Mom wants to fire one of the caregivers. Any advice?

Does mom need anxiety meds? Is there some physical malady that has her anxious or depressed? Ask the MD for help.

You say for years the care taker has been with her well as dear as she is I would think a stronger aid will not hurt as your mom is worried about her ability to lift her and I am glad she has the want to go out even if just in the yard or a sun room life is for the living either the helper needs a helper or the helper may be getting old herself and need to move to a night shift where getting her out of bed to go out will not be an issue if a helper is As she says mean and you think your mom is over playing it well it could be true because people do get birded out from time to timegive her a vacation and put in a temp when she comes back ask your mom if she is better to her if so talk to the care taker ask her if she wants shorter weeks iI bet she is just tiered and needing rest too

It's my experience that caregivers can sometimes (sometimes even often) actually be the cause that sparks problematic responsive behaviour in people with dementia (you don't say why your Mom needs care...). Despite the fact or maybe because of the fact that the caregiver has been with your Mom for years perhaps she IS mean to her.

Surely your Mom knows how she it treated and if she doesn't like the person, she should be replaced. And I find it sad that an earlier commenter would so quickly jump to "maybe she needs meds." The elderly are chronically and unnecessarily overmedicated for responsive behaviour that would be considered normal in "healthy" people.

If my mother wasn't happy with someone, I would replace them.

You do not state if your mother has dementia. If she does not, then she has every right to want to change a caregiver. Being upset with someone who takes care of you is very damaging to one's health, and I know you do not want to upset the apple cart, I side with your mother. Fire this caregiver, and get her one with whom she can relate. You are supposed to be doing this for her, aren't you? There are plenty of caregivers available, just search until you find one she likes better. Dropping someone is a BIG deal.

Unless your mother has been deemed incapable of making her own decisions, the decision to fire the caregiver is ultimately up to your mother. What has happened the last few months to make your mother even harder to care for? My suggestions would be to speak with the caregiver in general terms about how things are going. If she's having any difficulty caring for your mother. If anything has change to make it more difficult to care for your mother. Find out about how the caregiver feels about taking care of your mother.

The caregiver may be getting burned out and is ready for a change. The caregiver may be adjusting just fine to the increased difficulty. The caregiver is likely to have created a bond with your mother even though your mother apparently does not share this bond. The caretaker certainly does not want to get fired. Your mother may be making mountains out of molehills.

With all things considered, if you feel your mother is being abused, or is in immediate risk of being abuse, then fire this caregiver immediately and worry about a replacement later. If you or the caregiver feel this just isn't working out any more, then make arrangements with the caregiver for and "end" date that can coincide with a new caregiver "start" date. Before any of the changes happen, explain to your mother what is being considered and/or about to happen so she can voice her feeling on the matter. As stated early in this message, unless your mother has been deemed incapable of making her own decisions, justified or not, it is ultimately up to your mother if this caretaker is to stay or be replaced.

To work and not have to worry about who is taking care of your mother and whether or not her needs are being met, have regular meeting the the care givers to find out from them how things are going and if they have any concerns or suggestions about your mother or your mother's care.

I agree with ferris1 and TwoOfFive #fortherecord :)

not so fast everyone. First of all you need to really assess the situation and that means spending several days with Mom and the caregiver. Good caregivers are hard to find despite the mythe that they are 2 a penny. this one has been with your Mom for many years and knows you and the family. Have Mom's needs changed? mentally and/or physically. maybe offer to "help' the caregiver transfer Mom and see if it appears to have become more difficult. make suggestions like "would it be helpful to get a hoyer lift, this must be very hard on your back?" ask to be shown how Mom is being transferred to the bath/shower (so you can step in in an emergency). Look for any signs of bruising on Mom's body. have there been any major changes in Mom's abilities recently? Are there other caregivers?
Spend time with them too and ask if they think Mom has changed recently, maybe more demanding or critical, asks for one thing then critisizes when it is provided. You don't have to be there 24/7 just a few hours at different time of the day. If Mom has a dementia diagnosis this kind of behaviour is likely and will only get worse and Pam's suggestion of medication maybe the only way to go.
having excluded all else even changing the caregiver is unlikey to help because she will find even more fault with the next one.
Everyone gets older and their ability to do certain jobs changes over time so I repeat don't jump into action without a thorough investigation unless you see mom in imminent danger. care giving can be a thankless job on one hand but very rewarding on the other so find out what has changed.

