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I lived with my 89 year old mother, who has Alzheimer's, for the last 5-1/2 years until just one month ago the siblings decided to take turns caring for mom. Of course this is not working out and to cover the gaps I want to hire outside help. Problem? Mom thinks she is perfectly fine and gets angry if we even mention the fact. She cannot do anything for herself, unfortunately. She needs 24/7 care. I've been talking with a few agencies but have frozen when it comes time to "introduce the new caregiver." I will look like the "bad" daughter and I don't want to upset mom -- but know this may be what is best for her. Suggestions?

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I'm not sure exactly what kind of help you are hiring, but if at all possible I would try to spin it as someone coming in to help you/your sibs complete some plausible task that is not specifically related to her needing a caregiver.... cleaning? organizing? sorting paperwork? personal chef?
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Getting outside help to come in and provide 24/7 care for a person with significant dementia, who is resistant or not open to outside workers.....that's very challenging. Cwillie has some good ideas. Of course, it's more involved that that. I'd make sure that the agency is aware that there can be no gaps in time. What if someone is late or gets sick.....it's so risky. I'd really read the fine print on your contract.

With dementia, sadly, it's really the providing of care that has to take first priority and often you can't avoid the person being resistant, hostile, nasty or unhappy. I would work as much as possible to make it smooth, but, that's not always possible. I'd just develop a tough skin.

There are also some techniques on how to work with people who have dementia on You Tube. Look for the Teepa Snow videos on Dementia. She has some good and practical ideas. I hope you can find something that is helpful.
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The way I got this to work with my Dad was to tell him it was me who needed the help. He saw that I was always running around, so it made sense to him.
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It is usually difficult to provide 24-hour care for a person with dementia in a private home (because of the risk of gaps) and it is also expensive. Are you and your sibs considering a care center at all?
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Who are you going to look like "the bad daughter" to?

Your mom with dementia? Your siblings?

If this isn't working out, with the siblings taking turns, time for a family sitdown or Skype meeting to figure out the next step.

No upsetting your mother would be nice; but there also needs to be consideration given to keeping her safe and allowing you and your siblings time and space to live their own lives. Balancing this can be difficult, but it CAN be done.

Getting everyone on the same page is the start.
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Rather than introduce "the new caregiver" introduce Jane, or Mary, or Bill, or Pritti, or whoever the nice person is who has come to keep us company. These people aren't plumbers or doctors, they're individuals who will need to form a human relationship with your mother to do their job - so let your mother see them as such. If your mother asks directly "but what is she/he doing here?" you can answer truthfully that they have come to help you.

You need this time or you will break. Take courage, and enjoy the respite!
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Because this is the first time, it sounds like you do not yet need so much help. Also the first time and while she feels she can manage, she will feel like this. Why not tell your mother that nothing will change, and that the carer is only going to check on her, and nothing more. She may be willing to accept something as long as she does not feel she has lost control.
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I recall someone on here was able to introduce a home health care person as "the laundress" as it was a term her parents were able to wrap their head around. The next caregiver (when she needed to hire more help) was "the cook".

Initially, do you think your mom would accept help coming in to do her least favorite task?

