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Should my husband move her to a different facility?

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My Mom has been in AL for 4 years. I am there many days in the week. I can tell you that I can tell if a good aide or an aide who doesn't like my Mom has been on shift.

Mom is a bit needy. She is bed ridden and when the Aide comes in she extracts all she needs from them because she cant do for herself.

most of the Aides love her and are compassionate but two of them have been what I would call mean. One would leave her on her C-Pap which is in Bi-Pap settings until 9:30 am. She is so crippled she cant remove it.

I was a private duty aide and believe me, some tried my patience. I kept my act together and treated all if them with respect.

i would recommend that you both take turns being in the room during shift changes and see the interaction.

there may be nothing wrong except she is unhappy and is making it seem that she is being mistreated.
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Agentsmith Jan 2023
I was in a nursing three times, and finally left all three. Some people should no be in this line of work, period. I dred have to go back to a facility. She is more right than you think.
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Are cameras allowed in your state? A picture is worth a thousand words.

I would want facts before jumping to any conclusions.
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Let me guess. Your mother is a decent, kind lady who doesn't spend her every waking moment complaining? And your mil is the type of person who would complain about being put up at the Palace of Versailles saying the gold was tarnished?

If there were REAL issues going on in this AL like others insist "must be" the situation, both women would have the same complaints. Which is not the case.

I would not move your mil anywhere else bc she'll bring her attitude with her wherever she goes.
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Responding to Emma., Seems like the world still feels that its the woman who does the caregiving whether its the woman parents or the husbands. I am with you that MIL is husbands problem. From the time my SIL married my BIL it was "I will handle my parents and you will handle your"

So Mare, I would look into what the problem seems to be. I would then tell ur husband and let him handle it. If Mom has always been like this, changing ALs is not going to work. DH needs to tell Mom she needs to except where she is because this is it. You worry about your Mom he wirry's about his.
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Gray rock! Go gray rock! That would be my one and only response. And tell her SON, your husband, to address this, if you really think it’s worth fooling with. She’s not your mother. It constantly astounds me that people jump in to address problems that, really, belong to other people, or can at least be justifiably shoved off onto them. I honestly think that sometimes people look for ways to make their lives MORE, not less, difficult.
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I don't think Mare is trying to compare as so much trying to understand. My Mom was easy to care for. Easy to direct. The staff loved her. Then there was this other lady, who did nothing but complain. She even told the new residents coming in that she was not given her meds on time, and other negative things. (Poor son went thru his life savings to keep her there). When this woman came in the common room one day an aide said "Here comes trouble" Then said she could not stand the woman. I really saw her point. Did she take out her feelings on this woman, I don't think so but she probably didn't do anymore than she needed to be done for her. Where as my Mom. I knew she was in very good hands.

Your MIL may be demanding or expects things to be just so. Where Mom is not like that. She is happy with what ever attention she gets. In an AL there are at least 3 shifts of aides. Weekends may mean a whole batch of new ones. Or to cover the weekend, some aides are there one day during the week and not the other. So MIL may have a different one every day . She definitely has one in the morning and another at night. Shifts run 7 to 3, 3 to 11, 11 to 7. Moms AL was small so besides caring for the residents they may help serve meals and clean up. I know if I had a resident who was hard to care for, I would want to move on as soon as I could. One that was nicer and easier I would be more likely sit and talk a little and do a little extra. Its how we as human's deal with each other.

I would talk to the head Nurse. She is the one who deals with the aides. A director is a paper pusher. Really does not deal with the residents and their needs. Ask the Nurse if the aides have any complaints about ur MIL because she says they are mean to her. (Mean could be that they don't allow her to do whats dangerous for her. They do become like small children and they think Mommys mean because she said No) Not that you can change how MIL thinks but then you will know no matter where u put her the staff will be mean to her. Its the Dementia and the personality.

There was a member who posted about how her Mom did nothing but complain to her about how horrible the place was. One day she just stopped in and found her Mom was socializing and laughing with other residents. I remember when my daughter was in Daycare and picking her up and the chaos. I was one of the last to leave and said "I don't know how u do it" the woman said "they are good all day until the parent walks in and they change"

What was your MIL like before the AL. If she complained then when she could control things, it will be worse now she is loosing that control. My MIL was the sweetest person people would say. Yep, until she didn't get her own way. I can imagine how she would have been if we had placed her in an AL.
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You may need to spend more time, at random times of day, to observe what's going on. If MIL requires more care, she may be considered a pest or more work than your mother.

Being rude or less than kind to certain patients is very real.

Just because your mom doesn't complain does not indicate she is given quality care. Family must participate by showing up regularly.
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bkoropchak123 Jan 2023
Thanks for your thoughtful reply my2cents. Too often on this forum complaining residents and/or care staff are blamed. Spend time there, become “buddies” with charge nurses on different shifts. If you feel change is needed you to take the longer, harder road and form your own opinions.
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I have seen this personally where they are often mean to certain people.