Well said Veronica - just for the record and me sticking my two pennorth in if you are worried about mistreatment do look underneath the top of the arms. The soft skin there (right near the arm pit) is really tender when pinched and the nasty bad caregiver will often use that in the guise of assisting of course to 'encourage' the elderly person to stand. Ive only ever seen it in a care home setting twice but it is one to watch out for. If you see it report it immediately to the authorities and take photgraphs to PROVE what you have seen for that area does bruise easily too

Interesting Jude. Just gave myself a good pinch and really could not feel anything.
Should i have hubby pinch me harder. Do have some neuropathy though but did not realize I had lost feeling there. Going off to get a few good pinches. should look interesting as i am taking warfarin.!!!!!!!!!!!!

I had it shown to me how it was done Veronica and it flaming hurt ... a lot ....so you cant be pinching in the right way/place
In the fleshy part of the top of the arm on the underside...so if you imagine your left arm bent at 90 degrees at the elbow so that your forearm is in front of you then about halfway between your elbow and your arm pit on the side of your arm that is against your body thats where the demons go. They take a small bit of skin and pinch hard (it is usually as I understand it done with a pinch and a twist) and if there are two of them working in cahoots they will both do it. It looks to any onlooker as though they are being loving and caring holding her hand with one hand and the other under her arm for support because they say that they know it hurts poor Mary (sic) to stand unaided but it is far from that. The only time I saw it in practice was in a care home although I had seen the result of one such incident before. The whole scene in hindsight was quite surreal. On the one hand they were saying let us help you Mary (sic) yes sweetheart we know it hurts while on the other hand they were doing the hurting... there aren't enough expletives in the world to describe these people but.... The main trouble is that because a relative NEVER looks at an underarm it can go months unnoticed. In this case both 'carers' and I use the term loosely went to prison for the offences but god knows how many they had done it to in the past.

Saving I think you need to understand the problem before action is taken
Question 1 - does your mum have capacity to make decision? If answer is yes then she can I am afraid do as SHE pleases. However it is not incumbent upon you to find another carer - although your mum wont see it like that!!!! so be warned on that one
Question 2 If she doesnt have capacity is the caregiver really being "mean" to her and what does she mean by that? Of course if she doesnt have capacity then that could be very difficult to establish but that needs probing for sure

Question 3 The caregiver almost dropped her the other day. Well any carer worth her alt wont be lifting anyone - back injuries etc are too risky so in what way did she nearly drop her or did the carer get her to try and do as much for herself but your Mum was feeling a little shaky so the caregiver stepped in too support - you see that isnt nearly dropping its support - agaion your mum wont see it like that

Comment .....You say Mom is not the easiest person to care for and it has gotten much harder in the last few months - sadly it does I am afraid as they lose more and more strength they seem to gain more and more 'orneriness (is that even a word?).

Suggestion ......Caregivers are used to being accused so talk to the caregiver and tell her what your Mum has said and ask her outright - is there an issue? It may be the caregiver hasnt done a catch up with you of late and that your mum's needs need to be reviewed because they have changed.

It may be that long term familiarity has bred contempt from your mother. I'm sure there is a way through the maze of question that must be scrambling your head right now but one step at a time. Take a deep breath and talk to your mum first and write down all that she says so you dont forget and so that you have a record - god forbid that you ever need it. And monitor the situation - it may be in a day or two that same carer is flavour of the month again

worth her salt not alt^^^ grr

Thanks for all the replies. Mom is wheelchair bound, has had Parkinson's for 22 years, and is showing signs of dementia. She cannot use the bathroom by herself, cook, take her medications, etc. on her own and needs 24/7 care. I stay there during the week at night and was staying on the weekends until one of the caregivers (we have 3, 2 are scheduled and one is a backup) offered to stay every other weekend to give me a break.

