How do I make my patients friends and family back off and allow me to do my job?

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I am an LPN, I have been involved in Homehealth for 15+ years but in the medical field for 23 years doing various jobs from supervisor to homemaker. I have been in many situations and always resolved on my own, this time I would like alittle help. I recently started caring privately for an 84 year old lady with some sort of memory issue. Living in a small community, I noticed 3 years ago this lady was definitely having issues when she couldn't remember how to start her car, among other things. This lady lives in an independent living facility so, not knowing her family, I reported to the social services at the facility my concerns and asked they follow up with family, they did, her emergency contact is her sister who is 12 years younger, her children all live 500 miles + away and my concern was swept under the rug! Well, in May 2016 when the sister came back from her winter home she decided to notice what the rest of us had seen for some time but still let it go, never notifying her kids..until, August 2016 when she finally hit a parked car and was caught on camera, and the police had to get involved! So with that her sister took her keys, 1 of her 3 children got involved and decided to hire a caregiver, me. As I said I noticed long ago the issues, I was happy to help so began the 1st week of August. On my very 1st day I found meds to be a mess, hormone pills prescribed to be taken 1 time a month were being taken everyday sometimes more than once, blood pressure pill were taking more than 1 time daily, Tylenol PM was this ladies best friend, I can't guess how many large bottles she consumed. I immediately took medicine away, called Doc and started over. After the first full week all 3 kids and the sister were upset because she wasn't back to "normal " the sister is very controlling, always interfering with everything. As a month went by patient began improving but the kids decided to get on board and come visit mom tring to make up for several years of lost time and with every visit they run her all over and set her back 2 days for every 1 day I built up. And then, the ladies who hAve been soooo close to the patient all their lives 1 an RN and 1 has a doctorate in geriatrics come and are just soooo devastated at the decline in the patient, telling me what I need to be doing etc. Finally, I get an order for homebound PT mainly so folks would allow her to stay home and rest and not expect her to bounce right back. Fast forward to now, her meds are controlled, clearly there's some dementia, namenda and aricept are on board titration for namenda is over and as of 4 days ago I finally got everything as far as meds to correct dosage. PT is still in and between myself, them and doc we say putility patient at about a stage 3 with dementia. But her kids want to uproot her from her hometown and take her 500 miles away to an Alzheimer's facility. I agree she may need to be closer to her kids but not in an Alzheimer's unit. I am also very prepared to keep her home as long as her safety is not being jeopardized according to her family she has plenty of money to stay home. My questions are, how do I approach keeping her home with her kids? How do I get the sister to back off, and be a sister not a caregiver? How do I tell the long time educated, caring pals that if they wanted to care for her they could of years ago, it's my turn now?! Not to toot my own horn but I get compliments daily from folks at her apartment complex because she is doing so much better. I just want her to continue to be happy at home and I want to do my job the best way I know how without all of the drama!

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As your patient does have recognisable dementia, you will know better than I do what her prognosis is. And if the kids are going to move her to be nearer them, the sooner the better - after which she will cease to be your concern.

To do your best for your patient, write a summary of your observations which can be given to any future facility to form part of their needs assessment. But I don't see the point of your trying to move mountains to keep her home until she's so badly impaired that the move in itself will be potentially disastrous. Better for her to walk in to the right facility now than be wheeled in next year.
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You sound like a terrific caregiver. But you also seem to have a bit too much personally invested in being " right". That's going to make any job harder than it needs to be.
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I have to agree with Windyridge. Regardless of where her adult children have been up to now they are her family and family trumps caregiver in any situation. You did a great job getting her meds figured out and getting her on a schedule and you should pass that along to the family but be gracious and step aside and let the family take over now.
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To put it bluntly, you're the hired help. Her family is in the drivers seat, for better or worse it seems. You may diplomatically express your concerns and ask that they recognize your expertise but in the end they'll have the final say. If it gets too crazy give them proper notice and move on.
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