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I'm a caregiver. The elder I care for has dementia and gets abusive at times. Their son knows that they get this way. His solution is to give them space. This sometimes doesn't work; the elder has threatened to slap me and bucked up to me several times before. One time they raised their walker to me. I really need this job, so I can get a vehicle. What am I to do?

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Bayoubeaut: Good luck to you then. Personally, I would have to find another job if it meant that I am harmed by this lady. But then - No - I am not you. Others on this thread have said to continue to report this abuse to the son. Praying for you.
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Ahmijoy Nov 2019
Totally agree. From their responses, I believe that it was a vent and no solution was really expected or wanted. We can only hope that no serious harm comes to her.
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Bayou,

Are you from Louisiana? Your name reflects our state. I am thinking of Bayou St. John in New Orleans. I go to Greek fest on the bayou. Love it!

Just curious if you are my neighbor?
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I recommend the book "Elder Rage" by Jacqueline Marcell. It's her personal story, plus behavior modification guidelines towards the back of the book.
Got it at Amazon. They have both audio and paper back
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padlock in a tube sock .
youre welcome .
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I used to sit for a neighbor of mine with an aggressive teen with severe autism and I suspect other disorders. His mom had bipolar disorder and had been in and out of mental institutions caused by suicide attempts caused by her stress.

I had to finally tell her that I couldn’t sit with him for her to go to doctor appointments or run errands anymore because his aggressive behavior left me black and blue with bruises. I’m tiny. He was over 6’ tall and weighed quite a bit, strong as an ox!

Plus he started trying to push me down a flight of stairs too. Fortunately I was able to grab onto the banister and didn’t hit the tile floor below.

He was completely non verbal so his frustration level was extremely high not being able to communicate with anyone.

Anyway, my husband made me promise never to sit with him again. I felt so badly for her and I had sat for her since he was a toddler. He was fine when he was young. Outbursts happened but nothing like when he hit his teen years. He couldn’t ever be left alone. So sad.

She started losing it. At first she would apologize and tell me that he just needed his meds adjusted. So I gave her the benefit of the doubt thinking after his meds were adjusted he would calm down.

She was on disability due to her bipolar disorder but previously she was a nurse.

She upset me when she refused to listen to his psychiatrist about his meds and started adjusting his meds herself. Obviously that wasn’t working and I ended not only sitting for him but the friendship because she actually blamed me for the attack saying that I hadn’t run away fast enough to get to a bathroom or a closet where I could lock him out. I was terrified.

His father kept saying they needed to find a group home. They had been divorced and he lived several hours away. He saw his son every other weekend.

She refused to look for a suitable group home because she felt he would be abused. Yet she didn’t care about him abusing her or others. He attacked her mom, his grandma. Poor woman was scared to death. She was in her 70’s.

Her daughter went to live with her dad because he abused her too. The mom would tell people that she moved away because she hated her brother. The mom became very irrational. Her daughter had autism too but not like her brother. She was a very sweet girl. She had Aspergers. She did very well with her father.

Once he was in my car and flung open the door while I was driving on interstate. I nearly had a heart attack. Luckily his mom was able to grab the door. From that day I put the child locks on. She would call me to bring them to the ER after he had a seizure. I told her that she needed to call an ambulance because I didn’t feel safe. He would pull my hair while driving or reach over the back seat and pinch me so hard. Even though she sat in the back seat with him she wasn’t fast enough to stop him.

He constantly threw things at me. He would unscrew light bulbs out of light fixtures and hurl them at me and the glass would break into a million pieces.

So yes, abuse can happen from people we are trying to help and at that point we need to get away. It’s not worth the risk of being seriously hurt or worse. He could have killed me pushing me down the staircase.
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I am sorry you are going through this. I am in the same boat. I just recently moved back home at 38 after a divorce. I am living with my 60 year old mother and 80 year old grandmother. My grandmother is also mentally and physically abusive towards my mother and I. I have been in their home for a total of 9 days and she has had 4 episodes. It is hard for me because she seems to do this right before my interviews (I am also trying to get a job) and it gets me pretty emotional.

