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Whoever is in charge of hiring caregiver for dementia patient (bed-bound or walking) 24/7 at home should be also responsible for setting up top-priority rule, for example under no circumstances leave the patient alone at home. In addition, give the caregiver contact number in case of unexpectancy/emergency. It may prevent some of these problems from happening again, if not all.
The fix is easy. Communicate and make certain YOU provide premade food in home for both of them. Sign up for Meals on Wheels or another food delivery foe your Mother and Amazon food delivery for your employee/contractors caretaker as is your duty under law to provide ample, premade food; not having to make bread from scratch as an example, if it is 24 hour care.
Communicate and provide food. Problem solved.
The fact of the matter is that family members will complain about the aide not doing this or that, but aides are hired to help with cleaning and grocery shopping along with providing help with grooming and ADLs.
It is easier to blame the aide than to do the right thing and check to make sure there is food available for the elderly person to eat or at least leave a number of someone who can be responsible for the food and the banking.
Some caregiving companies now hire “contract” caregivers. That means it’s up to the hiring person to broke schedule and beaks. It’s a work around so the company has no liability. The caregivers then charge the caregiver a percentage. So the actual caregiver must make all decision and get all updated training rather the care fund company.
BRAVO BRAVO again for you having the intelligence and wisdom to not automatically misblame the caregiver as most ignorant assume was at fault, when they failed to realize providing food is part of being a caregiver and there is no requirment to be in presence of patient 24 hours a day, but only care for them 24 hours a day unless the contact says that.
Proving food is caring. And if bed-bound there is no safety issue and NO NEGLIGENCE.
If bed-bound they are probably already in a hospital managed care bed. So no difference between being bed-bound in home versus at managed care facility as you know.
So many people make false assumptions and conclusions. It’s wonderful this site of questions and answers exist to show and share things that others are uneducated about. It enhances the lives of all caregivers and the elderly who need them or managed care.
Some are stuck in 20th Century old misthinking about what us best for the elderly and about caregiving. They also claim “Neglect” when they have a pedestrian under staining of the law and no education nor training in law for the elderly.
You are amazing and so kind to share your first hand expert so ithers ehi never thought that the lack of prepared food in the home may have been why the dimentia patient, who poster indicated was not severely with dimentia if having an appetite and able to communicate to caregiver, went out 30 minutes not to speak to boyfriend, smoke or be on phone but yo get food for patient.
Great job. Thank you for sharing and thank you for the expert job you do enhancing the lives of patients and their families. And also for feeding those without food in home. Not everyone can self-reflect or think things out as logically as you are skilled.
Caregivers are often inexperienced. And they are less of “Care” givers and more of sitters who ensure elderly people are feed and safe. If the elderly person was complaining of hunger and you didn’t provide ample ready food thst did not requiring cooking, then caregiver may have acted in benefit if the elderly person.
instead of getting revenge with terminating caregiver, make a list of the exact rules. Often things seem obvious to you that are not obvious nor permitted.
There is a shortage of caregivers so train your caregiver rather than terminating. Again write list of your rules and obvious rules.
I know all this because we recently had a caregiver who put her iPhone into loud high pitched music that gave my Mum headache. She also left to go to get car. And she bought my Mother food at grocery story after her shift and returned with it and then later charged my Mother for her time and food that was never authorized when my Mum gets groceries for free and we went to grocery store day before so there was prepared food only needing to be microwaved.
so merely speak with the caregiver and write a list. Otherwise you may not get a caregiver when you need with them shortage.
If it occurs again, then take action. Also notify the service and send them your list obviously.
we installed a cheap $30 Blink camera or two in kitchen and living room to see if my Mum falls. This camera recorded caretaker. Invest in Blink inside camera to monitor.
This rush to mis-judgement agaibst caregivers who must leave to provide food which is caring for the patient, occurs much too often, so it is a great learning experiencing to others who hire caregivers but don’t provide food in the home.
There is a great reason this post is still up. It’s helpful. Just because I’ve may not like the responses doesn’t mean it should be removed because the original poster didn’t reply. He or she may be reading all the newer posts from time to time and real size error in his thinking and just learn to communicate with caregiver and provide food in the home.
If the OP's mother is so out of it with dementia that she can't be left alone for a little while she belongs in managed care with a full, round-the-clock staff to "watch" her.
The OP is the one who is negligent and putting dementia mom at risk here by leaving one person to provide round-the-clock care seven days a week.
In above post it is noteworthy dimentia patient stated she was hungry and asked for food. And given caretaker went out and got food evidences there was not ample food in the home. Hence, caretaker may have agreed to leave when asked for 30 minutes to get food, as a great necessity if not ample food in home. Think it out.
Same happens in 24 hour memory facilities. A care facility is also NOT required to be present at bedside 24 hours/day so life doesn’t improve in facility related to “watching patient.”
Moreover, having 24 caregiver in the home is unrealistic. The person deserves breaks to leave the home. It’s the law.
No harm was done proving it was not an undo undue risk. What might have happened did not. Since caregiver chose to accept patient’s request to go nearby for a half hour to return with food, that was the safer best option for well-being of patient- food. Everyone needs to eat. Everyone needs variety.