Jude, Mom doesn't have the capacity to hire someone on her own; I have DPOA over everything and she cannot pay bills, get money out of the bank, etc. She never had to pay a bill; Daddy always did it. As to Question #3, Mom didn't elaborate and they don't completely lift her; they help her stand and transfer from chair to chair, chair to bed, etc.

Mom has become more ornery as you said lately; she gets mad if she doesn't get her way (going out all day every day to Wal-Mart, grocery store, etc.) and pouts when she doesn't get her way. This morning she pouted because she didn't have cookies next to her bed when she went to sleep last night.

My sister called her to find out what is going on. Mom mentioned getting rid of caregiver but also said she may be jumping the gun. I am going to talk to the caregiver and ask her if she would like a week off, with pay, to get a break and take a breather. I hope she takes me up on it, and comes back refreshed. I also plan on talking to ALL the caregivers and let them know what Mom and I expect of them. I need to be able to work knowing Mom's needs are being taken care of.

I also realize that Mom has no one to vent to that isn't emotionally involved so I am going to call her home health agency and see if they can find someone that she can talk to once a month or so to get things off her chest.

Thanks again everyone. This site is wonderful!

Saving that explains so much - if she has had Parkinsons for so long the most likely dementia she may get is Lewy Body dementia which can be hallucinatory - forewarned is forearmed! If that does happen try to keep everything in the rooms she goes in plain no patterns at all because they will have an adverse effect on her. H*ll I can see faces in some patterned carpets and I dont have Lewy Body dementia .....it can be quite frightening for them though as it can be anything that they see.

If you are POA hun she cant fire them and she cant hire em either so really it is your call but you sound as though you have this well under control SO fingers crossed for you sweetheart xxx

I agree totally with Veronica and was going to same some of the very same things. It could be that your mom also wants more attention from you so in order to get it she makes these things up. The worse my mom's dementia got she wanted NO one in the house other than family. It made her a nervous wreck when even neighbors would come to visit and she had known them for 35 years. I think you need to do what they tell you to do in facilities (and day cares).....go at different times of day to see what's going on. Also, if this caregiver has been with your mom for a long time, it could be that she is on burnout but needs the job. Maybe she needs to be on a shorter shift for a while with another one coming in to help out. Many things to consider before you have to get rid of someone up until now you have had no reason to worry about. I would also agree that her doctor might need to be contacted and a check up might be in order. UTI's can bring on all sort of delusions and confusion. Anxiety? Just need to check everything out before you let her go. Good Luck and God Bless.

"If Mom has a dementia diagnosis this kind of behaviour is likely and will only get worse and Pam's suggestion of medication maybe the only way to go."

Totally disagree with this. My experience is problematic responsive behaviour can largely be averted with better understanding of what causes the behaviour --often the environment and/or the way care is delivered. See the work of Dr. Allen Power (Dementia Beyond Drugs), Teepa Snow and Naomi Feil.

I would agree that more investigation and better understanding of this particular situation would be helpful.

On the subject of becoming ornery, I think I probably would too if I was wheelchair-bound, reliant on other people, feeling confused, and being ill. In fact, I'd probably be REALLY REALLY ornery...

Further, everyone needs respite, care partnering with anyone is excruciatingly difficult. People just plain get worn out :(

I think the trouble with probably most of us is that because we haven't been trained in dementia, we don't understand it the way some professionals do (and even some of them will admit a lot of it is guesswork). Additionally because there are so many types of dementia and they accompany the general decline associated with aging the issue is made doubly difficult. Add to that the effects of polypharmacy - yes mum you do have to take this tablet - it is to counteract the side effects of that tablet - and you have a real cocktail of things that no-one truthfully understands

We don't know how much knowledge is locked away or how much is actually lost for ever. The mere fact that some periods of lucidity exist for mum - when she can talk quite normally, walk with aid of a rollator, climb stairs even - tell me the knowledge is still there..... but then they are intermingled with total non lucidity, the inevitable repetitiveness, anger, frustration, temper like you would only expect to see in a badly behaved child and confinement to wheelchair, when you think the curtain has come down over the knowledge and almost locked it away again. So so frustrating for everyone involved

So in her good periods she is frightened and in her bad ones doesnt care how badly (not the right word at all but describes a perception of behaviour) she behaves. It is incredibly frustrating for them but it is also incredibly frustrating for the caregiver too.

