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?

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.

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.

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.

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.

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

Her memory may be affected by the things Taarna mentioned. It could also be due to an infection. My dad had pneumonia which made him weak and fall. My mom had a urinary tract infection (with no usual symptoms) kept falling and was seeing people in her home that were not there. Took care of infection and mom was back to normal. It could also be the progression of your gransmother's dementia. But, I woulnd't rule out an infection.

Nursing home.

Get her checked for a UTI. It could account for at leas some of her behavior.
Look into telecalmprotects.calm. It’s an inexpensive phone system that addresses the needs of seniors experiencing different medical issues. One feature allows you to block unwanted outgoing and incoming calls.
That being said I agree that your grandmother is no longer capable of independent living. I hope she has a will and assigned you POA. If not you will need legal advice. I needed a doctor’s statement to activate POA for my mom, but she refused to go. When she fell in her home I called an ambulance. I knew that was the way I could get her evaluated. She went from the hospital to rehab to Memory Care. Her behavior became increasingly difficult and staff were unable to calm her. Even I couldn’t couldn’t calm her. Part of the problem was an UTI. Although she improved after treatment she’d still rage and refuse to comply with care. The doctor wanted to give her a very low dose of the antipsychotic Resperdal. I was opposed because of what I’d read. But the facility didn’t have the resources or training to provide alternatives and we couldn’t afford a facility that used a variety of behavior modifications instead of antipsychotics. I was afraid they wouldn’t keep her so I agreed. Resperdal did help a great deal. I keep a close watch on her medications, research them, ask questions, and insist on approval prior to changes. Start researching facilities now. There are many websites to guide your search. Talk to people in your circumstances. Talk to the appropriate agencies in your area. Ask them what other issues you should investigate. You don’t know what you don’t know. Talk to a lawyer about a Medicaid waiver. Talk to a tax specialist. Don’t throw away any documents; organize & file them. Take and keep notes of everything. When you you tour a facility ask about continuity of care. Each unit should have the same nurses and assistants working there. In my mom’s Memory Care unit I never know who will be on duty and it’s difficult to get information because they frequently have to check with someone who isn’t on duty.
I know this is a lot to consider and I hope you have a family member to help you. I wish you and your grandmother well.

Just because you unplug the phone, it does not change the underlying condition, and grandma may have an underlying infection. Like disconnecting a fire alarm, does not change the status of a fire, only your awareness of it. In the mean time, the house can burn down.

She doesn't belong in ind living anymore. Until she can be moved to memory care, someone needs to go there and take away her phone.

Was she given anesthesia? After my mom broke her hip was one of the most difficult times. Things “settle down” after about a month or two.

I had to take my 83 y/o mom's fone because she got so upset over not being able to use it properly anymore.

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.

My mother, 91, has dementia, and is in memory care. She had a phone (not a cell or smart phone.) Memory care told us that it would be better if she didn't have the phone. The nonstop spam calls were causing her anxiety. She was also making frequent calls via speed dial to the family business asking where "dad" (deceased) is. The employees did not know what to tell her. When I visited, I saw her puzzle how to dial, to answer...she did not remember how and cannot learn anything new. So the phone is gone now. We can still talk to her via a call to the nurses' station, if we need to.

The 911 calls take away emergency resources from people who may need them, like someone who is having a heart attack, by tying up the lines and the resources.

In the village where my mom lives, the fire and rescue departments have had a huge increase in paramedic calls due to the proliferating number of senior facilities. I often see 2 paramedic vehicles in the parking lot at the same time. The vehicles are mostly from surrounding communities under the "mutual aid" agreements in place. The village paramedics cannot keep up with all these calls.

Having been through this, I can recommend without hesitation: Your relative needs memory care and you need to get rid of the phone.

You must realize something right now - she has dementia, brain damage. She will continue to do crazy behaviors until she is stopped. No one in independent living can or will do this. This woman MUST BE MOVED INTO A NURSING HOME - NOW - or at the very minimum assisted living where she can be controlled in what she is doing. Sad but true. In the meantime, tell 911 to ignore her calls and explain the situation; same for the police. You cannot wait - you must have her placed at once. It is going to get worse and worse.

