My father-in-law lives independently but has visiting nurses and nurse practioners come in to see him. We have noticed snarky behavior and rudeness when dealing with his main visiting nurse. She is just "honey pie" all over him but treats us pretty hateful. I have no clue what my father-in-law has told her since he never got over "his baby" leaving the nest at 30 and getting married almost 20 years ago.
I thought things would be different with an agency. My grandmother had an independent care giver and she started putting up photos of her family on my grandmother's walls (did not live there with her, just ran errands, took her to the doctor, etc). We had it out when we discovered a registered sex offender had befriended my grandmother and she told everyone except the family how horrible it was. When I asked why she didn't tell us, she said, "well, I just didn't know what you would say." I told her she had always called us on everything. We were a six hour round trip away. Found out later that she told my grandmother that she needed to leave her the house.
So...do these caregivers think they are so awesome that family cannot do without them so they can treat people like dirt? Has anyone else had this problem?
20 Answers
Helpful Newest
First Oldest
First
ADVERTISEMENT
My husband is not in good health and works close to 50 hours a week. We found out today there is a push to get hospice involved after he threatned to kill himself. We are stepping away as much as possible because he is simply not worth killing ourselves over. It is now in the hands of his nurses and soon to be hospice. He has lived his life and we have a young child to live for. If he didn't need us, he wouldn't have any contact anyway.
The agency has told me to lie to my father-in-law and tell them that the nurse practioner is a doctor. I told them I'm not lying to anyone and what do I say when he demands new perscriptions that only a doctor can give? She said, "well, that is something to think about I guess."
After tracking down the last mess for over an hour, my husband just told me he received a text message from his fathers nurse saying he needed to pick up a prescription for his dad and to text her his responses and not to call her.
So I will no longer be contacting her for anything as I do not have a phone that can text unless I am with my husband at the time.
With hearing aide, that is in your discretion to make the suggestion, maybe even find an MD and schedule an appt. Elders often object to them, for they don't realize how hard it is for others to shout! You can ask for the home-carer's help in persuading him. Do you read the care notes? That can help you get onto the same wavelength as the caregiver, instead of arriving like the 5th wheel, when she has struggled to develop and implement her own strategies to reach your father in law and keep his care moving forward.
You may very well have a person who acts unprofessional, if she brings her husband over there - did you not ask her to explain precisely what she meant by saying, because "she felt it best"? That question needed to be asked, of her and also her supervisor. And it may well be that you are not comfortable with her methods and can ask for her to be replaced, you always have that option.
Yes, family have the need to follow what is going on, and they have the say - it's just that among different family members there are often conflicting expectations given, and on-site care people naturally get to know the pt better than the family. The whole process of reaching and persuading your father in law to cooperate with care, can be a real challenge, and she may have struggled to find peace and keep things moving well, and some smiles and flirting may do the trick and be understood between them, if she sets clear limits, as a joking way to get around his belligerence. That's not my style, but I've seen it from some others, who also understand how to keep it in context, and keep things in line. Dealing with a man who shouts "No!" on a regular basis and cannot hear is no picnic, and aides often have to figure out how to get on that person's side, so that they will cooperate with care needs - and aides do that in different ways, seeing cooperation as the goal, and some have better skills than others. So, it's not the problem unless someone has missed setting boundaries, and that help can be given to them not see them as awful.
After struggles to gain cooperation from difficult persons, it can be momentarily challenging to have family arrive with other issues, be unaware of the aides's struggles and gains, expecting her to suddenly grasp their ideas, described on the spot rather than planning a time for an individual, quieter conversation.
One agency in Mass that has set up a closed computer communication program for each case, and each aide writes their daily notes into the file, which is sent to all family members involved, and family members can comment - this way the complex challenges that are faced and addressed by the long term person in the home, are mentioned and considered and addressed by family as it goes along - a better way than having very separate involvements over time, which the on-site caregiver is addressing, and finding plans that leave out her challenges. I think the industry has major flaws in planning for supervision, but it is not background checks and worries about thieves that are the biggest issue - though those are essential elements to pre-check - but good supervisory practises of following up care in ways that are respectful to the caregiver and the family, different members with different ideas, with the middle man being an agency supervisor - lots of room for folks with few standards for good supervisory methods for getting at details with respect for all.
Then, issues can be explored, give someone the benefit of the doubt and arrange for later feedback - and if it doesn't work out, change the care person. That process takes time but dealing with a difficult elder who is losing abilities is a SLOW and challenging and evolving process, so families who expect instant understanding, would do better to ask questions when issues arise, not just focus on the care plans, for those who do in home care, know it's not easy.
I met her after she had been a visiting nurse for awhile. My father-in-law had one of his "emergercies" and his power-of-attorney was changed, then changed again, then the man died and my husband and I had alerted the 2nd in command. She asked us if the person knew and my father-in-law screaming (as he usually does) said, "no." I tried to inform her quitetly that the person had been informed and give her the info and she just got smart. I tried to tell her my father-in-law desperatly needs a hearing aid and she smart-assed back, "well, he doesn't want one." I then told her that I don't want to yell all the time, which is why I say little.
