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I'm an in-home caregiver for the 90-yo father of a friend. He has Parkinson's and at least moderate dementia, but when his daughter takes him to the doctor she coaches him on what day it is & so forth, so he can fool the doctor.
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He doesn't want to admit he can't do what he used to do, and they don't want to accept it either, which leaves me (& the other caregiver, but I don't think she's actually a CNA) stuck in the middle.
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The family:
doesn't encourage him to use his walker,
allows him to take showers by himself (without a nonslip mat),
won't consider an assisted living facility,
won't consider 24-hour care,
explains away the dangerous things he does,
buys junk food (which is what he prefers to eat)...
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It's just a dangerous situation for him & for me. I desperately need the income (in fact, I really need about twice what they're paying, and am looking for a real job) so I don't want to lose this job (which would include him hurting himself & ending up in a nursing home or dead). So how do I get him help, find a professional to convince the family that he needs 24-hour supervision, he's not really mentally together, etc. without making them mad at me?
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Dangerous things he's done include trying to go downstairs carrying a basket of laundry, repeatedly refusing to use his walker, insisting on taking extra doses of medicine, leaving the house alone (and at night!), taking a shower, and one day I came in to find him putting all his pills for the day into a cereal bowl! Just barely stopped him from ODing, and his daughter accepted his explanation that he was "counting them". There's always someone there to give him his pill, so he shouldn't be messing with them at all.
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Last night he claimed to have eaten dinner, when what he claimed to have eaten wasn't even in the house. Also, there was no evidence of him having eaten (no dirty plates, no plates in the dish rack, no cob from the corn he claimed to have eaten) so I'm pretty sure he had cookies. He'd eat cookies all day if you let him, and there's no way to get him to eat anything healthy when his family buys him junk food. (The daytime aide does the shopping, takes him along, so of course they come home every week with 3 boxes of cookies.)

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Part of providing care is keeping a daily log of what transpired during your shift. Make sure you do so. If you are not keeping one, start doing so for your own protection and his. Do you work for a service or are you self employed?

If you work for a service then you should talk to your supervisor of your concerns. Keep records of the days activities! Even if they do not require you to. If your self-employed then do so to protect yourself. When you write this record do not give your own personal opinion, keep it factual and just tell what happened. Example " Found Mr. XXXX putting all his pills for the day into a cereal bowl. He said he was 'counting' them, but it appeared he was going to eat them with his cereal as the milk and cereal box was close by. Reported findings to his daughter later that same day."

Your in a 'grey' area trying to mess with his right to decide his own diet if the family is not supportive, even with good intentions. So, unless the doctor, family, a judge, and or social services is willing to step in and say he is incompetent to make these decisions, you cannot change things just because you think you should. Be careful where your stepping in this regard.
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Regarding the junk food, he's 90 years old, he should be able to eat what he wants [unless it is a medical issue should as being diabetic].... maybe he won't eat anything else as once you reach 90 your sense of taste diminishes, so that's the reason many elders love sugary food.

My parents eat a lot of pie, ice cream, cookies, cakes, but I figured they got to their mid-90's, I am not going to ask them to change their eating habits now :)
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I think there comes a time when family just gets tired.

Tired of arguing, cajoling, manipulating, sounding short, feeling guilty after . . . just bone tired of it all. I certainly do. I try to shake it off, but it's hard. Eventually, at least in my case, I've accepted the FACT that I can't change some things mom does. And that my having to be her brain 24/7 means that I'll make mistakes.

I'll forget that she won't remember to put her arms in when I take her through a door in her wheelchair. Or, I'll tell her and she won't do it. Then get mad when I do it for her. Or won't take her pills even with applesauce. "I already took them!" Tired of explaining three times that she did not . . . tired of her saying, "I'll take them in a few minutes," then remembering to check again in 45 and they're still laying there. And her telling me she took them. Again.

Someone up top said it better, I can't find it now to credit her, but it was something about people forgetting that care givers can't force people to do things they are determined not to do. And when it happens day-in day-out, we just get . . . tired.

It's very easy to blame family. You're a care giver for him, too . . . if YOU can't get him to do these things, or stop him from doing some things, why are you surprised that his family may have given up?

Sounds to me as though his family is trying to keep him safe. They've hired care givers. That's more than many families do, believe me.

You got good advice here: keep a log; you're doing a good job by emailing and thus memorializing your concerns. Great work. Maybe just don't judge the family quite so harshly. They may be doing the best they can.
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even my aunts nh allows her to take limited risks . her wheelchair is alarmed but they want her to sneak into the restroom alone . the alarm summons them so they can oversee her , make sure she locks brakes etc . they want her to use her legs occasionally but they want to be close when she does .. there will always be an ongoing fall risk that will get worse as time passes . youve gotten good advice here . fix what you can and maybe alert the rest of the team to hazards you are seeing . there is no 100 % safe situation .. i used my ears a lot staying with my mom . if her shuffling thru the house sounded calm and steady i left her alone to rummage , wash clothes etc . if i heard her struggling with something id go see if she needed help . shes still an adult , still alive and you cant smother her with " shouldnt " ..
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I read the things that you wrote and realized I am guilty of neglect myself. My mother doesn't like nutritious type foods. She doesn't like to use her walker. She does her own laundry, takes a shower alone, and frequently wants to take extra pills. You could have written this about me, because I am not able to control my mother and she makes some decisions that many would think bad ones. Perhaps you need to see your client as a person with a personality and will of his own. People with Parkinson's are still competent to think and talk for themselves. Try to talk to him about why he needs better foods, etc. It may be he doesn't like heavy foods because the medicines he takes make him nauseous. I'm glad the family buys cookies for him to enjoy.
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Oh, I think they have accepted it if they have hired two caregivers. Do what you can on your shift and let the other caregiver know what has been done, too. As long as he is maintaining weight, you are coping well. Ask the family to get a seven day pill box. That will help. Help little bits at a time.
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Don't stick your nose into family business even if you have the best of intentions. It will come back on you and you will lose your job.
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"Competent to make his own decisions" is a legal concept. Unless he has been determined by a court to be incompetent there is limited control a family member or caregiver can exercise. For example, JessieBelle has been participating in these forums for a long time and I am familiar with her struggles to help her mother control her diabetes and not make dangerous decisions. But it is very difficult to control another adult unless you have guardianship over that adult, and you can't get that while they are legally "competent." Just having dementia does not make one automatically incompetent.

If his doctor has told the family that Father needs 24 hour supervision and they prefer to ignore that, there isn't much you can do about it. If the doctor has not said that, they are not likely to be convinced by you.

I think you would be more effective tackling the "unsafe" things one at a time. Ask if a non-skid mat could be put in the shower. Mention the possibility of keeping medicine locked up. Just one thing at a time, and only as a suggestion or question, not as a demand or instruction to them.

It bothers me that you don't consider what you are doing as a "real" job. I can understand that you want to find a better-paying job. But there is nothing "fake" or "imposter" in doing caregiving. It is as real as it comes.
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it takes a scary fall to get the elder to use the walker religiousy ..
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This is a bit of an aside. My husband Coy had some very scary falls WITH his walker. No wonder he didn't want to use it. Walkers aren't the perfect panaceas to prevent falls. I researched this at one point for Coy and was shocked to see how many of the ER visits for falls involved canes or walkers. Also, falls involving walkers resulted in more serious injuries.

Not saying there isn't a place for walkers, but I think we fool ourselves that we can relax if our loved ones would just use their walkers.
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