To emotionally exaggerate a response to then claim patient needs a facility is irrational, inhumane and not making the situation safer since facilities also do not sit with a patient 24 hours a day. (Since patient is requesting food, starvation may be issue a facility can resolve. Generally dimentia patients are thin and have no appetite.)
Getting food for patient is very important. If patient is hungry and is able to speak they need food, those are very healthy and good signs patient is not in severe dimentia. The days of institutionalizing a person merely, because they have a diagnosis of dimentia are over. A more humane approach is used now. Dimentia doesn’t mean people cannot reside alone accd to my Mum’s doctor in CA depending on level of dimentia and local support later.
People with dimentia often pass away with no family knowing they have dimentia. Hence, they were not unsafe by themselves. Mild dimentia patients can still legally drive. DMV not doctors decide who drivers and DMV uses objective tests.
Mild and moderate dimentia patients walk, feed, dress, bath, themselves, garden, operate telephones and TV, microwave themselves meals, make tea/coffee with instant water machine, They are not yet “dimented.” And have their legal rights to live alone.They might have peripheral help to ensure bills are paid or to drive to grocery store,doctors. This does NOt mean they cannot reside alone safely.
I know this first hand. My Mother is moderate. Doctors give me signed document saying she is LEGALLY ABLE to make her own legal decisions. This means so she can live alone if she wants to in her own home. To place in a facility mean they do not get same amount of comfort in their surroundings (well-being), do not get to see family photos around, cannot chose their own likeable food, treated as patients not as family which degrade their feeling of independence is taken from them which negatively impacts their live.
So what if they cannot recall date, time, what happened yesterday, names, don’t their medicine (unless schizophrenia or bipolar meds. It is their body and choice without dimentia so they have thst same right with it. And it no longer matters at that age if high blood pressure, or whatever. That doesn’t make them fire/fall threat to themselves or others. Just remove oven and stove knobs if memory issues. So long as family come to replenish groceries,socialize once/week or more. Than your life isn’t uprooted either and you both keep your independence and mental health more. Train caregiver with list of dos and don’t is easier, wiser, faster.
when she was in a nursing home she was left for a lot longer with no one checking on her. This was true for most of the people there. I could not get them to even change her diaper. In fact it was their lack of care taking her to the bathroom that gave her the idea it’s ok to go in the diaper. I once waited 4 hours to get them to change the diaper after I asked them.
If any of them had to leave for whatever reason, I expect them to call me so I can come home.
If they ever left my mother alone I would fire them without hesitation, even if it put a temporary hardship on me.
I agree, food can be delivered just as groceries are so that a caregiver does not have to use their car and their gas to run errands for your mom. I think there are just more issues with your arrangement. I did 24/7 care for my mother, but even if I was going to venture out to be an employee to care for someone else - there's no way I'd be tied to a house for 24/7 with no relief in sight. You might want to reconsider and hire 2 or 3 different people to do overlapping shifts. Also, be more realistic about your expectations of an employee.
Of course there may be more to this story: the lady needed a place to live and you needed help, etc.
Id tell her right up front. I hired you for this. Its not working out. Change the locks and get the credit cards. How do you know it was for 30 mins? Did you see the food containers? Do you know it was just that 1 time, and just for 30 mins?
I'd get cameras. That way you know what's going on. They can be an alarm clock or phone charger. And tell her come December you need that time filled, so you need to hire someone. If I left my job for a month, I wouldn't expect a job when I came back unless it was my earned vacation.
Where are people reading the caretaker is working 24/7. That's not legal. If that's the case, I'd go out too. My answer would be different.
This sounds very abusive to the caretaker.
On the other hand, you are suggesting your mother is incompetent by saying she is 'bedbound and in a diaper and cannot stop anyone from doing anything.'
Which is it? Is she mentally competent to make decisions, or is she incompetent b/c she's physically unable to stop anyone from doing anything?
You would have us believe your mother is the equivalent of an adult baby lying in a bed wearing a big diaper, yet in the same breath have us believe she's in full possession of all of her faculties (based on other things you've said in previous posts).
Your mother gets to decide how this caregiver operates provided she has not been deemed incompetent due to dementia. She likes and trusts this caregiver and now you want to fire her b/c YOU don't trust her. Where's your mother's say in all these decisions you are making on her behalf?? You say you 'don't want to do anything that my mom is uncomfortable with' yet are planning to wait and 'replace her' while she's visiting family in the Philippines in December???
Again, when does your MOM get to have a say in all this? Isn't SHE the one paying the bills? And perfectly competent b/c she has all her faculties???
It's good that you want to help. It's not good that you are trying to micromanage the caregiver and override your mother's wishes. Respect your mother enough to speak with her about what SHE wants to do here. Don't go behind mom's back to fire a caregiver she likes and trusts b/c she sent her out to get food and you didn't agree with her decision to do that!!! As POAs, we only get to make these types of decisions on behalf of our mother's when they are deemed incompetent to do so themselves. Until that time, THEY get a BIG say in who cares for them, it's not all up to us!
