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my mom is 85 and has dementia due to a brain injury that also causes seizures. I have made many life changes recently....quit my job and found a daytime job just going through training now and hope things get better. Had a good caregiver mon wed fri and she is quitting now. I know they only pay minimum wage so its hard for them to keep anybody. Not sure if its just easier to have more hours on weekend but i will be home more since im working daytime hours.I try very hard to keep my mom calm but it just seems so hard lately. Any suggestions would be appreciated.

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really not sure what I can do. The schedulers/supervisors don't even tell the caregivers what they are going in to. they know about my mom's conditions, her likes/dislikes. Before I quit my job I took time off to train new caregivers myself and now the one that has been coming regularly on MWF has quit because they won't even pay her properly. I understand but the ones ON TT don't even show up. Its only 2 or 3 hours a day (1 hr in morning and 2 hours in early evening) The remainder of day my mom is at adult daycare, homecare service comes from the daycare center. the agency that pays for the services says this is the last place I can use because its our second choice. The states pays for all services, but they do not offer over night so if I do need to be gone my brother has to stay over with her. I don't think they even train for alzheimers patients. My mom used to be a CNA and she used to know but she would come home with bruises, cuts and very sore from being beat up. She isn't combative like that yet except with me. At this time she gets combative verbally and confused. the lady that was h ere couple days ago she is older and quite bossy with my mom and my mom doesn't like th at at all which I understand. with my new schedule im in and out of the house more but sometimes I will need to be gone for a couple hours at night. Setup an hour for caregivers in morning to make sure my mom is ready for daycare bus since I have to work early in morning. 2 hours of caregiver in afternoon/early evening. They give us 16 hours a week along with daycare so usually 3 hours a day and if I want weekend hours I cancel a day during the week. I give them as much information as I can but they are terrible at communicating, returning my calls. the first homecare service was this way too...I will keep trying. I did insist on having the regular caregiver we have had untiil she quits the end of next week then I will need to start over. Tried to depend on my brother to train but that didn't work.
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I'm so sorry you're having such a hard time finding good staff. I'm a home healthcare nurse and my agency pays it's caregivers more than minimum wage. More for a nightshift and more on weekends and holidays.

When I am given a new case I'm always told if the patient is difficult, combative, etc. I'm 44 and from my experience some of my patients prefer someone more my age. You can request someone older if your loved one would be more comfortable with that. I understand why an elderly person might not feel comfortable having a 23-year-old transfer her in and out of the shower, however capable the caregiver may be.

If the family is aware of certain problem behaviors they are always relayed to me. I've never taken issue with a patient's behavior because I know it's not personal. The goal of the family, patient, and staff should always be continuity and routine. This means having the same staff member on the same days, for example having "Sue" come in M,W,F, and having "Mary" on T, Th, and "Kay" on Sat. and Sun. Or whatever routine fits best for you. Also, do you prefer 12-hour shifts? 8-hour shifts? Longer shifts mean less people coming in. That SHOULD be the goal of the agency you work with as well. Having a rotating door with new faces all the time is very disruptive and it's difficult to build trust with new people coming around all the time. YOU have to trust the person coming in to care for your mom, your mom has to trust the person, and the staff member should be familiar with the routines and the way you prefer to do things. You can also discuss this situation with the agency you're working with. Let them know that you prefer regular's. Most people prefer regular staff on regular days but not all. Some families are comfortable with new people coming through, it all depends on the situation. But if someone is to become one of your regular caregivers she'll have to be new at some point so give the new caregivers a chance if you can and if you really like one or your mom has really taken to one, call that agency ASAP and request that person again before they get booked on another case.

If you don't like the agency you're working with, try another one. There are a zillion of these agencies and you shouldn't have to be stuck with an agency you're not comfortable with. And if your mom can be a grump or has a potty mouth, be honest with the agency and they'll book someone who may have more experience or who isn't overly sensitive. My agency will tell me: "Mr. Smith is a racist." If I have a problem with that I don't have to take the case just like I don't have to take a case where there's a cat if I'm allergic to cats. A good agency will treat their employee's with respect and in turn, will have good employees. Just be honest with the agency if your mom is combative or has other behavioral issues. I'd much rather my agency tell me these things in advance then get on the job and be surprised when the patient takes a swing at me (which has happened, and I went back the next week). Your agency should do everything they can to accommodate you and your needs and requests.

