It's been 3 weeks. Her memory got worse since she fell. She is constantly trying to kick out the aides but she needs them because her pain, balance, and its hard for her to go to the bathroom alone , dress alone, etc. She forgets she needs them and tries to kick them out. Now she is calling 911 and having the police come to kick them out. She called 911, 11 times today and the police came out 3 times. I don't know what to do.
Although you will not be able to move forward until the present crisis abates, ask the social service department at her residence if they can recommend a psychiatrist/psychologist/social worker who can assess her cognitive/psychiatric status with the potential of medication or behavior management techniques to help her understand her significant need for her aides, and increase her willingness to accept them.
Within the current circumstances it really isn’t fair to her because of her dementia, disorienting accident, and subsequent stress of pain, to place expectations on her that she most likely can’t meet. “Kick them out” needs to be ignored and soothed.
If she becomes noisy and disruptive, she can be told that it’s the law that the aide be there, or that they’re already paid for. The aide needs to be as calm and quiet as she/he can manage to be.
If there is a Memory Care unit in her AL you may need to consider that she might be better served there. It will cost more, but if she gets too much more disruptive the AL may not be able to manage her.
Yes, get the phone away from her. Tell her whatever you must (product recall for example) to stop the 911 calls.
Your job is a tough one, but first you must make her safe, and that means the aide stays and the phone goes.
So, no phone. She adjusted. It all worked out for the best.
You don't actually have to take the phone away form her. Just cut off the service. Phone doesn't work. We've made a service call. They'll get back to us.
Be well, hang in there. and remember, your grandmother is very lucky to have so much care.
How much physical space, how many rooms/walls/doors, do they have to work with? Can they at least keep out of direct sight?
Are they trained in managing dementia-related behaviours?
It sounds like a discussion to be had with the Facility where she is living.
Second thought ....The aides should be doing a much better job at calming, distracting and helping her so she does not make the phone calls. It may get to a point where she will be charged for making the calls to 911 (they can levy fines)
Take her phone away from her. If there is an emergency the aides can call.
(and you can not let her keep the phone but deactivate it as any charged phone can still make a 911 call.)
It is possible that the fall as set in motion a rapid decline. If she is on medication these may also be a problem if they are making her brain a bit "foggier" than usual.
It is possible that she has another medical issue like a UTI that is causing more confusion.
Only the handset that she has, of course - there would be others tucked away for use by family and carers etc!!
She suggests to take a look at all of her meds! My grandma broke her back about a year ago & we experienced something similar. The harder narcotic pain medications will cause a lot of problems for older people with dementia. If she's not used to taking the harder pain meds that could be your problem.
We started our gma on Tylenol on the 2nd day after her surgery. That seemed to help tremendously! The Dr put her on morphine and gma was way out of character! Then we went to Percocet & that was even worse.
After about 36 hours of stopping the narcotic pain meds gma was back to normal. She was still in a lot of pain so we gave her Tylenol. The Tylenol was just enough as long as we didn't miss her next dose.
We are now at a point where we give her children's Tylenol and not that often!
· Dementia patients should not take ibuprofen unless they are allergic to acetaminophen (Tylenol). It causes some kind of problem with the dementia brain.
· If you have POA then yes you can take the phone but in this case you need to be sure that gma or the caregivers have a way to contact emergency personnel if needed!
· Trying to explain & help gma to understand that she is in need of the home health aide's is not gonna work if gma's Dementia is at a certain stage. Grandma1954 has a very good point as well as Countrymouse.
· Being around family & loved one's help to keep them more comfortable. They are afraid when someone new comes around.
*So, imagine that you are your grandmother. You have these strange people coming in your home. You are not in good shape to fight them off if they come in and physically harm you. You do remember how to call 911 currently. So that's exactly what you do.
Your grandma is only trying to keep herself safe.
I Hope that this helps even just a little bit! Let me know if you have any other questions. I am a care provider as well, I have my STNA & have a little over 20yrs experience with caring for the elderly. Good luck!!!!
My concern is also for her legal protection. Please make sure she has POAs written up by a lawyer for financial and healthcare oversight. It not, get those taken care of now - before the doctor declares her mentally incompetent.
Look into telecalmprotects.calm. It’s an inexpensive phone system that addresses the needs of seniors experiencing different medical issues. One feature allows you to block unwanted outgoing and incoming calls.