Sometimes it is to the ones that require more care, sometimes it is to the ones who are more aware of what is going on around them and they don't want anyone to find out how neglectful or abusive they are. Try to monitor the situation and find out what is going on.

There is often neglect and abuse in these facilities. Please watch out for BOTH your mother and mother in law!
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my2cents Jan 2023
Correct. My parent was mid nineties and a rehab assumed they could get away with poor care and attention. She even tried to tell them they gave her wrong meds and they tried to brush it off by indicating she was not clear headed. I spent many random hrs there and finally caught their error. Not once but twice. Had to explain that being old doesn't mean demented.
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MareMare222: Perchance does your MIL also suffer from dementia? You could always ask the staff at the facility for an assessment. Don't ask your husband to relocate his mother until you obtain some more firsthand information.
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I'm assuming that the same people take care of your mother and your mother-in-law. It is possible that it is different groups of people.

Either way, first, I would try to get more information from your MIL. Identify which behaviors and when it happened, your mother-in-law are considering mean. For instance, they could be arguing with her to take a bath. They could also have her on a schedule of when she has to go to a toilet. They could be making her go to her room when she doesn't want to. She could be impatient for her snack. She could be last in the dining room, therefore, last to be served.

If she can't remember, then everyday, ask her for examples. Then once you have a general idea, if appropriate, ask for a description of the person who did it.

Don't prompt her for ideas or actions.

Once you have that information, if her concerns are valid, talk to the director, or head nurse or the person in charge of that floor. They may or may not be able to do something about it.

If her concerns are not valid, try to get her to accept it the way it is.

For instance, my Mom was arguing with the nurses about taking her meds. She claimed she already took them and that they were trying to give her a double dose. I found this out through the Head Nurse. I told my Mom that when the nurses come to give her her meds, she just had to take them, regardless of whether she thought she just took them or not. I told her that I could tell whether they gave her too much or not, since I deliver all the meds to them. It took me a few days to figure out that she only refused the meds from 1 nurse. The reason? The nurse didn't answer her question. Her question? How many pills am I taking?

The question was so absurd to the nurse, the nurse just repeated the request for my Mom to take the pills so my Mom refused to take the pills.

Once we got the nurse to answer the question, my Mom willing took the pills from her. In the meantime, my Mom said that nurse was mean and she wasn't to be trusted.

So, identify the behavior and investigate the circumstances. If valid, talk to the Head Nurse to see if you can figure out a way around the issue. If not, decide if the issue is nasty enough that it is worth the move.

P.S. All problems are "real" problems to the person complaining. However, to get resolution or compromise, one has to get the facts surrounding the "real" problem so that one can take the appropriate action (or inaction).
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Contact Director of Nursing. Make sure your mother has same Nurse asst. and tell her the problem. The Director will decide if your mother needs a psychologist or, she knows how to handle disputes with staff and she will do it. The Director also will determine if there are other complaints and do what is appropriate. As a former Adult Protective Worker. I could do the evaluation with your mother and the Aid or…always with success. The Director always wants to be involved and wants to find and see problem is resolved. If a A.P.S worker is called and He or She must do the investigation. I always involved the Director. There is always an Ombudsman available. Their tele.number is posted in the facility. The Director can determine if she has problems the aid is not able to help her. If this is a “real problem” with an aid…there are weekend aids with the same problem. I have never found “one person” with a problem, usually the nurses aid and others have “the problem”. When people are “covering” for each other and the Director was in denial (of problem). I would tell (as investigator) She must “handle it with the aid” if aid was the problem. “I will be back” and if problem still exists I will call licensing I always made friends and there was resolution. I would have called the owner before licensing. Believe me…I do not see problems now days like many years past. The “rules” for the facility are so patient centered and strict and the fines keep the quality of care super. Don
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Dig in a little to find out which workers and "how" they are "mean" to her. She may have some prejudices (we all do) or be experiencing anxiety. If so, a move to a new facility won't be any better than the facility she is already at. Talk to her doctor and the facility about this issue.
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How about moving her to a respite care situation and let her decide which residence appeals to her. I believe a lot of the tug-o-war situations happen because the patient is not given choices.

https://www.nia.nih.gov/health/what-respite-care

Or, perhaps the director would agree to placing a camera in mom's room and then you and the director will see what is (and isn't) going on. If everything is about mom's dementia, then a Geriatric Psychiatrist can assist. If, on the other hand, there is a "bad apple," management would rather know than face lawsuits from Adult Protect Services.
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What is the level of your MIL's dementia? This is important to know as it determines, to a degree, how she is processing incoming information. Dementia 'filters' information that you and I would see / internalize as normal with different brain chemistry, i.e., she may be fearful thinking they are going to hurt her. We do not know how she is relating to the outside world.
- Dementia inflicted are highly (higher) sensitive to voice / tone / touch - be sure the caregivers are speaking / interacting with her with settle / calm tones. If their English is a second language, this could be part of the issue / how information is heard (although it still likely has more to do with the emotional 'evenness' of the caregiver). How to interact with a person w dementia is a learned behavior. It is not easy.