Another poster introduced a home health care aide as the sister of a friend who needed a job.
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hhhmmm i wonder if you could act like they are family members that she forgot about
since she has not a good memory you might be able to fool her & get someone that looks like someone that of a family member ..then it may not be so bad .
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Are you working with a care coordinator? In my area, care coordinators are either very experienced geriatric nurses or geriatric social workers. A good care coordinator will have 'local knowledge', that is, know the local home care agencies and send you to one she (usually but not always a care coordinator is a woman) knows is reliable. She will be able to give you a 'lay of the land' talk about what it's like providing 24/7 home care for a dementia patient. A lot of families don't realize how difficult it is to take care of a dementia patient who needs this level of care--it is *very* emotionally and physically draining. It's very easy to neglect your spouse and your family--and caring for your family should be more important than caring for your demented mother. Many times, families realize that mom would be better off in a memory care assisted living. She will also have experience dealing with the local memory care facilities. She'll surely advise you to tour them (and nursing homes as well) and get your mother on the waiting list. Good places inevitably have waiting lists. Remember this: when your mother's name comes to the top of the list and she doesn't need that level of care yet, you can ask them to put her at the bottom of the waiting list. Another important thing she can do is develop a care plan--so that your mother gets the *right* level of care and that the family understands how much it will cost. Care coordinators routinely mediate family meetings, which is important when siblings disagree. (such as 24/7 home care vs a memory care unit in an assisted living). Care coordinators are not cheap, but in the long run, using one will help you get appropriate and timely care for your mother and save your sanity. Using a care coordinator is pretty much a must if one of your siblings is mentally ill (my brother is a functioning sociopath) and in this case, you will definitely want one with mental health experience. I've used a care coordinator; she had worked for my doctor when he was the chief hospitalist. She always had my mother's best interest at heart. Because she had extensive mental health training and experience, she knew how to talk to my NPD mother and my sociopath brother. She could get points across to them when they refused to listen to me.
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Hi...I think you should consider assisted living/memory care if you can afford it. They have the experience to care for your mother and hopefully she could make some friends and the family could still visit her and take her out. Do your homework and find a good place for her...In the long run everyone will be better off.
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My dad was also resistant to the idea. What I did was the moment he said he was having trouble with something (in his case, just getting the garbage out to the curb) I just casually suggested that maybe we could get someone to help with that? Only an hour 2x a week. He went for it! And then we just kept adding hours on so it was pretty seamless. Yes it does get expensive!! And it was a pain in the butt scheduling everyone. In the end we hired a live in full time caregiver and that worked out great.
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We hired a care giver for my Mom during the middle stages of dementia. She was very resistant at that time. As time went on we eventually hired another person when my Mom was further along and she didn't resist then. My siblings and I still took shifts, my Dad was there at night. The care giver helped us mornings and was there for breakfast and lunch. We helped at dinner time and bedtime. Eventually Hospice also helped us, palliative care initially.
It is great you want to keep her at home, we felt the same. But if you are not getting much help from siblings you might have to hire more help. We used a private hire list we got through the Office of the Aging. Our girl had her CNA certification.
Best of luck to you and your family.
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It sounds like your mom is still in the mild-moderate stages. As mentioned, Teepa Snow videos are good. She may be able to go to a senior center, or if he dementia is moderate there is adult daycare. For my mom the county had transportation, although we chose to provide our own. This took the worry of not having a caregiver show up as scheduled, which has happened with my FIL,s caregiving agency. (it may be because they know we are able to cover). My mom just over a year prior to starting at the daycare told me that her and Dad were going to be independent to the end. As the Littlemidnight suggested, tell her what ever you chose to do that you are doing this because you need it, "so she isn't the one needing help".
As far as looking bad, you need to stop feeling guilt. We are all doing what we can to give great care to our loved ones. And Dementia will let you feeling short of that goal many times. 2004 is when we first started seeing evidence of dementia. June, 2008 at 69, she was "layed off",September she was diagnosed with Probable AD. Next week she is starting her 4th year in memory care unit. There are fewer moments when she seems to connect with the world. Since I live 11/2 hours away, I miss most of them. So when guilt wants to rear it's head, it tells me I should bring her to my house, so she has the comfort of family at those moments. I have to tell myself, I would have no support system, and there is a lot of care between those moments, plus I am the main caregiver for my in-laws. I wish you well.
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I agree with the everyone who said just have the new person introduced as a friend etc.

My mom has Alzheimer's and refused any sort of help. She insisted she was fine.
I hired caregivers a few times. One time I said this person was my friend and needed a place to stay and hang out while her house was being painted and she was more accepting of that. Another time I hired someone and I said "this person is going to stay with you while I am gone" and it ended miserably. She got angry, agitated and I had to send the person home.

If your mom is already resistant to needing help than she probably won't like the idea. So give it a try, have a "friend" or someone that you hired come over to "help you".  The agency you hire will also need to come out and assess her. Make sure whom ever you hire, that the caregivers are trained in dementia.
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I am facing this also I found two things I have tried to see her reaction. One was to tell mom that I think we should have a maid like some people have, her being old school said oh we could never afford that. she didn't say no just she didn't want strangers in the house, I told her I would be right there.
The other thing I told her was I had a dear friend I wanted her to meet she was excited about that so that opened a door to other ways to introduce a stranger in the house. hope it helps, God Bless
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For whatever reason it worked to tell my Mom that her doctor had ordered the caregiver. She would be so impressed that her doctor sent the help she would forget about arguing as she didn't want to upset her doctor. Probably won't work for all but worth a try.
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Don't delay. My 96 year old father is in hospice now. For years he refused to let me bring in the help he needed. He said, " I won't pay anyone to clean here while I have daughters." He also would not let me really decluttering or do anything at his house. It was a an anxiety provoking battle to Fix his broken toilet, get rid of the mouse infestation, to do his laundry for goodness sake. We tried to care for him as a family but it was impossible to create a safe sanitary environment. Finally we hired an Eastern European woman to come during the day-- although he was very resistant initially, he said after a few weeks. "This is a good thing." He was totallly different with her than with us. The belligerence was gone. My father has severe memory loss but has not been diagnosed with Alzheimer's. as I look back now I regret that I did not force a professional caregiver on him five years earlier who could have cleaned up his environment, made sure he was eating properly and alerted us to developments in his health. Ultimately we all did the best we could, given our knowledge and his stubbornness. We currently have two caregivers providing. 24/7 coverage for him and it is very expensive. I know people who have had success that was much less less costly bringing in 24/7 coverage live in homemakers. But Alzheimer's is particularly distressing for everyone-- if you can afford it I would look for a well regarded facility. It will be difficult at first, but ultimately you will know she is getting the care she needs.
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I would look for a "friend" that your parent is familiar with. This will make the introduction easier. If this familiar friend is willing to help with tasks your parent needs, this may be the way to go in the beginning. You can take it from there as the weeks, months progress.
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The above answers are really good. Try to introduce the person as someone there to help you. And as far as anyone trying to make you out to be the bad guy in this, keep in mind that the chances are good that, sooner or later, your mother will not remember who did it anyway. If we must go through this at least we can try to look at some of what as happening as a sort of help. We do what we have to do, and we usually have to fight with the person we are caring for while we are doing it. But it is what it is and it will not last forever. Look for the good things and the good times.
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I used to have aides from an agency. However, after difficulties with agency meeting my mother's needs, my siblings and I researched and found a program called CD PASS-- consumer-directed personal assistant services and support. This program has allowed us to interview and hire people we know and trust, such as family members and friends.
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Sue, I hired caregivers from a nationwide agency and they sent me a variety of different people to see which person my Mom would like.... well, Mom didn't like any of them... Mom said she had her husband and her daughter to help her. Earth to Mom, my Dad was in his 90's, same as Mom, and I was a senior citizen who was busy with my career.  Mom just didn't want strangers in the house.  The caregiver could have been Hazel or Mary Poppins and Mom would have said no.

