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My mother is in moderate to late stage Alzheimer's. She has been receiving in-home care through BrightStar for a year and a half. Her usual aide that she had for about a year, left the company and since then, a variety of aides have come and gone and many times there are 2-3 aides coming within a week. My mom has always given some of the aides a hard time. She wants me to do all of the caregiving which I and my brother can't because we have to go to work. As time passes and the disease progresses, this is getting worse. Recently, a new aide started caring for her. My mother has developed a delusion that this woman is trying to take over her family and trying to get money (which we don't have any money or assets). She believes the aide is harmful to her. The aide does her job pretty well. She is experienced and I see no signs of her abusing my mother. I called BrightStar last night after a particularly hard day with my mother and told them how this isn't working out, hoping they would send someone new this morning even though I like the aide. They said they would talk to the aide and get back to me but didn't and the same aide came today. I feel sorry for her because she can't really even stay in my mother's room and my mother rejects her caregiving. The aide is currently just trying to find things around the house to do to be occupied and keeping her caregiving with my mother to a minimum. The problem is that I'm not even sure if a new aide would help. She has been rejecting of aides before although not always as bad as this. I don't know if I should just find a nursing home for her or try to manage the situation at home. If she goes into a nursing home, I don't want her placed somewhere far away because I need to be able to see her pretty regularly because I know she is very frightened about what is happening to her and I don't want her left somewhere alone with strangers most of the time struggling with this. Is there anyway to get someone like my mother to be more accommodating to aides? I live with her as does my brother and the stress from this is taking it's toll.

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My spouse has ALZ, diagnosed two years ago. This is a very strange disease and if you think they understand what you say or do or can even remember it after a day you are probably wrong. My spouse thinks he is 18 never been married etc. and to try and tell him otherwise just makes him angry. He is now in a wonderful facility, doing well as can be expected and living in his own world. I am just a person who visits now and than. If you can place her in a good facility, she will adjust - as will you. Good luck
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The most glaring symptom of my own mom's dementia was paranoia and hallucinations. She also tended to strike out at the aides and occasionally at the other residents. However, even considering her behavior in the facility, that was where she needed to be. She didn't want anyone in her home--her private space. No home health aide would have pleased her. I would have spent all my time trying to reason with her and looking for new aides. IMHO, if I were you, I'd seriously consider a facility for Mom.
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I'm interested in seeing what comes of this too. My mother agreed last week that in home aides would be wonderful!! And to get started on the process of hiring someone (through an agency). She somehow did a 180 and on Sunday, late, I get word that she isn't feeling that she needs anyone. So--waste of time. She didn't even MEET anyone to reject them. She is getting worse and worse and said when she felt she needed help "like that" she'd let me know. (2 years ago, she needed THAT kind of help).
Honestly, if your mom is going to be difficult, you're NEVER going to find someone to work well with her. May be time to put her in a Memory Care facility. She'll hate it, and you, and everyone associated with it, likely, but she won't be at your home, making life difficult/impossible for you.

I don't see her becoming more pliable about the aides. It ISN'T the aides she doesn't like, it's what she knows about her own condition that's scaring her.

Changing out caregivers regularly is disturbing and hard on everyone. You can certainly keep trying, but do you really WANT to?

My mother is one serious fall away from being placed in a NH. An aide would make her life SO much better. I'm sure she'll never accept one. And she has only mild dementia, and a lot of physical issues.

Do come back and let us know what you decide!
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A psychiatrist who specializes in Alzheimer's? What a daunting job that would be. In order for therapy/meds to be helpful..the patient has to be somewhat compliant. My mother would no more see a psychiatrist than she'd fly to the moon. She's mortified that I see one, and routinely have been in therapy for 20 years. The psych dr can dx her, but you already know what's wrong.

If I could get a DR to tell my mother she needed aides, she might listen. Emphasis on might.
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Resistance to care is frustrating, though not uncommon. It's hard to say if this is a phase that will pass or not. How long has it been going on?

How is her mobility? Does she need a lot of other hands on care? Does she need skilled nursing care? I might consult with a professional assessment person. With the information that you, her caregivers and her doctor provide, it should be easier to decide what to do. Of course, I'd keep in mind that the agency who is sending caregivers to the home, may lean towards her staying at home, since they are getting business that way. Still, if it's too stressful for your mom, it may need to be changed.

I'd discuss it with the doctor, because the delusions that she is having must be very disturbing and distressing for her. I wonder if any medication for anxiety might help her relax and avoid this stress. I'd explore that.

Eventually, around the clock care in the home does become challenging. I'd consider if this might be a good time to make the transition. You can visit some of the facilities in your area. My LO was initially in a regular AL and that's not designed for significant dementia patients. She is now in Secure Memory Care and it's just right for her needs. I'm not sure how a nursing home would manage your mom's care. Would she be constantly trying to leave and/or resisting care? Maybe, others around here know how they handle that, but, I don't know. I would think that a place that is designed for significant dementia would be better trained and equipped to manage her care.

I hope you find some answers. Please let us know what you decide.
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My Mom, who was in her 90's, also rejected caregivers. No other woman was going to come into her house. That just wasn't going to happen. The Agency even sent over their one caregiver who could win anyone over.... nope, never, nada... Mom shooed her out of the house.

Usually we need to wait for a very serious injury so the elder goes from the hospital, to rehab, to nursing home.

Thus, the quicker one can get a parent into senior living, and if the budget can afford it into Assisted Living/Memory Care the better. That way their mind can still learn the floor plan of the floor they are living on... still learn new faces of the Staff... and still learn to make new friends with the other residents. This worked very well with my Dad.
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Stick with the lady who is understanding of your mother's resistance and aiming to work round it - it sounds as if she really grasps the situation, is still discreetly keeping your mother safe and finding ways to make herself useful. Conscientious, knowledgeable and responsible! - and that makes her a keeper.

You've already put your finger on it: the problem is the recent changes in personnel. Only solution to that is to avoid further changes and give it more time.
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Your Mom seems to be halfway thru her journey. They can not be reasoned with. And I agree, no aide is going to be able to make Mom do. They aides should be trained to work around her "no". Keep the one u have. I would ask the agency not to keep sending different ones. That it confuses ur Mom. She needs to form a bond.
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I have to agree with those who say its time for a memory care facility. My mom never, ever accepted home health aides. She is 94, lives in a memory care facility and still refuses help at times. But - she believes she is in her own apartment and the dining hall is a restaurant and she is getting the 24/7 care that she needs.

My mom also is highly delusional. You can only do so much. Once she got the cancer diagnosis a year ago, I knew her dementia would get worse and it has. She is now highly anemic and incontinent and I know I did the right thing. Don't expect mom to change. Start visiting places and get a plan in place. I also work fulltime and realized my mom was needing more care and I needed to place her.

Good luck.
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Mom needs to go into a facility. This is ridiculous. Look around and find some place. Enough is enough.
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