That being said I agree that your grandmother is no longer capable of independent living. I hope she has a will and assigned you POA. If not you will need legal advice. I needed a doctor’s statement to activate POA for my mom, but she refused to go. When she fell in her home I called an ambulance. I knew that was the way I could get her evaluated. She went from the hospital to rehab to Memory Care. Her behavior became increasingly difficult and staff were unable to calm her. Even I couldn’t couldn’t calm her. Part of the problem was an UTI. Although she improved after treatment she’d still rage and refuse to comply with care. The doctor wanted to give her a very low dose of the antipsychotic Resperdal. I was opposed because of what I’d read. But the facility didn’t have the resources or training to provide alternatives and we couldn’t afford a facility that used a variety of behavior modifications instead of antipsychotics. I was afraid they wouldn’t keep her so I agreed. Resperdal did help a great deal. I keep a close watch on her medications, research them, ask questions, and insist on approval prior to changes. Start researching facilities now. There are many websites to guide your search. Talk to people in your circumstances. Talk to the appropriate agencies in your area. Ask them what other issues you should investigate. You don’t know what you don’t know. Talk to a lawyer about a Medicaid waiver. Talk to a tax specialist. Don’t throw away any documents; organize & file them. Take and keep notes of everything. When you you tour a facility ask about continuity of care. Each unit should have the same nurses and assistants working there. In my mom’s Memory Care unit I never know who will be on duty and it’s difficult to get information because they frequently have to check with someone who isn’t on duty.
I know this is a lot to consider and I hope you have a family member to help you. I wish you and your grandmother well.
The 911 calls take away emergency resources from people who may need them, like someone who is having a heart attack, by tying up the lines and the resources.
In the village where my mom lives, the fire and rescue departments have had a huge increase in paramedic calls due to the proliferating number of senior facilities. I often see 2 paramedic vehicles in the parking lot at the same time. The vehicles are mostly from surrounding communities under the "mutual aid" agreements in place. The village paramedics cannot keep up with all these calls.
Having been through this, I can recommend without hesitation: Your relative needs memory care and you need to get rid of the phone.
and
2) If #1 weren't true, it would spell disaster if there WAS an emergency.
I know for a fact (it happened to me!) even if you call to try to cancel the call, they will tell you they can't and they will STILL show up.
If someone w/her 24/7, take the phone away from her. If no urinary issue, ask dr if there is a medication to help with anxiety issues. The facility is probably going to be contacting the family if she is no longer considered 'independent' or able to rehab back to an independent state.
Although mom was not happy about moving to MC, she was, in general, easy for them to care for and didn't make much trouble. THEN the UTI hit! They could do nothing with her, she was out of control and of course it happened on a Friday evening, so no access to doc until Monday! She had to take Lorazepam (anti-anxiety) while being treated - very low dose, only in the afternoon, worked like a charm from day 1 and when the UTI was treated, no more Lorazepam.
Since it's an easy test and easily treatable, it is wise to try that first, if the behavior/demeanor has changed abruptly. Even better is a urine culture - more sensitive and Rx can be more specific. Still an easy test, just takes a little longer for results.
For now, you may need to ask the aide to disconnect the cord on her phone. I assume it could be taped to the back or something so they can reconnect quickly? And, that the aides have cell phones for emergencies?
Could her doctors work with you to give her something very light to keep her sleeping overnight? Will she accept diapers just for this period while her foot is healing? If not, get a really good mattress cover (or 2) and her gowns and sheets may need to be changed at night.
Unfortunately, you are going to need to move her. Not at this time with COVID19, but soon. If possible, move her close by. If you are her family member/caretaker, you have to move her closer. Please do not give up your life for hers. I know that sounds terrible, it isn’t meant to be.
Good luck.
“I broke my ribs and while I heal
these nice people are here to help me.“
Along with checking for a UTI, confirming medications, and taking the phone away (which we did), just show her the sign and hang it up in her room. She will read it and mull it over and still ask, but ultimately she has fear: where am I, what happened to me, why am I in pain, who are these people? Keep confirming you want them there to help when you aren’t there. Hope this helps.
ALL along-- redirect--- the MGMT is offering cake and ice-cream in the dining room... !!! Fight the GOOD FIGHT !
assuming the caregivers have a cell phone for emergencies
If she needs help getting dressed, getting to the bathroom, etc., then, clearly, she is no longer "independent." If she is confused to the point where she is calling 911 eleven times a day, then it is unsafe for her to be in independent living.
A higher level of care seems to be warranted for her.