The one thing I have noticed is that she is happy when she has someone to talk to about what she wants to talk about. I think a lot of the problem is that she does not know what is going on with herself mentally and can not communicate her own fears. If there is anything you can find that makes them happy, try to do that as much as possible. Painting, talking about interest, magazines or books, animals (dog therapy), music therapy, etc
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Bayoubeaut: "But no" there is no gate. Even if there were, is there some way she could do harm to you? I really don't like the fact that 60 % of the time that when you sit down with her it DOESN'T WORK. Good grief.
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Bayoubeaut Nov 2019
Ok let me say this. Leave me alone if ya ain't gone help. Also she can harm me, she has gotten physical before. Me talking to here doesn't work. She is forgetting English words and is reverting to Portuguese. When I don't understand her she tells me to get away.
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This is happening more often with my mother in law too. What we usually do is tell her we are going to leave the room for a few minutes until she calms down. Then when we come back in we make sure we sit down and make eye contact with her and calmly discuss the issue (not always easy that's for sure!). If she is still riled up we slowly start to change the subject onto something that she likes (like her cat). I don't know if she forgets what she got so angry about or if she likes the idea of talking about something she likes. If that doesn't work it does help if there is a relative that you can call at the time and let them vent over the phone. It's a lot easier to get yelled at over the phone than face to face! As for physical abuse, maybe having a safety gate in a doorway that they can't pass through but you are still able to observe them? It's really a tough situation :(
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Bayoubeaut Nov 2019
I do sit down after awhile to talk things out with her and 40% of the time it works. Mais non there is no gate.
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As an employee, you have a right to be safe. That being said, depending on when they are abusive, say resisting care, it could be that the behavior needs to be reported to the phys8cian to see if medication is warranted. I would continue to report the abuse to the son emphasizing that you are fearful of being hurt. Good luck. Last resort: start looking for another employment. If you work for an agency, make sure your supervisor is aware so that they can intervene with the son as well.
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Oh, my! Okay - so you can have a talk with the son again. I know that you need this job so that you can get a vehicle, BUT at what cost - you in the hospital due to an injury the elder inflicts on you OR WORSE?!
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My sympathies. I worked in the mental health field before I retired so my perspective on an abusive client as opposed to an abusive elder client are a bit different. No matter. No one should be put in danger of physical abuse. If you are working through an agency, as the immediate solution would be two caregivers or recommendations that responsible family member or guardian is either present or available during visits. If you are working independantly, the precautions for your safety, therefore your client's safety are the same. If not a second caregiver, then ask if a family member is available when your charge becomes combative. Keep in mind that your client is exhibiting behavior consistent with dementia. It is not personal. I am curious. Did the client's family mention the behavior during the interview? Take care and I hope you and the client's family will find a way to create a safe environment for all concerned.
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Bayoubeaut Nov 2019
I was not told that they get abusive at times.. I was just told that they had dementia.. . They are my first client with dementia. Here recently they had gotten in my face and laughed.
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With dementia sometimes there is no way to know what has triggered a behavior. Approach and looking for triggers are very important but there simply are times when people react due to the disease.

No one should stay in an unsafe situation and risk injury. The family needs to know what is going on and take steps to do what is best for all involved.

Being a paid caregiver is a very hard job and often undervalued by others. There is so much need and likely to get worse, so look for another job, and go where you feel safe.
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Find out about their core beliefs structure. How they were raised. Then pull concepts from that.

Use a soft but firm voice.
"You know not to treat a lady ...your wife...one of God's Children... like that".
"I need you to act like your Mama taught you"
"Would you let your Nana see you act like this? Think about her. Remember her and make her proud!"

These are examples. Remember the illness makes a person have a short fuse, feel like a cornered animal, and almost no impulse control. So help them, I a gentle voice, find their inner calm. Find memories and behavior habits they can still link into and feel secure.

I was often called when a LO living across the street got threatening to his wife, or others. This worked..very powerful!
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There's no 'reasoning' with dementia, so don't bother trying to apply logic to an illogical disease. Who knows what 'triggers' aggressive behavior, either? It can literally be ANYTHING!

When I was a caregiver for an elder with Alzheimer's about 15 years ago, he'd go off on tirades about anything and everything. The eggs I cooked him were not like the ones he was served on The QE II. Never mind that we weren't ON The QE II, huh? The cookies I bought him weren't the cookies he WANTED even though they were the ones he asked me to buy, etc. He'd raise his walker up over his head & come charging at me like a bull. After about the 3rd time he'd done this to me, I called the Agency & QUIT. Why on earth would I expose myself to potential danger? It's quite easy to get another job in this type of field, so don't put up with any dangerous behavior for any reason. Don't risk life or limb for a job.........disease or no disease...............it ain't worth it.