If there are many details to your mom's routine you can request a new person be trained in your home by one of your regular staff. I don't know how the agency would handle the billing in this situation but it's worth asking about.

Bottom line: You and your mom have to be comfortable with the agency and the people they send out. When I work with someone with Alzheimer's I know the possibility exists that that person can become combative. I trust my company to let me know if it's a real big issue that's been a problem in the past. Or if I have a problem with a patient who's extremely combative I'll call my company after my shift and let them know so they can pass that information along in future reports as needed to other staff members.

Healthcare professionals shouldn't take it personally when a patient with Alzheimer's or dementia becomes combative. My agency has another nurse who won't work with folks with Alzheimer's because she's caring for her mom who has Alzheimer's and my agency understands this completely and schedule's her accordingly. I haven't really come up against anything that would make me say, "I won't do THAT again!" I know it's not personal, it's not who the person really is, and I feel so bad for the family because they feel so bad that their mom or dad or whoever smacks me in the face. The least I can do is let them know that it's ok.....I understand, and they don't have to feel bad about it. Then I just learn to either duck or discontinue whatever it was we were doing that caused mom or dad to deck me! ;-)
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yes jeannegibbs....I understand that. I have had many caregivers in the last three years that did well with her but its hard to find that great person. Its just very unreliable and the center for older adults that setup service told us that there is no service that is better than the others. I am going to do my best. I have left instruction for different things to do for my mom but they just dont do them... getting her a bath, shampooing her hair, light housecleaning and cooking some meals none of it happens. I'm around more now when they are here im trying to train them and let them know things she likes. I know its another experiment and something will work out soon I will keep positive. Thanks.
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Bad situations get more publicity than good ones, so let me just say that the only PCA we had was terrific. She helped my husband with his baths, she made his breakfast and lunch, she helped with his PT exercises, they did puzzles together, and she went on outings with us. He really liked her. One of the caregivers in my support group also had a health aide her husband enjoyed. Good outcomes are possible!
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My mom's biggest problem is that she goes to adult daycare and is very tired when she gets home. We are on the second agency and have just started. The schedulers are very unorganized and not very helpful. I have found a couple good ones that my mom likes but they always send the other ones in. They don't explain her situation either. I had found one good one but she has put in her notice and hopefully can find someone better. My mom had an african american one that she liked at the other center but then one day had a bad episode and she wouldn't come back. If im not here to help or be around I never know what she says is true or not. I have changed my job situation and am working more daytime hours so I will be around more. Daycare center employees says my mom is sweet and loveable but at home even with her family she can be difficult. Just trying to work outside and do things around house she hates to sit down. I will keep trying with this homecare I have never heard many good stories people have had. I know they only pay minimum wage so it is hard to find someone good.
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Not certain where you live (large city or small town) but have you considered different agencies? We have had the same concern with my FIL. He had one helper coming in, my husband 3-4 times daily, rotating between visiting nurses, volunteers and hospice and he is hospitalized now. I spoke with one agency recently and they asked me several detailed questions. My FIL can be very hostile, sling the N-word around as well as other profanities. The gentleman told me that he usually does not say this to potential customers but that he would have a difficult time finding the right person to help as much of his help is Afriician-American and that after other questions he asked, he said he would not feel comfortable sending someone young. I do know that something (do not know what) happened with one of my FIL's visiting nurses and when she returned she brought her husband and then evidentally something was relayed to her supervisior. Of course my FIL was, "don't you believe anything they say."
We have finally came to the conclusion that when he is released from the hospital, he will be going to a rehab facility and if it escalates to long-term care and they end up attaching his pension, bank account and house, then so be it.
I do not know your mom of course, but in my FIL's case, nothing would make him happier than to have my husband quit his job, move in with him and caregive full time. Whoever comes in to help my FIL will not be good enough. He just finshed cursing the nurse out at the hospital this evening.
Best of luck, but I would start looking at different agencies, as many as I could. If she is very difficult, word will spred within an agency.
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