You can NEVER compare 'two different brains" that are also changing and have different ailments/conditions. Even without dementia, they are two individual people with their own history, triggers, memories, emotional-psychological makeup.

Talk to her. Listen. What does she see ? experience ?

* Are the care providers experienced?
* Are they trained to manage a dementia inflicted person who exhibits anger? or other negatively received behavior(s)?
* Do they 'argue' with her - further provoking her, even if unintentionally?

I wouldn't suggest 'just complain to the person in charge' - you need a lot more information first.
- Does this 'person in charge' get feedback / reports from the caregivers? Do they write it down? (Review it if they do). They should be writing down all unusual behavior.

* Remember, behavior is the only way some people w dementia can express themselves. We / you / others need to figure out what is going on.

* Your MIL may 'just' need to relax a bit (FEEL SAFE) , i.e., massage her feet, get her a massage, touch her more (get the oxytocin moving (the 'feel good' hormones). Try this and see how it affects her.

* I would bet that the care providers do not interact with her 'well' (appropriately) when she has these outbursts or behavior issues. Caregivers need to be neutral.
- And, yes, when / as the brain chemistry changes, the behavior will to.
- Get MIL re-evaluated by medical professionals.

From personal experience, it is REALLY difficult to maintain 'calm' when a person is 'running at the mouth' screaming insults or whatever they are doing / acting out.' When these things happen, the care provider needs to step away and collect themselves. Unfortunately, workers at a facility do not have this luxury as they are on a schedule.
- If you can, hire your own care provider for a few hours a day - and see how that works out. Be sure the care provider is TRAINED and UNDERSTANDS that dementia is the brain chemistry - and the person inflicted is fearful, perhaps seeing - hearing things.

IMPORTANT: Their behavior is a way of 'self-protection' that we do not understand (because we are not in THEIR brain).

- If you hire someone new, you will have a ... barometer / a gauge ... to see if (more of) the behavior has to do with the caregiver(s) or is more internalized. Nothing here is a science. It is a hit and miss / trial and error. And, time of day matters / needs to be considered.

When it gets HARD and it does . . . put yourself in her shoes ... this will help with resetting to patience and compassion. And, breaks are really needed.

Gena / Touch Matters
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Just complain to the person in charge. I have seen firsthand some very mean caregivers. It could also be a personality conflict. I wouldn’t change facilities as staff changes more often than residents.
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Do they have the same caregivers? When my MIL was in Memory Care, Hubby would go at different times during the day, to assess her care and the interaction between her and the CNA's who worked there. Each employee had their own personality, as we all do. Some exhibited more of a gentle personality than others. It's a tough situation for everyone, isn't it? Good luck.
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Workers may be reflecting MIL's own attitude and behavior. Perhaps she is a more demanding personality than your own mother is. If MIL has a negative attitude, she is going to find workers "mean to her" wherever she goes.
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Has your Mother-In-Law been evaluated by a doctor to rule out medical and mental conditions?

May be dementia, Alzheimer's or bipolar disorder.
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Unless there is more to go on, he should not move her. Is she usually happy go lucky or more of a complainer? Dementia? Take all these into consideration and give it a little time. Likely she'll have the same complaints elsewhere.
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Does her MIL and Mom have dementia? It says AL, not MC, and her profile just says she is caring for her Mom. I am surprised that MIL and Mom have not buddied up, but perhaps they don;t get along, and Mom is just easier going? Maybe MIL wants OUT and to live on her own or with Mare and her hubs? Some people are just never happy with anything!
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Absolutely not. People with dementia confabulate, and she’ll do it wherever, whatever. You already know it’s a good place that you trust for your mom.
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I have no doubt there are people working there who are less than kind but she will encounter that no matter where she goes. I don't know whether she has a more abrasive personality or is overly sensitive or if your mother is just oblivious and that doesn't matter, you get nowhere comparing your mother and MIL's experiences.
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TouchMatters Jan 2023
Thank you. Apples and oranges.
Although these are people and differing needs / conditions must be respected. None of us would want to be compared to another person when / if we are in their shoes . . .
It is a matter of respect(ing an individual human b-e-i-n-g.

God knows, I will be totally different from my sister should we both end up with the same type / degree of dementia. We are different people, as all of us are. Yes. I wouldn't be the nice one.
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No, and most certainly NOT based on what “she says”.

My mother “SAID” that she’d been married TWICE one day at her very good residence. She hadn’t been. She HAD DEMENTIA.

People who have dementia progressively lose the ability to filter what they say.

Your MIL MAY be resistant to complying with her caregivers’ requests, but one of the reasons that she’s reading in an AL is because she NEEDS structure and consistency.

Watch the situation for both of your mothers, but quick, unsupportable (with FACTS) moves are not usually in the best interests of people with dementia.

GOOD LUCK.
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How long has she been there? She will probably have the same complaints wherever she is.
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