In the meantime, it is a good idea to make your wishes known up front and honestly to this caregiver, once you run everything by mom first. This situation is all new to you, so you don't have all the rules down pat yourself. Give this woman some grace, that is my suggestion. And give your mother a say in who gets to care for her moving forward. Don't treat her like an incompetent child just b/c she's lying in a bed wearing a diaper. If she's able to call 911, she's capable of being left alone for short periods of time.
Hiring and firing a whole bunch of aides is a headache in and of itself. Nobody's perfect and nothing in life is perfect. Unless this CG has done something very untrustworthy you've seen with your own two eyes, I'd have a chat with her and give her another chance.
This is a tough situation for you being new to caregiving and hiring people. You love your mother & want the best for her. There is a fine line between wanting good care for her and suffocating her. I always try to think of things as if I were in the position myself, lying in bed after a stroke. Firstly, I'd want to be gotten up OUT of that bed and into a wheelchair every morning so I could use my legs & get the blood circulating by 'walking' in the w/c. I would not want to be treated like an invalid, and I'd want to have a big say in my own care and in my own life and rehab. What would you want for yourself, if you were in your mom's shoes? That's how to make decisions moving forward.
Good luck.
My Mom was masterful in telling the caregiver to go to a different part of the house to get her something, then as soon as the caregiver left, my Mom would get up and go do something, attempting to prove that she was independent and didn't need those caregivers....and would lie about it.
I gave explicit instructions to the caregivers that their first and only priority was to be with my Mom. The dishes that my Mom just used could be left in the sink unwashed. If my Mom needed something from a different part of the house, the caregiver was to help my Mom to her walker and make my Mom go to the same room to point it out. If it was on a different level of the house, then they were told to say that they were not allowed to get it. Only when my Mom was asleep could they eat or do dishes or go to the bathroom. I instructed them to say "Your daughter told me not to do it" and not do it. I always had the back of the caregiver if my Mom quizzed me.
I've heard of people putting a mini-fridge and small microwave in the bathrooms or closets, just so that the caregiver didn't have to leave the room
In the morning, the caregiver would give me a rundown of all the things my Mom asked for and whether she could or could not fulfill the request. Then I would ask my Mom whether she asked for the things. My Mom would usually deny ever asking them. Some of the requests were absurd. My Mom was in the beginning stages of dementia (we didn't know it at the time) and she was totally unaware or played dumb (once, in a weak moment, she actually said that she "played" the caregivers)
Regarding trust, what other things has she done that you do not trust? It is extremely important to completely have complete trust between the patient, the caregiver, and the person responsible for the patient. I'm assuming that you have removed anything of value from the home. Do you stay there at night or do you go somewhere else? Also be cognizant of cultural differences and try to see if the non-trust behavior is culture based. If culture based, then speak specifically to the caregiver about it and see if you and she can come to an agreement.
So, I would be straight with the caregiver and make it easy to comply. She is NEVER to leave Mom's bedroom while your Mom is awake or could be awake. If the caregiver has been asked to do something that would take her out of the bedroom, then the caregiver is to call you. Chances are, you already have it figured out and Mom and the caregiver just need to know how you have accommodated for that. Hopefully, your Mom is not as manipulative as my Mom.
Regarding trust, if you have found that the caregiver has done something that disobeys your specific instructions and your Mom does not own up to it, and the behavior is a serious breach, then consider terminating the caregiver immediately (she doesn't come in after that shift is over) and paying 2 weeks salary plus living arrangements for 1 night (since she is 24 x 7). In the meantime, I would start interviewing new caregivers since you will have to do this anyway when she leaves for vacation. In the search, you might find someone that is better than what you have now.
Good luck.
https://www.dol.gov/agencies/whd/fact-sheets/79b-flsa-live-in-domestic-workers
By 24/7 do you mean just this one person is there all the time? Or she is one of group of aides that you have to provide 24/7 care?
Because if this person is working 24/7 without time off this is illegal. An aide works just like any other working person. 40 hrs a week at a decent wage (at least minimum wage which in my state is now $12) Time and a half for overtime. Days off. You are suppose to be taking payroll taxes out and making sure they are being sent quarterly to the correct agencies. She should get a W2 at the EOY. IRS does not consider her self-employed.
The IRS will let a live-in domestic servant like a nanny (for elderly or kids) file as self-employed if they make under a certain amount.
No matter what the employee feels or thinks, debster is her boss. In all the jobs I have had, what bosses say go. At times I may question, I even had one boss sign off that he told me something to do I knew would come back at me and it did. He tried to blame me and I brought out my signed paper. His response, touche.
"She has done other things that I do not trust." I think it needs to made plain that you hired her and what you say goes. Because Mom likes her, you really want to keep her on. Tell her if she wants to keep the job she has to realize she answers to you.
I think that many times a conflict gets causes because families don't know what are reasonable expectations to have with a caregiver and what aren't.
Many times families do not understand that one person cannot do the work of a staff. The caregiver can't sit and hold your "loved one's" hand all day or night long while still getting all the other work done.