Staff shaming MIL in assisted living. How should I handle this?

Lots of people get advice they were not consciously expecting on here - it may sting to hear it, and sometimes it really is unfair. But, it may be good to help see what the other points of view may be, and sometimes the unexpected is exactly what you need! Don't give up on posting - and maybe nose around about elders and hygiene on here, you'll see what I mean.

I'm a physician, but on the pediatric side, and I'm the first to admit I was totally at sea in the geriatric world I was thrust into when my parents started to seriously decline. There is a LOT to learn. And very, very emotionally hard when it is our parent, our spouse, and not someone else's loved one/our patient.

lindek, your MIL has dementia, right? People with dementia don't always respond logically or "appropriately" to what they are told. They may feel hurt when no one involved said or did anything remotely hurtful. They may believe their caretaker is plotting against them when the caregiver is just on phone ordering their incontinence supplies. Their reactions are real to them and need to be respected and dealt with. But I think Maggie was just pointing out that just because MIL felt shamed doesn't necessarily mean someone was shaming her.

This is a public forum. We are all entitled to post on any thread. If we violate the forum's standards of behavior the moderators need to be notified. That is what the "Report this Post" link is for. If you feel someone is doing that you should report the post. The moderator can tell someone not to post or to delete their post. But none of us can tell each other that they can't post on "our" thread. Once we post, the entire thread is public.

You know THAT your mother feels shamed. She told you. But you don't really know WHY she feels shamed. Maybe the answer is because staff handled the situation very badly. But it is also possible that part of the answer is "because she has dementia and isn't perceiving the situation the way you or I would." If you are new to this role, that can be a helpful insight to share. It is not "nasty" to share a different perspective.

I'm willing to bet that resorting to name-calling "Your a jerk" is not your normal coping mechanism. You are under a lot of stress. Actually, at any point in time probably 75 to 90% of the participants on this forum are stressed. Let's try to respect each other, even when we don't agree with each other.

When staff tell mom they will call me when she doesn't cooperate with a shower, her perception is I am trying to control her life. My husband is an only child, diagnosed with Parkinson's 18 years ago. He is unable to assist with his mothers care and business due to the progression of his disease. You are right jeannegibbs, I do have a great deal of stress and and am doing the best I can.
Staff telling mom they are going to call if she doesn't take a shower, pitts her against me which makes it even more difficult to deal with an already difficult situation. By no means have I ever "pulled rank", or criticized staff. I know all to well how hard they work and thank them at every opportunity.
No more posts for me. I am now an official lurker
God Bless.

Well now Maggie-Marshall. I don't have to ask myself the question as to why my MIL feels shamed. BECAUSE SHE TOLD ME SO!
If you can't be nice, please don't repond to my posts.

I agree that they don;t seem that out of line, as you posted they were to call you if there was a problem. I think that makes you look MORE caring in that you want to know if Mom is having hygene problems. If Mom was a toddler at daycare the story would be the same,, and in alot of ways mom IS a toddler. Unless they were rude ( as in You are stinky, I am calling your daughter..) then I think this is a situation that can be resolved with a conversation and good will.

lindek, when I read the title my immediate reaction was "find a better ALF!" But when I read your explanation I was just puzzled.

First, you have your mother's interpretation of what was said and how it was said. I certainly believe you that she feels shamed, but that may not be reasonable response to what happened. Mom has dementia. She may have taken things out of context or taken things more seriously than they were meant.

And you did ask staff to call you so what the aide said does not seem terribly out of line to me. I'm trying to think how I would react if an aide said to my mother, "Now we really have to give you your shower. Jeanne wants us to keep you nice and clean and we'll have to call her if you don't cooperate." Hmmm ... well, first of all I'd think that calling me isn't going to do any good. I wasn't able to get her to shower for me at home. And beyond that, if it worked I'd say use it every time. Getting elders bathed can be such a huge struggle. If it made my mother feel terrible I'd joke with her about it and then I'd ask staff to revise their approach. I wouldn't criticize them but I'd point out that bringing my name into didn't seem to be helping.

Now that everyone knows that this approach makes your mother feel very bad then everyone should stop using it. Talk to whomever you have to to see that it stops. (Maybe it has stopped, and your mother is remembering an earlier time.)

