How are ways to deal with a family member?

It sounds like this is a difficult pt and that you're doing the best you can. Sometimes it's important to remember that you not only care for the pt but also for the family. Sometimes family members strike out at staff and their caregiving because they no longer have total control of the situation. Some are saddened at seeing their loved one failing and there is nothing at all they can do to stop it. Many times family members don't even realize the real reason they are lashing out at staff. The quality of the caregiving can be an easy target.
I would encourage you and your coworkers to really self evaluate your care of this pt. If you are doing the best you can for her begin to look at ways to help the pts daughter. You might want to bring the daughter more into care planning for the pt, it might help the situation. You mention that the pt is always on edge maybe a talk with the daughter and the pts doc might help.
Dementia pts are some of the most difficult pts to deal with. Its hard on caregivers and it's incredibly hard on family. As a family member with a Mother who has dementia I can tell you there is grieving everyday for the loss of your parent. Everyday it seems there is a little less of the person you used to know. It is a long, slow process down dementia road and it takes a tremendous toll on family. I wish you the best of luck in your care of this pt and her family.

In a case like this, could the daughter hire a full-time one-on-one Caregiver to come into the facility? Would that be allowed?

I just have a couple of practical questions. Why do you have to keep her mother sitting down, what is wrong with letting her walk around? If she can walk 3 miles in a day, she's probably pretty fit. Secondly, can you trim her fingernails so that she's not as likely to scratch her skin? Thirdly, can an administrator or social worker admonish the daughter about yelling at the staff? She is wound too tight and needs someone to talk to.

What kind of facility are you? The fact that she is always threatening to take her home makes me think that for some reason she thinks she can't?

I think the daughter needs some meds. She is not dealing with the situation well. Any threats about taking her mother home could be met by something like, "When should we have her ready for you to pick up?" or "Will that be for the weekend or permanently?"

Being abusive to staff is not acceptable. The facility director should speak to her about it.

You sound very caring and that you are doing a great job.

Tris - first of all, thanks for coming onto this site, it's good to have the perspective of staff at a facility as to issues! It sounds like you work at a small board & care home rather than at a large AL or NH. Is that the case? My answer is based on that.

If so, part of the problems is likely the " level of expectation" of this residents family AND the owners of the facility. Board & care are very much less expensive than either AL or NH, which means less staffing and support services. I looked at a couple for my mom, but although she could "do" what was expected for ADL 's & be self-directed in medication at the Board & Care home, it was better for her to go into an IL which was part of a larger tiered facility that had AL & NH - so that if something happened there would be a higher level of trained professionals and services at the ready. Now mom never needed it, but was good to know could be.

Daughter is expecting Ritz Carlton for Quality Inn, she is never going to be happy. The whole list of what has to be done for mom is, her way of manipulating to get this. Not going to ever work as your place is just not set up for individualized care plans. Owners probably run on a tight profit margin, so want to keep all residents. Plus they are wary of daughter as it sound like she will threaten lawsuit or reporting to city, state, board of health. So a part of how they deal is to place the excessive caregiving on this 1 resident to the small staff of 3.

You need to let owners know how much time this 1 resident is taking up. Maybe you all - all the caregivers - do a log of time spent 24/7 for a week on the time demands of this 1 resident. Note ever item that daughter wants addressed too. Do all with exact time. With all this the owners can decide just what to do. With documentation, they can send the daughter a "30 day notice" that resident needs to move; that although they have loved having mom there, the level of care that the mom needs cannot be provided. Daughter will not be happy as the costs will go from maybe 2k to 8k, but she isnt going to be happy no matter what now is she.

Facility does not have to help find a new place for the lady either. That protection - I think - is only for SNF/NH on Medicare & Medicaid paying. They can however, attach a list of nearby ALF & NH.

Good luck in all this. You sound like a gem of a caregiver!

Would it be so bad for you if she took her Mother home? I am sure there is a waiting list for people who would really appreciate your help. Maybe her Mother needs a higher level of care, and her daughter should find a place that can accommodate that need.

Trissfit: Sounds like you've done about all you can! Sometimes you just have to accept the fact that you aren't going to make someone happy and just move on. You are probably right this family member won't be happy until her Mom is at home with her, and then I doubt that she'll be happy. The next time she threatens to take her Mom home refer her to your facility administrator (I am assuming you have discussed the situation with him/her). It may be time that she do just that, take her Mom home. Family have the right to expect good care of their loved ones but they DO NOT have the right to verbally or physically abuse staff. Again, best of luck and thank you for loving your job, it truly makes a difference in the care pts receive.

What do you mean, the daughter is messing with her meds? Aren't the meds prescribed by a physician?

Trissfit, it sounds like you are a very caring and concerned caregiver. Although the daughter is going through a difficult time and has every reason to be concerned it's not okay that she yells and criticizes you and the other caregivers. She has a right to express her concerns and her preferences however she shouldn't be allowed to run over the caregivers at every turn. Perhaps you could speak to the director of your facility and he/she could intervene and help the daughter come up with a better way of communicating her needs? My mom is in assisted living and been diagnosed with dementia. There have been some instances that I wasn't happy with how they were caring for my mom but I would never go in and just rip into her caregivers. You have a very tough job and don't need that. I have hired a caregiver to come in once per week for a few hours on the one day that I can't get there just to make sure things are getting done. Maybe the daughter should try taking the mother home even for just a week and then she will see how difficult caring for her can be. If you haven't already, I would strongly suggest getting the director involved to work things out. Good luck to you!

She can take her home at any time. She just threatening us all the time. Thank you for your input everyone, I guess I'm going to have to ride it out