Do I tell my dad if he doesn’t change his behavior we are moving him?

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Do I tell my dad if he doesn’t change his behavior we are moving him?

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My dad is at a small group family home-my Mom is there too. There are six total residents. My dad does not like one of the night time caregivers-because she is african American. He won’t let her change his brief and he soaks the bed -makes quite a mess.

My dad has early stages of dementia. He expresses thoughts of paranoia and thinks this woman is stealing from him. He has sundowners and in the evening he will say things like-I work with her and I know she’s not good,

My mom lives at the house too-they are in different rooms. There is a long complicated history of mental abuse dad toward my mom-but at this point my mom isn’t really nice to him. However, they have a need for eachother in a codependent way- they have been together for over 45 years so it’s complicated.

My dad wants to move back home. He thinks he’s only at the house because of my mom (my mom has more obvious physical needs-feeding tube, needs help walking). He cannot live alone (heart failure, kidney failure, and has hallucinations/is dillusional)-but he thinks he’s fine.

Do I tell my dad if he doesn’t let this woman change him we are going to move him? That feels like a threat and I know threats and ultimatums don’t work. Do I just move him? It will cause huge decline if we move him. I will likely give him the choice-he can be moved to another home (without my mom) or he can let her change him. How can we get him to cooperate? I really feel for the staff-his behavior is unacceptable

Assisted Living Dementia Behaviors Moving Paranoia

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is there any medication to help him be more calm? its hard for some people to accept someone of color to be changing them......especially older people due to their up-bringing. Just explain (if you can) that she is a nurse and she is highly qualified to do her job and if he doesn't allow her to do her job, he could get some serious sores that will require more intensive cleaning, etc. Maybe it might be time for him to be in a different area depending on his level of dementia, has he been examined by a doctor to determine that? And most staff are trained to deal with the dementia patients and their outbursts, etc. My mother was in with a woman (mom broke her arm) who had some dementia and their night nurse was a man. The other woman refused to allow him to bath her etc. My mother said he is a nurse just like the other ones and that my mom had no problem with him doing his job.......the lady finally allowed him to take care of her. Wishing you luck in your situation.

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I think you have to point blank tell him he has options - this or that. If he does not cooperate, THEN ARRANGE FOR MOVEMENT TO ANOTHER PLACE. Do not let him control you and cause hell for you. Don't do it. He is responsible for his behavior so let him lie in the bed he has made. It has to stop.

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Rebeccaal: Praying for you.

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Rebeccaal;

"Yes I’ve spoken to the caregiver and she’s handling it well it seems- she told me that it’s definitely not the first time it’s happened."

Only quoted one of your comments, but clearly YOU are doing the right thing! Bad enough that residents might be like this, but if family is supportive, it helps.

Best you can do for now is wait for the test results (psych, UTI) and make decisions when you have more info. Warning him may have no impact - certainly you can try, but don't hold your breath! The facility may also be the ones to make the "decision" for you, if they decide he's too disruptive and has to move. If they are "okay" with it and can work around it, leave him where he is.
CM - "Is she the only African American lady on the staff (I'd be surprised)?" Why surprised? It is likely very dependent on where a facility is. Larger cities, more populous areas, higher percentage of non-white people in the population, there are many factors that go into who might work at a facility.

Mom's MC, at least since I was last allowed in, didn't have any obvious people of "color." I honestly don't think I have seen any in the AL area either (one has to enter through the lobby and pass through some dining and sitting areas.) I can only imagine my mother would be a bit pig-headed as well. Depends on one's background and exposure to "others" who look different. Thankfully I didn't inherit this kind of bias from her! I didn't chose it for that reason - it was care, cost, convenience for me (closer so I can monitor and visit.) The facility had actually been torn down and rebuilt for IL/AL/MC, so it wasn't even ready to be seen at the time we signed up, so we wouldn't have a clue who would work there. I didn't care for the others nearby, and the one YB found, opening around the same time, was MORE expensive, lousy set up (shared room, window views parking lot and 4-lane road/businesses) and would be at least 45m drive for me, on a good day!