The Agency even sent a caregiver who had a knack of getting the elder to accept her. She met her challenge with my Mom, who shooed everyone out, so I had to cancel the Agency. Before long Mom had to be placed in long-term-care. And the caregiver that Mom shooed out became my Dad's caregiver who he then had for over a year. She was great.

Please note having 24 hour care at home will become costly. For my Dad it was $20k per month, yes per month.
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I worked in Elder Care for my "profession" if, you want to call it that. My "longest" client didn't WANT outside help and had fired several previous women. I went to "meet" her, introduced myself as a personal Assistant, someone who would be coming to help her organize her many activities and be her private chauffeur. This went over beautifully, she accepted me on the spot and we got along great. I was not a teenager, nor an immigrant (sorry, she was a bit of a racist and I can't sugar coat that)...and she referred to me as her PA many times. Needless to say, I was an underpaid, overworked caregiver for an elderly lady and I knew it. What SHE knew was that her privileged lifestyle was going to continue.
When she eventually required 24/7 care, I was instrumental in the adjustment, change and move. I visited her a few times after she moved.

This was a less than 32 hr week gig, OT only on holidays, so the family still had to step up a lot, but they got some respite.
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As freqflyer said home care 24/7 is costly. For us adult daycare was the best resolution, for dependability as well as price. She was there until she progressed beyond there ability. One of the problems there was that there were more developmentally challenged people who could not understand my mother's need to nurture them (mother of 6) Where if she would have been at one for dementia clients, they would have been better trained, hopefully, allowing her to stay at home longer.
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For me its getting over the guilty feeling of leaving her side.
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Been there. Done that! The big agencies wouldn't do things as I wanted such as administer meds. I asked them why do they say they have med nurses if that's the case? Tried neighbors, didn't work. Tried Care.com, HUGE mistake, caregiver was sweet enough but she brought BED BUGS into my home! If family will help, take them up on it, dictate who does what and when. I had no help from literally 100 family members, wish even one would have stepped up, now mom is gone but I know I took wonderful care of her for nearly 22 years on my own!
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I did this, I got to know the caregiver first and then invited mom to ice cream with caregiver and my son (moms favorite grandson) and explained this was a good friend of mine, we did a couple of things together first and the caregiver got to know mom with me. Then when I felt comfortable, I explained to mom that CG was coming in my place that day because I couldn't get away from work. It took some time, but worked like a charm!
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Hire a middle aged immigrant woman, preferably Haitian or Mexican. Most of these women are loyal and hardworking and are not going to jeopardize their liberty, especially in our current political climate. Besides, you could get someone at a better rate than and agency. This may not be legal or politically correct, but after all is said and done, this is your mother. Nothing else matters and nobody has to know. Also, install a surveillance system that will enable you to monitor everything from your computer or phone. This will help you stay on top of things in real time. Ruben
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I have heard of others that tell LO that they know someone who needs a job and they want to help them out. The LO feels they are helping the caregiver out.
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This is one of the toughest positions to find yourself in, especially if your mother has been very independent or "in control" for most of her life as mine was. Most of these answers are excellent counsel!
Take heart and you will find a way. My mom finally wound up with an RN who was willing and able to take care of her...because this woman "NEEDED THE INCOME" (Turned out that Mom was more right than we thought.) They became so close that the care continued after Mom went to a nursing home!!
It seemed to make Mom feel better that she could still contribute something to someone's life. (Mom was a retired English teacher/guidance counselor.) She hated feeling worthless and "like a burden". Your mother and mine would have been of the same generation. That's their MO!
I think one of the hardest things on an older person is to feel worthless and helpless. It's frightening and depressing, in spite of the mental capacity - or lack thereof.
Seek support and intervention for yourself and your siblings. Don't let yourselves become stressed to the point of breaking and burnout. You are a GOOD daughter as you are showing by seeking answers for your mom. And just one other thing:
Tell her occasionally that you are proud of her. (You will be happy you did later.)
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