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The (not) fun with paid caregivers..
Eric L
Posted: Thursday, December 6, 2018 2:36 PM
Joined: 12/5/2014
Posts: 1016

MILs dementia has progressed rather rapidly over the last few months. We suspect that she's had a few TIAs and they have really taken a toll on her. A couple of years back when our family started to realize that it might be time to bring in paid help, my wife and her brother hired a geriatric care manager to help us out a bit. Though her services can be a bit pricey, she's been a nice resource to have when we are at a loss in certain areas.

With MILs progression, we started to become a bit concerned that our current caregiver might not be qualified to handle the changes. My wife and her brother contacted the care manager and she suggested that if we were looking to make any changes, it might be best to do it sooner rather than later. She also said that she hadn't seen MIL in about a year and it might be a good idea for her to come out and observe MIL and the caregiver and assess whether or not any changes should be made. Of course she will be paid for this, but since we have kind of been on the "should we or shouldn't we" ledge the last few weeks, we figured it would be good to get another (expert) opinion on the matter.

She came out yesterday and did her assessment. The first thing out of her mouth after the caregiver left was "You need a new caregiver ASAP. She spent the entire time I was talking with her badmouthing you guys. I know the care that you provide Mom is top notch and you need someone that is on your side." We were already concerned that caregiver didn't understand MILs dementia. The badmouthing stuff really caught us off guard.

Apparently, one of the things that she told the care manager was that she always made sure that she took MIL out for exercise and had her walk places because she was concerned that our family made her use a wheel chair whenever she went out. A couple of years ago, we did buy her a wheel chair. MIL also has psoriatic arthritis and mobility was becoming a bit of a concern with us. I think we've used it once in the 2 or 3 years since we bought it. In the (almost) year since our current caregiver has been with us, she has never once seen her in the chair (because we haven't used it).

I suspect that she was telling the care manager that sort of stuff to make her position with us more "vital" than it actually is. Needless to say, her last day with us will be in a couple of weeks and we are starting the search for a new caregiver right now.
Posted: Thursday, December 6, 2018 5:34 PM
Joined: 11/3/2018
Posts: 120

Dealing with bad or sub-par caregivers is the worst. I have a young man who lives in and provides respite care in lieu of rent but I'm seriously considering kicking him to the curb because he doesn't answer texts or e-mails. A schedule change I sent him yesterday went unanswsered for 18 hours and he said, "I can't, I have some things to take care of."

I'm really peeved. I mean angry. On the other hand, if I kick him to the curb I'll have no respite care for myself and I'll be back in the loony bin within two weeks. I just don't know what to do here.

Posted: Thursday, December 6, 2018 6:53 PM
Joined: 11/13/2014
Posts: 2115

Oh goodness! I would fire her,too! Bad mouthing you guys who are doing a wonderful job! So what if you take her out in a wheelchair! Can't fall to far that way . The MCF's and NH love keeping people in wheelchairs, they consider it easier.  I agree with the vital comment.
Posted: Thursday, December 6, 2018 7:52 PM
Joined: 3/8/2018
Posts: 713

The second thing I did when I engaged a HHA (after I locked up the valuables and checkbooks) was to get wifi security cameras for the house: kitchen, living room and moms bedroom. Comes with an app so I could watch and listen at work.

Worth. Every. Penny.

Saw lots of questionable and inappropriate behavior with the first aide, she lasted about 7 days and then I called the agency and kicked her to the curb.

Also, my GCM does monthly in-home visits, I was surprised when you wrote she hadn’t seen your MIL in a year

King Boo
Posted: Saturday, December 8, 2018 7:13 PM
Joined: 1/9/2012
Posts: 2965

I think you need more clarification about the bad mouthing - which really doesn't sound like badmouthing to me.

A good caregiver can get very invested in a client too - they may not have the expertise or knowledge to know everything - so if the caregiver believes Mom should get more exercise, the question I would have is is she being safe with Mom?

My caregivers were outright disapproving when my LO went onto hospice - they didn't grumble to Dad, but I heard some - and talked about it with them.  

Just make sure it was really badmouthing and not a misunderstanding.  The GCM may be spot on, or she may be jumping to a quick conclusion.  Proceed and investigate.

Eric L
Posted: Saturday, December 8, 2018 9:47 PM
Joined: 12/5/2014
Posts: 1016

SEL - Things had been going pretty well since like the 1st of the year or so and the GCM said (basically) "Since things are going well, there is no need to utilize my services until you need me again". We didn't mind because it saved my MIL a bit of money and we really didn't need her during that time period.

King Boo - She straight up lied to the GCM about us "pushing her around in her wheelchair" all of the time. It would be one thing if she had seen us do it or that one of us had made mention of it. Truth be told, we were starting to have some concerns about her future abilities going forward. She seems to want to blame us for MILs progression (as if we aren't doing enough).
Eric L
Posted: Tuesday, December 11, 2018 11:16 AM
Joined: 12/5/2014
Posts: 1016

So, I have given some thought to this, especially since King Boo's post made me really think about how this misunderstanding might have come to be. I think the conclusion is still that it's time to move on, but not necessarily because she lied (though it still could have been a lie).

The caregiver started about a year ago (give or take). MIL was still a bit feisty and still had the ability to answer questions with seemingly reasonable answers. I'm fairly certain that she was still complaining here and there about "being stuck in this damned house all of the time". It wouldn't surprise me if she told the caregiver this at various points and I could see how the caregiver would think that her once a week outings were more important than they actually were. In reality, MIL was fixated on the idea of being stuck at home while she actually wasn't.

I can also see that maybe at some point in time that the caregiver had asked her about the wheelchair and may or may not have asked a leading question and maybe my MIL told her that we pushed her around in it all of the time. I can see the caregiver taking her word as gospel, because I ran into that stuff with the CG a few times. Just as an example, during the school week, we tend to get my MIL up and ready by about 6:30am. I'd say for at least the last couple of years, we have had breakfast ready to go before she gets up. It's part of our morning routine. More than once, the caregiver would ask "Did MIL breakfast today? She told me she didn't" and I'd have to remind her "She eats breakfast at the same time everyday. It's the same thing everyday. It's a muffin, hardboiled egg, fruit, and juice. After that, she gets her morning pills. It's part of our routine." Yet, the question would still pop up from time to time about breakfast.

So yes, I can see how a misunderstanding would pop up, but I think our original concerns about her not having the proper tools to deal with a dementia patient are probably valid.

King Boo
Posted: Tuesday, December 11, 2018 11:40 AM
Joined: 1/9/2012
Posts: 2965

OK, sounds like a good call!  You definitely need good skills and compassion moving ahead so if the caregiver doesn't have them, there's a better option out there!

An outright lie tilts this whole banana in a different direction - good call!