I am happy with the place she is in, and hope perhaps in the future that care-givers and residents alike can be more of a mix of people from all walks of life. Maybe pipe-dream, but one can hope!

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Please have your dad's "delusions" treated. If it is the confusion that comes with Alzheimer's disease and Sundowner's Syndrome, then it is more about fear and loss of control. He may need a little medication to help with that. If not, he may need dialysis if his kidneys are not filtering out toxins or he may have an infection. If either of these, do not expect his thought processes to change. If you choose to move him to another facility. He will find another staff person to be upset about.

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I think dementia is a lot like being drunk; who you are deep down tends to come out. Just as there are mean drunks and happy drunks, there are folks in memory care who don't remember much, but they remember they don't trust people of color. Unfortunately, you can't make demands of someone who won't remember the demand or understand why he's wrong. Logic and social niceties tend to go first. As far as he concerned, he's right, you're wrong, and everybody needs to leave him alone. I hate to indulge racists, but is there anyone else there who could change him and potentially avoid all these battles? It would be better for the caregiver not to have to deal with him.

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First, don’t threaten ur dad about moving it’s a federal offense. U chose the right word “give him a choice.” Also, he may be obnoxious, but listen to your Dad. You don’t have a clue how real his comments are. I know it’s hard to accept, but look at his bruises and inconspicuous places on his body & check your mom out as well. He may be saying delusional things, but he’s saying things in a combination where parts are true & others aren’t. He’s trying to tell you to read between the lines. He’s being hurt & I don’t care what their ethnicity is. Don’t ever ignore his negative comments about a staff member. It’s not going to do you any good though. Once you’ve put anyone in a facility they are what I call “free game.” It’s disgusting to think this way, and I know you don’t want to hear or believe this, but it’s true. It’s a rampant issue abd I would be Leary if any home that took ONLY dementia human beings.
Plz. really read about Sundowners. it will give U a better understanding of what they are saying and doing. Some things truly are real, just not as he described. He’s associating with someone he worked with he didn’t care for. It’s hard to explain. Unless you are physically there you don’t know what the true story is what’s happening to him.

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Off the top, has someone with appropriate training actually determined that this is “early stages of dementia”, because it really doesn’t sound like his symptoms match “early”.

If he isn’t on some sort of mood stabilizing medication, would you be willing to consider that? From what you’ve stated, it seems as though as any dutiful duty daughter would, you’re listening to some of the things he’s said as though they’re meaningful. In face of his outward and verbal actions, his thinking is probably pretty seriously distorted at this point.

The point about his behavior and conduct being progressive is also something to take into account. Whatever you do, he won’t be able to do better than he is now. A tragic and horrible truth, but a reality that needs to be part of planning for him.

Then too, “staff” working with patients disabled with dementia have to be tough. It’s part of the job to be “verbally assaulted” when the “client” is losing control of social niceties.

I’d personally give medication a shot. If you base your decision on love and research, and you do the best you can, you’ll have nothing to question yourself about.

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I know this issue will likely never go away! But you’re right I’ll wait for the staff to call it out and suggest moving him- and yes that may happen at the right time when he has progressed to needing something different- we’ll see.
thanks for the thoughtful info.

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Im sorry Rebeccaal. I am going through the same exact situation myself with my mother. I talk to her every conversation about being kind and accepting of all skin colors. It is useless. She does not listen and does not care. Very stubborn. I know she will never change and has always been a racist. This breaks my heart. My children do not want to see their grandmother because of her racist comments and behaviors toward them. She throws her pills across the room when an African American aid comes in to give them to her.

Her AL tells me she needs more care than they can provide. Which to me means they do not want to deal with her negative and nasty behaviors any longer.
She is under PACE program and waiting for them to decide where to place her next. So difficult. I know what you are going through and how it makes us feel.
good luck! Keep us posted!

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Honestly, they've seen and heard this all before. The manager should deal with the night changing issue somehow, but your dad isn't going to change. Just apologize profusely to the caregiver whenever you see her.