Do they know they are being difficult? Sometimes I know my mum knows, sometimes I know she doesn't. She even tells me that sometimes she just likes to 'wind me up because she can' (her words). Let me give you two examples. Mum has never been a brilliant eater but has always insisted we cleaned our plates ....starving in Africa would like to have the opportunity being a common phrase when I was growing up. Now she deliberately leaves 1 teaspoon of food on her plate every time I cook a meal. Now please don't dispute the rationale here because I KNOW she does it deliberately she told my daughter she does it deliberately and said 'I only do it because I know it annoys your mum' does she do the same for anyone else - absolutely not
When I put Mum to bed at night she spends at least 15 minutes arranging and rearranging her things on the table next to her and it drives me nuts because she WILL not get into bed until she has done it. If I go out of the room she stops and then when I come back in the rearranging starts again. Does she do that for anyone else ? Again absolutely not. My daughter in law witnessed it once and queried her over it....Why are you doing that Nan she asked. Nan (My mum) smiled and said you watch ....Judith wont stay in here while I do that and it's fun to see her getting crosser and crosser... so I will wait till she gets back before I do it again
Now I know the dementia is responsible for this but really? Am I supposed to just ignore it day in day out as if it isn't happening because I tried that and it doesn't stop the behaviour she KNOWS it annoys me even when I don't show it. That's the frustrations of caregiving FOR ME I hasten to add not for anyone else. I can give all the care with total devotion when she cannot do for herself but when she is 'ornery and I accept I would be too then I am afraid caregiving is a pain in the butt

Jude, I think we may be sister's from another mister! My Mom does the same thing....rearranging her side tables until they are "just right" before she will get settled...and then still buzzes me to fluff her pillow, or make sure she has cookies next to her bed (God forbid if she ever develops diabetes!!), etc. One of the caregivers told me that Mom loves to push my buttons...and boy does she!

I talked to the morning caregiver this morning and she is going to take a week off, with pay. I told her all she had to do was ask for time off, as we ALL need a break from this. She said she has been doing it so long it didn't occur to her to ask for time off. As long as her shifts are covered it is fine with me. We split the shifts, one comes in from 7 am until 2 pm and the other from 2 pm until 8 pm. I had changed the schedule a few months ago where they each worked 2 full days but then had 2 full days off. Morning caregiver didn't like being there all day so we went back to old schedule.

I hate that Mom doesn't have a life outside the house but anytime I bring up going to the Senior Citizens Building she balks. Sometimes I think she would enjoy a nursing home for all the activities they provide, but I also believe that she is so used to having someone with her 24/7 that she would call me constantly asking for someone to visit.

All we can do is take it one day at a time, or even one hour at a time, right?

Absolutely saving. Just something the geriatic psych said to me. Older people gain tremendous benefit from interacting with older people. We are not ever going to be sufficient for their interactive needs apparently.

That said I am having a good day - Mum royally annoyed my daughter today and was really rude to her so she just up and went no goodbye no nothing. Mum was really upset but she has HAD to talk to me about it because she KNOWS that I am the ONLY one who can sort it for her. I told her she would have to apologise and she went back to her old routine of I was only joking (jesus those 4 words run thin) I wan't having any of it and said I dont care if you were joking you upset XXXXX. Well she should learn to take a joke.....erm really? Trust me when Mum does rude she does it BIG style and then some and she excelled herself this morning. She asked me to ring daughter so she could say sorry ....now daughter has thrown toys out of the pram FFS. I have told them both caregiving is tough enough without expecting me to play piggy in the middle as well. Mums reply? Well you wont do that you wont even play patacake with the koala (who incidentally now has a name - Kevin the Koala). Oh and now she wants me to buy a kitten. Not a chance in h*ll I dont do animals in the house. Personal choice - I like animals and I like pets - OTHER PEOPLES!