My grandma has dementia is 88 and lives in independent living with a 24 hour aide ever since she fell and broke 2 ribs. Any suggestions?

When there’s an abrupt change in behavior, a psychiatric assessment can give caregivers useful information.

Although you will not be able to move forward until the present crisis abates, ask the social service department at her residence if they can recommend a psychiatrist/psychologist/social worker who can assess her cognitive/psychiatric status with the potential of medication or behavior management techniques to help her understand her significant need for her aides, and increase her willingness to accept them.

Within the current circumstances it really isn’t fair to her because of her dementia, disorienting accident, and subsequent stress of pain, to place expectations on her that she most likely can’t meet. “Kick them out” needs to be ignored and soothed.

If she becomes noisy and disruptive, she can be told that it’s the law that the aide be there, or that they’re already paid for. The aide needs to be as calm and quiet as she/he can manage to be.

If there is a Memory Care unit in her AL you may need to consider that she might be better served there. It will cost more, but if she gets too much more disruptive the AL may not be able to manage her.

Yes, get the phone away from her. Tell her whatever you must (product recall for example) to stop the 911 calls.

Your job is a tough one, but first you must make her safe, and that means the aide stays and the phone goes.

Unplug the phone. Tell her that you've called the phone company and they can't get out to check it for o few days.

For what it's worth, I never got my mom a phone when she went into RC. She was all fired up to wreak havoc, call a lawyer, etc. She was raging.

So, no phone. She adjusted. It all worked out for the best.

You don't actually have to take the phone away form her. Just cut off the service. Phone doesn't work. We've made a service call. They'll get back to us.

Be well, hang in there. and remember, your grandmother is very lucky to have so much care.

I would say it's time to move her into a different facility. Not independent anymore. It's time.

The aides might perhaps be handling this a bit better. There is a knack to being self-effacing, so that although you are continuously monitoring your client and on the spot when wanted, you are not actually in her face the entire time.

How much physical space, how many rooms/walls/doors, do they have to work with? Can they at least keep out of direct sight?

Are they trained in managing dementia-related behaviours?

First thought I had was...It sounds like Grandma is past the point of Independent Living and should be in Memory Care or at least Assisted Living. But if she has that reaction to aides now she would have the same problem with them in AL.
It sounds like a discussion to be had with the Facility where she is living.

Second thought ....The aides should be doing a much better job at calming, distracting and helping her so she does not make the phone calls. It may get to a point where she will be charged for making the calls to 911 (they can levy fines)
Take her phone away from her. If there is an emergency the aides can call.
(and you can not let her keep the phone but deactivate it as any charged phone can still make a 911 call.)

It is possible that the fall as set in motion a rapid decline. If she is on medication these may also be a problem if they are making her brain a bit "foggier" than usual.
It is possible that she has another medical issue like a UTI that is causing more confusion.

I agree to take away her phone. It's not fair to the responders or others who need their services. Start there to reduce chaos and begin to get things under control. Make up whatever therapeutic fib is necessary to take it from her.

I just discussed this with my sister. We care for our grandmother which is in the advanced stages of Alzheimer's.
She suggests to take a look at all of her meds! My grandma broke her back about a year ago & we experienced something similar. The harder narcotic pain medications will cause a lot of problems for older people with dementia. If she's not used to taking the harder pain meds that could be your problem.
We started our gma on Tylenol on the 2nd day after her surgery. That seemed to help tremendously! The Dr put her on morphine and gma was way out of character! Then we went to Percocet & that was even worse.
After about 36 hours of stopping the narcotic pain meds gma was back to normal. She was still in a lot of pain so we gave her Tylenol. The Tylenol was just enough as long as we didn't miss her next dose.
We are now at a point where we give her children's Tylenol and not that often!
· Dementia patients should not take ibuprofen unless they are allergic to acetaminophen (Tylenol). It causes some kind of problem with the dementia brain.
· If you have POA then yes you can take the phone but in this case you need to be sure that gma or the caregivers have a way to contact emergency personnel if needed!
· Trying to explain & help gma to understand that she is in need of the home health aide's is not gonna work if gma's Dementia is at a certain stage. Grandma1954 has a very good point as well as Countrymouse.
· Being around family & loved one's help to keep them more comfortable. They are afraid when someone new comes around.
*So, imagine that you are your grandmother. You have these strange people coming in your home. You are not in good shape to fight them off if they come in and physically harm you. You do remember how to call 911 currently. So that's exactly what you do.

Your grandma is only trying to keep herself safe.
I Hope that this helps even just a little bit! Let me know if you have any other questions. I am a care provider as well, I have my STNA & have a little over 20yrs experience with caring for the elderly. Good luck!!!!

Several things can cause your grandmother's ,memory problems: she may have had a stroke at the time of her fall, she may be on pain medications that are impairing her memory, or she may have dementia that is now apparent since her usual routine is interrupted. All of these point to one treatment: get her to a doctor for evaluation. The aides should keep a journal of all grandma's incidents. You can show this to her doctor. She very well may have dementia that requires her to be in a memory care facility or to have stricter measures at home. The doctor is the start to evaluate and diagnose.

My concern is also for her legal protection. Please make sure she has POAs written up by a lawyer for financial and healthcare oversight. It not, get those taken care of now - before the doctor declares her mentally incompetent.

I would respectfully suggest that her access to the phone be removed. Since she has a live in aide, I would let the aide be responsible for the phone. Calling 911 11 tones in one day is unacceptable. Her calling and then personnel being sent to the apartment is a drain on resources especially during the pandemic. It could be that it may be time to move her to a more structured environment especially if there is a unit or units available within her current community. Assisted living or memory care. The move also would preserve her resources since the services she needs would be part of her care plan. It is hard to make the decision for increasing the level of care but it may be better for you to initiate the change rather than the facility. Good luck.