My mother is struggling with dementia and keeps fighting with the aides in the nursing home. What can I do to get my mother to stop?
Mother has been in the nursing home three weeks. She fights with the aides and nurses over everything...taking her insulin, medicine, showering, getting up in the morning, taking a nap, dressing, etc. The doctor was giving her Ativan, when needed, 1 mg., but she slept through meals, etc. So, he cut it back to .5 mg. in an injection form. She hasn't had this yet...waiting for the medicine to come in.
If mother wasn't fighting everything else would be really good. They keep her clean and dress her well. Her hair looks nice everyday.
I go twice a day and am pleased by what I am seeing. It isn't perfect, but it isn't too bad either.
If anyone has delt with this dementia and fighting, please help let me know if there is anything I can do. I've talked to her, but it doesn't stick in her brain.
Thanks so much.
17 Answers
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My dad on the other hand, has no diagnosed dementia, he's just stubborn as heck, don't like being told what to do, even when he knows it's for his own good. He used to be quite the dresser, so he fusses with the staff because his shirt isn't tucked in right ( he's confined from bed to wheel chair!) he wants showers when and how he wants it done, I tell ya...this 96 yr old can make me LOOSE it with him! He's used to me but surrre tries to control everyone else around him. Fortunately, the NH staff knows how James is, and the deal gets done.
Anyway, your moms NH staff sounds like their familiar with this type of behavior so thank them, show appreciation towards them and thank our lucky stars for them.
Rest assured, this is not unusual behavior, hopefully Mom will adjust soon but if she doesn't....this is the new normal.
1) She suggested that some members of the staff and I would meet with mom and explain that she is in the best possible place she can be now. Mom broke her back so is in a wheelchair, so has an alarm just in the middle of her shoulder blades that she is not able to reach. She has a bed alarm so she doesn't forget and try to get up by herself. She also has a roommate Doris who "tattles" if she sees my mother trying to do things w/o assistance (which she is prone to do).
2) The charge nurse at mom's Vacaville, CA Conv./Rehab also suggested that we purchase a binder with a letter assuring my mom that we love her and want the best for her. It also mentions the talk we had with the staff at our meeting about the family members and staff feeling that this is the best possible scenario for my mother at this time. At the end of August the letter states that my mom will be re-evaluated. The charge nurse makes an effort to include the rest of the staff so we are on the same page as far as what we say to my mother. The charge nurse has a copy of my letter so she can refer to it and can also show my mother the binder. Also included in the binder: a couple of pages with her favorite pictures, and an "update letter" for her relatives and friends again stating that my mother is in the best possible place at this time of her life and giving the phone number where they can reach her. Today I had a Pedicure lady come to mom's facility to take care of her toes. My mom was pleasant during our visit, but when we returned to her room, my mother's belongings were on her bed and she said she was ready to go home NOW. I needed to be firm & pleasant with her; to disengage from the conversation and redirect it. I gave her a hug, a kiss, some of her fav magazines and the homemade chocolate chip cookies I brought to her. I told her I loved her and would see her on Sunday. I used to "go through it emotionally when I needed to do this"--now, as I see that there is no other option--it makes it easier. If you can find staff that are willing to support you and are behind you and can encourage you and give their input--you are a blessed person! I need to remind myself that my mother is cognitively impaired. Unless a miracle happens she will always be that way, and she may worsen as the days go by... We take each day at a time and I try to make the most of every opportunity. Hats off to you who has a heart to do the best for your mother--hang in there:! I hope the above helps you.
This has worked with Mom, even got her to more wonderful plateau in her life participating...she often says thank you spontaneously now. She did not say thank you in over nine years.
If you have a jokester type caregiver there who can kid alot, you can try a smiling... NO NO NO NO NO??? Hey, how bout YES YES YES YES YES?? hopefully that makes them laugh...and you can go to the next step. Do not look for total up and dressed and out to eat and back for a sponge bath. There are dozens of steps, each with opportunity for combativeness. This same caregiver was rubbing mom's cold arm, and mom was being a grouch. She instinctively tickled one spot on her upper arm and mom smiled. that is the sort of thing you know from trying dozens of "didn't work" maneuvers. Please share your techniques. These little tricks are what we have to really work with on the ground. Suggestions like "approach them from the front, get on eye level, don't argue.." look nice on a list...but we are dealing with raw behavior here, more like a wild dog or cat. Instincts kick in.
The above posters are correct we see this behavior all the time and have come to expect that some of the residents that we care for are combative.
You say in your post that your Mom has only been in the home for 3 weeks. She is still new and adjusting to the environment. She is out of her element and comfort zone which is probably one reason she is combative. She has individuals that are caring for her that she does not know yet. With time she may adjust and become more cooperative with her care givers. But she may remain combative.
Also understand that the combativeness may be part of her disease process as well.
There are some things as a caregiver that I have found to be helpful with combative residents. The care givers need to slow down when they give care and not rush. Take things one step at a time. Also they need to talk to her the entire time in a normal voice and tell her exactly what they are doing each step of the way.
As a care giver I do not like to have Ativan administered to a resident that I am caring for. I know that it will help relieve her anxiety but if by the way I provide care can not be so upsetting to her then we can save the Ativan for when she actually needs it.
I wish you and your mother all the best.
The others are correct: there is no point in trying to talk Mon into behaving differently.
Sometimes the NH staff can make matters worse, without meaning to, of course. Just as an example, one of my local caregivers' group happened to be in the room when an aid came in to give her mother a bed bath. The first thing she did was wash the mother's genital area. If you were semi-out of it and confused about your surroundings and some strange came in and grabbed at your crotch with no warning, you might feel combative, too! A little retraining was in order here, including introducing yourself, explaining what you are going to be doing, stroking gently and telling the resident exact what you are going to do next, etc.
I am very glad that you are happy with the NH. It may be that the staff isn't doing anything to alarm your mother. But keep your eyes open for anything that might set her off. The aid in the example knew the resident didn't like baths so she was just trying to get it over with fast and get out. No unkind intentions. But sometimes small details can make a big difference to someone with dementia.
If she is anything like my mom she would forget in a minute or less what she just did. So there is really no use in trying to discourage her behavior. How much is she really going to understand the point your making?
Just be appreciative towards the workers, that let them know you understand.
You said that the doctor is giving her Ativan and she was sleeping all the time. My mom did take .5mg and it did nothing. She moved up to 1mg and was droggy until her body got used to it. Now when she takes it, she is just mellow, more alert and naps off and on but is easily awakened at meal times. Ativan helped alot with moms anxiety. But everyone is different with meds. See how the .5mg affects your mom, maybe Ativan is just not right for her.
Don't beat yourself up about your moms actions! Your mom just doesn't understand. Since she has only been there a few weeks she is most likely confussed with changes happening. Give it sometime she should calm down when she gets used to her new surroundings.