
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Just to make you laugh... my mom the other day insisted all the work to get her ready for her ride to adult day care was done. Bath, dressing, breakfast etc. Then when her bus driver came she lifted her blouse in "Girls Gone Wild Style" and said "The Girls aren't covered!" She can not put on a bra by herself and she just realized that her little ruse was going to result in her beng in public without proper foundations. Oh!! my teenaged kids roared when I told them what Granny had pulled.
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I agree with Ruth. I used to leave lists for the caregivers of things that needed to be done. I would tell them on the side that it was ok if they didn't get everything on the list done but that otherwise dad would say, don't worry about that, my daughter will do that when she gets home from work. If I left a list, they could say, oh,no, your daughter left this list for me and I don't want her to be upset if this isn't done. He was much more cooperative with it when put to him that way. Good luck ~ Kuli
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Here's a task list based on the one we use at our home care agency. Some states have restrictions on what can be done by a paid caregiver - check with your local Area Agency on Aging.

Tasks To Be Completed 3

Bathing:
Bathing and washing hair
Getting in or out of shower or tub

Personal Hygiene:
Shaving
Denture care
Brushing teeth/caring for mouth

Dressing:
Assist with dressing/undressing

Grooming:
Nail care (toenail/fingernail)
Brushing and combing hair

Toileting:
Getting to and from the toilet
Assist with using bedpan
Urinal
Commode
Wiping/cleansing afterward
Cleaning assistive devices
Adjusting clothing before/after

Cognition/Memory Care:
Wandering
Coping with change
Making decisions
Help with confusion
Help understanding basic health and safety needs
Responding to behaviors

Bowel:
Changing incontinence supplies
Digital stimulation
Ostomy care
Toileting schedule
Suppository insertion
Enemas

Bladder:
Changing incontinence supplies
Catheter care
Ostomy care
Toileting schedule
Monitoring for infection
3
Eating:
Feeding or cueing during eating
Monitoring to prevent choking
Assistance with special utensils
Tube feeding
Nutritional IV set up

Medication/Oxygen:
Giving medicines
Giving oxygen
Reminding or organizing
Checking for effect
Assuring adequate oxygen supply

Transfer:
Moving to or from a chair, bed or wheelchair inside the home

Mobility/Ambulation:
Assistance moving around inside home
Assistance moving around outside

Meal Preparation/basic nutrition:
Cutting food
Placing food/utensils within reach
Breakfast
Lunch
Dinner

Housekeeping:
Wiping surfaces
Dusting
Cleaning floors
Making bed
Cleaning dishes
Taking out the garbage

Laundry:
Gather and wash soiled clothing and linens
Use washing machines/dryers
Hang/fold/put away clothing

Transportation:
Assisting during a ride
Assist to get in/out of a vehicle
Arranging a ride

Shopping/Outings:
(for each item, indicate if provider will be
Driving
Accompanying
Assisting with making selections
Assisting with money transactions)
Medical appointments
Grocery store
Retail store
Pharmacist
Restaurants
Barber/Hairdresser
Place of worship
Social/Recreational
Other:
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Thank you, Goose, for asking this question. Thank you, Bribri, for answering with a checklist. The past couple weeks or so I've been wrestling with the very same issue so how timely this is. If you google "Caregiver Daily Checklist" you'll come up with some good hits. Of course, anything we find, we'll have to do some revisions on.

Again, thank you!
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I am new to this site, just found it a minute ago. So nice to know, I'm not alone!
My mother had Dementia, and I, as the only child that will help her, I have been struggling for 5 years taking care of her, my family and two houses. Cleaning and financial.
I did have a wonderful lady coming for 1 1/2 years to help daily, and she did her own daily task list, but posted it on the calendar for me to see. Therefore, when she did not get to something one day, either she or I finished it the next. The house and my mom were always clean and mom was happy and stimulated.
Now, I'm stuck again, but I hired a Co. recently, and we are still trying to work out the kinks. I'm not sure it is going to work out yet. More money, less hours because of that, and this new person is not as motivated or dedicated!