Good luck!
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NeedHelpWithMom Nov 2019
Certainly not worth it!
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I'd start looking for another job while you still have this one...I'm guessing you are not the only caregiver? Do you communicate with anyone else, or is it family on the scene when you're not there? It must be scary not knowing when you'll be confronted with the behavior. I so feel for you...needing the $$ to get to the point of having more control and having the car...of course the car will come with payments and insurance and gas needs as well...hopefully another job will open up with the same arrangements you can handle as far as being there but for someone less problematic. good luck...
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One of those interesting paradoxes in life: (a) Every communication is a cycle that develops between sender and receiver. (b) Either person can change the cycle at any time by behaving differently. (c) The party with the most choices (the one most innovative at finding alternative choices) is the one with the power — to be used positively, one hopes.
Usually, instead of looking for what we can try that might get a better outcome, we focus on what THEY should be doing instead. And the paradox is that assigning blame is completely irrelevant and useless. Neither of you has to be blamed. It’s no one’s “fault”. The only question that matters is, “Is this getting outcomes I like or outcomes I don’t like?” And if it’s getting outcomes you don’t like (“if I lose this job, I can’t buy a truck”), you can take charge by looking for alternatives rather than blame.
So try this: (1) Each time the negativity starts, ask yourself, “What specifically triggered that?” Was it a word you used that they are sensitive to, or a tone of voice, or a way of holding your body or touching them — or maybe just something that reminded them there was a “stranger” in their space and that feeling made them sad and frustrated and defensive. (2) Once you identify “triggers”, you can - as an intelligent and caring human person - try different ways of approaching them - ways that don’t “trigger” their aggression. Ask yourself, “If I were in their shoes, what might someone do to help me stay positive and cooperative?” Then do that. (3) Give them positive feedback when a cycle of communication goes well. Example from my Mom’s care when she was in a hospital toward the end of her life: The trigger that put Mom into fighting mode: Medical personnel that kept saying, “This is what we’re going to do, okay?” Then they went about doing it methodically but without any hint of respecting my Mom and her dignity or intelligence. Why that was a trigger: (a) They were asking a question, then doing what they intended to do without waiting for an answer. Mom would say, “No that’s NOT okay.” And they would look surprised, then proceed with no acknowledgement of her response or feelings. (b) Their tone of voice was very loud, bossy and condescending. (Mom was not deaf, so the constant loudness of their voices was annoying. Also, even with dementia, my Mom maintained some sense of social appropriateness and did NOT like being treated like a child.) Alternatives that worked: We suggested that (1) they keep their voices to a normal, conversational level; (2) don’t end their statement with the question of “okay?” unless they really want her opinion on how okay it is. The brain hates an unanswered question and immediately starts thinking of responses; (3) If they DO end with a question, remember that dementia-altered processing is slow. Give them enough time to get their thoughts organized and expressed. (3) Instead of “okay?”, what if you ended with something like “do you have any questions about what we’re about to do or how it should help you?” (Mom‘s career was as a nurse, so this collegial approach worked very well in calming her down.). Once they did these things, it saved us and them of time, energy, & unpleasantness.
I’m not saying your situation is anything like that. Still the formula is worth a try: (1) Identify what triggers them to behave aggressively toward you; (2) Instead of assigning blame, experiment with doing something differently when those triggers occur. (Hint: always do something that is how you would want to be treated if you were in their shoes - or houseshoes). (3) At the end of the interaction, say something you appreciate about how they handled it. (“Well done! It’s no fun having to take pills, but you swallowed those like a pro!”) NOT “come on now dear, take your pills like a good girl”)! Keep trying new things until you find yourself enjoying the challenge of paving the way for them to stay nice. Why bother? That truck!
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GraceNBCC Nov 2019
Thank you for your response.

If you can remember being so sleep deprived that "anything" could set you off, or because maybe you were cranky from pain or high dose steroids... you will realize 'some thing' set them off.

The last thing an angry or agitated person wants to hear is, "Just calm down" or "I am not going to talk to you until you calm down". That just doesn't work. Truly acknowledge that they are upset, etc.

We can adapt to deal with their world. They can not adapt like that. They need us to read the room..so to speak..& learn to help get them some dignity, empowerment, respect & a feeling of Being Heard!
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Yes, you do need a job, and it is ok to change jobs.
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Talk with son about how dad's behavior is probably a result of frustration - not getting his way or not understanding what is happening. Ask son to talk to dad's doctor about anti-anxiety medications. You'll need to explain things very simply to dad and use lots of diversion to help him control his frustration/anger. Also allow twice as much time to accomplish tasks: bathing, eating, dressing, toileting... Yes, less tasks will get done in the course of the day. If dad is clean, fed, and dressed... you're doing a great job!
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It can Grow increasingly Worse Here, dear. Talk to th Son, Hun, About Finding perhaps a More Experienced One, Hun, And you Begin your Beguine in Between, Looking for a Better job to Suite you.
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Have you tried working for an agency? Please do not stay with an abusive elder because you may get blamed for anything he does. You are not being paid to be abused. You may even get injured by him...then what.
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gdaughter Nov 2019
Safer, but probably pays considerably less. Without benefits.
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Another vote that, in the meantime, you request that they be evaluated for increased medication. And do consider the box-store advice as a backup, love that. It doesn’t make you any less professional and you can get back following your dream career after the holidays.
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You might want to go on YouTube and look at the videos posted by Teepa Snow on handling people with Alz/dementia. You must have training in techniques for working with them. Her videos are invaluable
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Have patience, speak with family, medical team and be faster. And please remember do not take it personal.
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To me, being “somewhat abusive” is like being “a little bit pregnant”. No such thing. If this elder has tried to slap you or “bucked up” to you (not sure what that means) and tried to clobber you with their walker, I’d have to say you aren’t very safe there. No job is worth the threat of physical harm and chances are this family has been through this before with other caregivers who most likely quit. Quite frankly, you could make just as much (or more) at a Big Box store, especially now when stores are gearing up for the Holidays. You could even get some benefits to boot.
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Yes, I agree, the family should take this seriously. A Dementia/ALZ people have extraordinary strength. There are meds that may help.
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gdaughter Nov 2019
Yep. My little mama who could be easily knocked off balance is very strong when she uses her arms and wants to push me away or dig her nails into me!
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Are you through an agency or are they paying you privately? If through an agency you need to talk with your manager.

if hired privately? You need to talk to you employer and make sure they have liability insurance to cover any injuries you may get.

The family should be taking this seriously and talking to her doctor about possible interventions.
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