The television is so loud (which he refuses to turn down) that you can hear it through a brick house, a security door and in the driveway with the car doors closed and the windows rolled up. A caring professional care giver would encourage a hearing aid (and yes it is the type of hearing loss a hearing aid would help).
While there, she made a remark of a sexual nature and my husband and I feels she flirts with him. Her last name on her cell phone does not match her work name and on a recent visit (husband came by unannounced), she had brought her husband because, "she felt it best." Then after she leaves, my father-in-law begins yelling at my husband that he never wants her to bring her husband back in his house again.
We recently had to call her about a perscription. She called back the next day, took 10 seconds for the call and hung up without giving us complete info. It took me an hour to track down all the information of what was needed because she was in plain speak: a jerk.
My father-in-law has 2 nurses, 2 house cleaners and expects my husband to check on him 2-3 times per day. He curses and screams if we are not at his door in 5 minutes (it takes 15-20 to drive to his sanctuary). My husband is giving it until spring and then is going to tell him to find full-time help. He cannot work 50 hours a week and do this too.
BBB, Angie's list and I am appalled at what I have read, I can tell you that
Main visiting nurse might be treating you like some sort of "fifth wheel intruder," but the bottom line is that you don't have to take that kind of treatment. Doesn't matter whom, doesn't matter when, doesn't matter where. Make that clear to her.
Have you quietly and clearly addressed the problem with the caregiver, not in a confrontational manner, but in a questioning way in order to clear the air? Your father may have really poisoned the waters, so speak, but qualified caregivers usually understand family dynamics and if present family members are loving, attentive and respectful to the parent they get treated by the caregiver in kind. Are you going in being bossy and commanding? Even if just out of frustration and concern? That will certainly confirm any bad stories Dad may have said, even if they were not true.
You are clearly the employer if writing the check even if Dad lives independently. If not, are you the legal guardian for your father? Contact the resource where you found this person and get them to address this problem immediately. If this is not successful I would get them replaced. They may "sweetie pie" your Dad in from of you, but heaven only knows what goes on in your absence. I am quite fond of the "nanny cams" when there is no one at home to watch just what happens. If the caregiver is wonderful and a jerk to you, then so be it. Deal with it. if the caregiver is manipulating Dad in your absence, then you need to act to remove her immediately.
Look at the evidence: is he clean, eating, any unusual bruises on his body, does he seem overly exhausted when she has been there? or, he the opposite of all these things, seems well and content and the nurse is just witchy to you? The bottom line may be that she is great with Dad and hates you, so suck it up.
You need more data to decide.
On the topic. Working for an agency, I have found that most caregivers try to bring kindness and care, and each one has their different ways of pacing themselves, and all try to deal with the patient's moods that can be difficult as the person ages and they lose their memory and imagine they can do a lot more than they can, or have the same conversation 40 times. The caregiver gets to know the patient, and sometimes I have found it very difficult to later shift gears, when a family relative arrives, for they have their own memories of the person, their own understandings, and these are often outdated. I learned most of my skills in dealing with balance and mobility, and also belligerence and memory issues, from my years of responsibility for my youngest brother with brain injury, not from formal nurses aide training. I found my flexibility an asset, not a detriment, for I knew to watch for adjacent issues when one issue was resolved, and handle each one promptly, which I knew reassured my brother - and later, my patients. But it is a thankless job, when the elder's mind deteriorates, and family, long distant, come back on the scene, and if the elder has developed alzheimers and forgets the caregiver and wants above all, to please the daughter - one finds oneself ignored. I learned to use the pt's energy and planning for any parts of mobility that they can, which I believe retains their mental abilility and sense of competence, but family arrrived and called my agency to complain because I was not following behind him with my hand on his belt. I found my what had evolved over years as my real work ignored by my agency, who only hired carers to do set list of nursing aide tasks, not to provide any other reassurance, companionship, unique friendship which can develop - all that is not seen as part of the job.
I don't know the solution, but I see the issues as a major gap in healthcare services, for both family and aides could use some training in how to communicate with each other, so that you don't have some charismatic aides doing all the communicating with family, or just the agency - when the real help and healing and reassurance are coming from someone left invisible.
The loved one is very needy for attention, and plays a victim to the caregiver by fabricating a relationship of neglect and abuse by his family. An untrained and inexperienced caregiver with her own psychological agenda assumes the role of savior angel to the loved one, and forms inappropriate and untrue judgements of the loved one's family, and openly expresses hostility and disdain for them.
I have racked my brain to try to find a *real* solution to the caregiver (integrity) issue. I still don't have any good answers. : ( It just seems that every "solution" is only a trade-off that leads to some other kind of problem.