Bless all of you who care for the elderly! I did it in my early 20's. I worked in two nursing homes, and I also took care of my grandmother for years. Now, my mother needs me, and like I said, I have been doing so for over 5 years without help from my sibling, just my hubby, and two kids.
Any tips or advice you can give me, or words of encouragement would be appreciated.
Thank you,
Starla
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I am a caregiver and just left a house because the patient was soaked in urine since bedtime last night until 1pm when I arrive, the husband demanded that I not change her until I forced her to drink 4 full bottles of ensure. I explained that getting her up and to the bathroom washed and cleaned up would make her feel better, not forgetting preventing a UTI or skin breakdown along the way. I explained that if she was clean and comfortable she was more likely to take fluids etc than when she was uncomfortable sitting in urine soaked clothing. I was told not to change her and to make sure I did nothing else other than force her to drink 4 bottles of ensure. I couldn't bring myself to do this and politely explained to the husband my reasons. He became angry and I left the house. Any one have any good article showing that patients will eat better when clean and dry. or how bad sitting in wet urine soaked clothing for over 15 hours is really really bad
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I don't know about a one-size-fits all checklist, but I make one for mom's care givers on my computer. Bullet points, tidbits in a red font. I'd never leave a care giver with mom without one.

Includes things like:

Our home address for easy reference if it's necessary to call 911.
My and Tom's cell phone numbers. What time we'll be home.
My cousin's cell phone number if we're going to be further than thirty minutes away.
Where her state-approved DNR is located. (On the fridge)
What time she gets her medicine. (Daily dose laid out. Pill box locked away.)
What time to serve her meals and snacks. Foods she absolutely CANNOT eat are listed with a smiley face that says, "Even if she pleads!"
List of things she might want to do -- and any paraphernalia to do them left out.

I'll bet if you all put your heads together you could come up with a dynamite list that could evolve with time. Good luck!
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Caring65, I think you should have had a conversation with him about the folly of what he's doing. That's cruel. I'd report him, frankly.

"I'll be back in a few minutes. I'm going to McDonald's to get four milkshakes for YOU to drink." Is this jamoke kidding??

That guy either needs a virtual slap in the back of the head, or his wife needs to be removed from his care.
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Hi Maggie and thanks for your reply. I did try and explain all to him but to no avail. I have tried reaching out to his daughter so I can explain my concerns but I am guessing they will think Dad knows best. I just couldn't sit and do this to the poor woman,
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Oh caring65, what that husband is doing is abuse. If he were running a care center he'd be shut down. His intentions might be awesome (maybe) but you are absolutely right about his methods. I am glad you did not participate. Do you work through an agency? Report this.

Even as an independent I think that you are morally if not legally obligated to report this abuse. I'm just sure to whom. Adult Protection Services maybe. Perhaps if his intentions really are good this man could be trained, but it is highly unlikely that he will accept the lessons from you.

I hope other members will have more specific suggestions for you. What you describe is appalling.
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The more information I have about my client, the better the transition and care...
I have had to ask for emergency numbers and about DNR's.....
In one instance I was told by the husband to not do something that I knew needed to be done with his wife.... as he argued and was getting upset, I dialed the daughters phone number and handed him the phone, asked him to talk to her and I did what needed to be done while he was on the phone.....like Ruth, I use humor..... and a tone of voice that is loving yet firm....if it is something that is not priority, I will let it ride and explain in the log book.....for either the next shift or the family to do... or will do it the next day myself....
It is so important for a paid caregiver to not make the client feel we are taking over..... I include them in as many decisions as they are capable of helping with...for instance... first time helping with a shower.... ' I haven't helped you with this before, I need you to tell me how to do this.... how do you like your water?' ect.....Most of the time it works... sometimes it doesn't no matter what you try..... I simply let the family know this was a no-go this time around, but will get done the next time.....I don't have a list, but the day lady does....mine is fairly simple.... but with a list. and the family understanding that some days it can't all be done..... is a working solution..my primary job is taking care of my clients.....
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Hi Jeanne, I agree with you. I am hoping the daughter will meet with me so I can try and explain all this to her. If not then I will call and express my concerns to DCFS regarding her care. The sad thing is he loves his wife so much and in his attempts to keep her alive he is not seeing reason. If he keeps this up she wont live for long.
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Caring65 I hope you call APS, because he is off his rocker. Maybe a little dementia or burnout on his part.
Goose: checklists won't help if mom won't cooperate. We did have good luck by having the MD order OT, who got mom to shower after we added grab bars all around the tub. Give it a shot.
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Thanks Pam.
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UPDATE:

I just spoke to the daughter she has gone to the house and told Dad this is not acceptable. They have asked me to go back on my next shift. He is going to apologize for his behavior and agree to what needs to be done for his wife. Not just pushing ensure down her.
Watch this space, I will let you all know how it goes on Tuesday after my shift.
Thank you for all the support, I was second guessing my actions and feelings thinking I may have overacted but hearing you all made me see that I did the right thing.
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I left a sheet for our CG with info about dads personal life, what he did, what he likes etc so they could engage him. His lunch prefernces, etc, things to make them more aware of HIM and not so much the chores. If they get along the rest is easier!
And Caring65, you did the right thing.. good luck!!
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