Have you had her checked out for a urinary infection. I know that gets repeated on these posts over and over, but it is very common to see memory issues, confusion, accusing people of things that didn't happen. Rule that out, for sure.

If someone w/her 24/7, take the phone away from her. If no urinary issue, ask dr if there is a medication to help with anxiety issues. The facility is probably going to be contacting the family if she is no longer considered 'independent' or able to rehab back to an independent state.

Does she have any kind of call button? Most independent living places do have an emergency call. Surely they can assist the aides in this short-term situation with the break.

For now, you may need to ask the aide to disconnect the cord on her phone. I assume it could be taped to the back or something so they can reconnect quickly? And, that the aides have cell phones for emergencies?

Could her doctors work with you to give her something very light to keep her sleeping overnight? Will she accept diapers just for this period while her foot is healing? If not, get a really good mattress cover (or 2) and her gowns and sheets may need to be changed at night.

Unfortunately, you are going to need to move her. Not at this time with COVID19, but soon. If possible, move her close by. If you are her family member/caretaker, you have to move her closer. Please do not give up your life for hers. I know that sounds terrible, it isn’t meant to be.

Good luck.

I can't add to the great advice you've been given. When I had surgery the meds they used during the procedure really affected me badly. Think of positive things you can take away from this situation - she still knows what 911 is most of all she has you!

I read through all the answers and they’re great answers but I didn’t see this Idea that worked for us when my father broke his femur. Write up a simple sign:
“I broke my ribs and while I heal
these nice people are here to help me.“
Along with checking for a UTI, confirming medications, and taking the phone away (which we did), just show her the sign and hang it up in her room. She will read it and mull it over and still ask, but ultimately she has fear: where am I, what happened to me, why am I in pain, who are these people? Keep confirming you want them there to help when you aren’t there. Hope this helps.

Redirect--- a FREE minivacation in an assisted living facility ! With better food--- more arts and crafts, shows,,, great movies, a courtyard with flowers to sit and get some sun... endless possibilities-- so why in Gawd's Name would anyone fight fair if someone's health and well-being is at stake ? So many of y'all want to fight fair even if it means losing... the Good Fight... That is not using the brains that God gives you and the strength as well. Take her there for a lunch and then a movie after lunch and then a nap. Then you--- go shopping and come back later and spin another tale. The management has decided to let her have a the room all weekend.
ALL along-- redirect--- the MGMT is offering cake and ice-cream in the dining room... !!! Fight the GOOD FIGHT !

If she has 24/7 aides take her phone away.
assuming the caregivers have a cell phone for emergencies

It is very common when an elderly person or someone with dementia has a hospitalization and/or illness/injury, that it is like falling off a cliff, mentally. They never quite make it back to where they were mentally before the incident occurred. This is probably the new norm for her. If she tries to fire the aide, instruct the aide to walk away for a few minutes, making sure she is safe before leaving, then come back to redirect her like the firing never occurred. She may not remember that she fired them. Take away the phone, notify 911 and the EMS station that is sent to her home what the situation is, ask what they suggest to prevent the wasting of their time if she does happen to call them. Perhaps letting them know that this is happening will help everyone devise a plan. You are not the first peerson who has gone through this so they might already have a protocol in place.

She is not of lucid mind and therefore should not have a phone.

For those saying nursing home, please stop. To be eligible for NH, one must have need of specialized nursing care. Dementia alone is NOT a criteria for NH. Yes, this woman needs assistance, but she doesn't sound like she would meet the NH criteria. AL or MC/AL if 24/7 care at home doesn't work out, but sure, that'll be easy to accomplish at this point...

In my nursing opinion, her medical care needs have advanced beyond the point where it is safe for her to continue in "independent living." (I am an RN.)

If she needs help getting dressed, getting to the bathroom, etc., then, clearly, she is no longer "independent." If she is confused to the point where she is calling 911 eleven times a day, then it is unsafe for her to be in independent living.

A higher level of care seems to be warranted for her.