You asked for advice. You are getting advice. Not all of it sits well with you. That is OK. You are certainly free to ignore what doesn't apply to your situation.

But seeing how quickly you jumped on Maggie's response and labeled it "rude" makes me wonder if the difficult and delicate situation you are in and the stress level that goes with it has you in over-sensitive mode. And I sure hope you don't pull rank that quickly with the ALF staff. You have been an RN for 35 years. That is certainly something to be very proud of. How many of them were in a care center? How much of your experience has been specifically with patients who have dementia? If in fact your career has prepared you for getting dementia patients to bathe on schedule, then by all means share your expertise by going in on shower day and showing how to do it without making MIL feel bad.

The more likely scenario is to go in and work together with a staff person and after the experience put your heads together to figure out how it could go more smoothly next time.

You certainly have the right and duty to advocate for the best care for your loved one. Usually you attract more bees with flowers than with vinegar. I'm glad to hear that you are very good at supporting staff. Don't let the stress of this situation deter you from that path!

If the staff does call you without saying anything to your MIL, how would you handle getting her to shower? I agree the staff should not have said anything after you had addressed this issue.

You think my post is rude. I think I'm on target. If you're trying to reason with someone who has Alzheimer's/dementia, most of the time you'll find yourself fighting a losing battle. Ask yourself, "Why would that shame my mother-in-law?" Why would it? I'm asking you. Her thoughts aren't completely lucid, after all. What if next time she's shamed by people encouraging her to eat? Or put her clothes on?

IMO, our job is to referee and diffuse between NH staff and our loved ones. You could have laughed it off; you choose to criticize the staff. *shrug*

"Shaming" your mom would be telling her she smelled in front of others. Shaming her by saying, "If you don't get squeaky clean today, we're going to have to call your daughter-in-law?" After you told them to do exactly that? I just don't get it.

Nevertheless, you have plenty of other advice here. If you don't agree with mine and find it rude? *shrug again*

MaggieMarshall - I take exception to your rude post.
I am asking for advice on a delicate situation. It is never appropriate to shame a client. MIL is entitled to her feelings and this is what she has expressed to me. I certainly hope you are not in the healthcare field with the snarky attitude that you have. I have been an RN for 35 years. MIL RN for 50 years, so don't talk to me about criticizing staff. Defensive? Yes! My job is to be an advocate for my MIL while at the same time supporting staff which I do very well thank you.

lindek, your profile says your Mother has dementia/Alzheimer's, it's my understanding that sometimes the patient will say things that aren't actually happening.

If what is being said is actually happening, what does the assistant-living facility suggest in order for your Mother to bathe?

How long has she been in AL? Is this a new situation for her? Perhaps talk to switch staff about how long an adjustment period you can expect. Does she really need to shower every week right now?

I see where you are coming from MaggieMarshall but, I have seen the other side too many times from working for an AL for 10 years. Many times the aides take too much on themselves with resident care. The MIL doesn't have to feel like she is being tattled on. It would be a good idea for DILaw to be there on shower day.

You should let the AL facility use every tool at their disposal short of abuse. What's wrong with letting your mom know you'll be told if she is obstinate? Why would you object to that?

Your job is to support staff, not find reasons to criticize them. Theirs is a thankless job...made more thankless by relatives who don't appreciate the problems they face caring for their loved ones every day.

Shame on the nurses aide for doing this. Request a meeting with the DON and the administrator. Put the request in writing. (Document everything) The nurses aides need to be instructed on confidentiality and patient care.

Can you arrange to be there at a specified time for her to shower? They may be having trouble remembering who wants called with what and who doesn't want called, though you'd think you could put it on a care plan that everyone could look at.

Go beyond the head nurse and talk to someone in administration, maybe DON or the administrator of the facility. And put in writing then give the letter of concern to the administrator. Maybe if they know you're documentating, they'll be more responsive.

But do approach it as an attempt to solve an issue, and hopefully they might be more responsive. If it's a complaint, they could "get their back up" and be defensive.

Also have a heart-to-heart talk with your mother and explain that you're not behind this tactic, that you have asked them repeatedly to call you but they haven't. She's probably hurt and embarrassed.

It's too bad they can't be more responsive in dealing with this issue.