My mother likes to loudly talk about how fat some of the caregivers are. At five-foot-2 and 200 pounds, she has no business criticizing others, but she thinks it's 1948 and she's thin and pretty again. I'm always horrified when she makes one of her comments loudly (and yes, she's also made some racist comments, too), and the caregivers just tell me they've heard it all before.

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Thank you for the laugh! And yes the house and staff handle it well.

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Are you sure that he has taken against this caregiver purely because of her race? Is she the only African American lady on the staff (I'd be surprised)?

I feel this is actually for the home's managers to sort out. They ought to be able to give their employee their full support and also reconcile your father to accepting care - not from an individual with particular characteristics (race, sex, expressed culture e.g.) but from a trained professional with the required skills. Which is what she is.

I do wonder how the poor worker feels. No one should have to face any sort of abuse at work. Having said that, when your work involves supporting people with dementia at its various stages, you are going to hear abusive remarks (no matter what colour or sex you are) and some of them will feel personal. It's a tricky issue. I agree that his behaviour is unacceptable but I'm afraid that no threats or ultimata will change it; not here, and not in any other care setting either. Besides, a punitive approach is both pointless and unethical when you're handling a person with dementia.

Presumably you've talked to the home's managers - what do they say?

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Yes punitive approach - not fair to dementia- even if he had these behaviors ore dementia!

I know he’s mean to others- at night. I’ve spoken to the one woman -she’s definitely the only African-American- this is a small home. She told me it’s not the first time and it requires a lot of patience she was really kind and I told her to call me if she ever needs me to talk him through things- I want to support her and she knows that I’m sure she felt it. I have also spoken with the owner and I know that he treats others this way at night. I also know that the way he treats the one African-American has happened before with other residents-unfortunately I was told it’s actually fairly common.

thank you for your reply

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I don't think talking to your dad about his behavior is going to change how he responds to the caregiver that he does not like.

There is no way of getting a different night caregiver?

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No way to change- it’s a small group home- but your first point is definitely true- I needed to hear that again. Thank you

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I can see how this is a stressful situation. I’m wondering how the caregiver is handling it. Has she complained directly to you? Does she chalk it up to his cognitive decline?

I am not saying that it isn’t disturbing. I am sure that it is. She is aware of his mental status. I’m quite sure that she is also aware of some people of an older age group being this way.

Unfortunately, even some younger people have these feelings too. I am sure that you feel it is inexcusable. I don’t blame you. I would too.

The hallucinations are making the situation worse. Have you spoken to his nurse or doctor to see if a particular medication could possibly help?

You are concerned about his behavior and I am certain that you have apologized for him and I am sure that his actions don’t cause her to feel badly towards you. Still it’s awkward.

Best wishes to you and your family.

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Yes I’ve spoken to the caregiver and she’s handling it well it seems- she told me that it’s definitely not the first time it’s happened.

not easy but more and more I agree -there’s definitely no use in expecting him to change his behavior- not possible to even discuss at this point.

thanks for your response.

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Sounds like your dad’s dementia has progressed past the early stage. I doubt he will be able to follow the conversation you are thinking of and any promise to behave that you may get from him couldn’t be relied on to last. Have you had his doctor address the issues of paranoia, delusions, and hallucinations? Sounds like a medication change or addition may be in order to help with this

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Thank you- a psych nurse will see him this week- it’s also a bit of a behavior change- the extreme of it- so we will have him tested for a UTI and he has some pain in his feet/toes- there may be an underlying issue- we are exploring.

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Dad has an issue, doesn't he? I wouldn't voluntarily move him or tell him you're going to move him if he doesn't behave. I would tell him that his attitude and behavior is unacceptable in your eyes. I would let the staff decide they can no longer tolerate his behavior. When, and if, that time comes he would most likely require either AL or MC depending on his care needs. However, that move would not address his dislike for anyone other than white anglosaxons. Most facility caregivers are African Americans who care for their residents.

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Do I tell my dad if he doesn’t change his behavior we are moving him?

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