My mother-in-law is in a memory care facility, her second. I visit 6 out of seven days. My husband, still works fulltime, will go one day & maybe another with me. She use to get embarrassed or let me know when she had to go. After COVID she didn't do much on her own. It is easier for the employees to get it done themselves. I am not blaming anyone but it is true. She sometimes tells me that they do it for her, get her dressed, changed her briefs, etc. She will say it gets loud & is better not to say anything. I have seen & heard employees give hell to residents. I want her to do as much as she can on her own for as long as she can. Any ideas?
If you hear aides "yelling" at residents, report it to the Executive Director. Set up regular care conferences to get reports on how your MIL is doing and how her dementia is progressing. My mother would take regular steps down along her journey where she'd go from being able to do something one day to totally unable the next.
Your MIL likely has reached the point where trying to
explain to her about sitting on the toilet or letting you know she has to urinate isn't possible....she cannot comprehend what you're saying. I suggest you read this 33 page booklet online about managing dementia and what to expect with an elder who's been diagnosed with it. Lots of Do's and Don't tips for dealing with dementia sufferers are suggested in the booklet.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.
The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.
The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2
Educate yourself about what lies ahead as dementia progresses before you decide what things to try with MIL and what things not to.
Best of luck to you.
In your profile, you write " I am her secondary care giver."
WHY????
"It is easier for the employees to get it done themselves" Do you mean MIL thinks she is capable of dressing herself? Or do you mean the aides think its easier just to use Depends then to take MIL to the toilet? For someone who can "hold" it, they should be toileted every 2 hours. But if MIL can not toilet because she can no longer hold it, then the Depends need to be used. And when u suspect that she needs changing you ask an aide. Not one time when Mom was in AL
did I change her. I tried to make life a little easier for the aids. I hung her tops and slacks together for each day. Easier for me to keep track of her clothes too. They kept her in the Common area and the toilet was close by but they would walk her all the way back to her room where the supplies were. So, I put a couple of Depends in her walker basket and bought a travel container for wipes so they could take her to the closer bathroom.
You need to check Moms care plan. Aides do not dress someone if its not on the care plan. I bet changing her is on the care plan. If so, she is paying for these. And it is faster for the aide to dress MIL, or help her, then to stand there and make sure she gets dressed. Or come back later to find she is not dressed and she needs to be in the dining room. MIL is not the only resident the aide is responsible for. Your MIL is in MC because her Dementia has gotten to the point she needs care for most if her ADLs.
When u have a problem with an aide you go to their boss who is the head RN or RN if just one. RNs oversee aides. If your problem is not resolved, then you see the Administrator/director.
Is the yelling really the resident not wanting to get dressed and the Aide trying to talk over the screaming? My DD is an RN in LTC for over 20 yrs. She explained to me an aides morning. If u know what they go through, you would understand a lot better. You had one person to dress, what if you had 10 or 12. Your shift starts 6 am and they all need to be down to breakfast by 8 or 9 am. So, you first have to get them out of bed. Toilet them or clean them up. Get them to brush their teeth, then dress them starting with the top down. Then brush their hair. All this within a half hour if 9 am is breakfast, 20 min if 8am. Then out of those 10 or 12 residents half of them fight you all the way. Hitting you, screaming at you, acting like toddlers. My daughter was punched in the head. When she asked the resident why she did it, the resident said "I don't know" and probably didn't know why she did it. So after having a couple of these types of residents, it probably a lot easier "just to do it themselves".
I do think going 6 days a week is a little much especially if you stayfora long time. My Moms AL was 5 min up the road so I would stop in daily. I stayed no more than a half hour, sometimes 15 min. I did her wash so dropped that off. When she went to LTC, it was every other day, no more than an hour.
Your 4th paragraph, sorry but 😆
Had this happen yesterday, but the head RN let the guy I'm rooming with head out for a smoke, well he almost did anyway, even though he was supposed to be isolated. The aide and she got into a disagreement about this.
By the way you forgot to mention if a contagious disease is involved.
If something were to happen and she slipped and fell, or you were hurt changing her....
But the staff is being paid to change her. MIL is paying to be cared for by the staff.
If MIL tells you she needs to go to the bathroom you press the call button or you go get someone. Or have MIL press the call button.
Getting the bladder to empty fully is not always possible. (hence one of the reasons for some of the UTI's that occur)
But changing position a few minutes beforehand sometimes helps. So if she was sitting in a chair walking for a bit might help. If she is in a recliner sitting the chair up or even laying it back for a little bit before the trip to the bathroom sometimes helps.
I do understand that you would like your mother in law to be as independent as possible. My mother had mobility issues and she would say that she thought she would do better if she were in a wheelchair.
I spoke to mom’s neurologist and he said that she could still walk on her own and if she started using a wheelchair that she would become dependent upon it. So, we opted for home health to work on strength and balance issues. She gained strength and never ended up in a wheelchair.
Your issue seems to be different. She may not be able to do everything that she could do before. Is she in any pain? Mom had Parkinson’s disease, rotator cuff problem and arthritis which made it difficult for her to dress herself. I did help her.
Ask her why she’s struggling to get dressed and then address those issues.
As far as toileting issues, she most likely can’t control that. My mom couldn’t hold it either as she aged.
Sometimes mom would go to the bathroom and then have to go again a few minutes later. We started using Depends. Do you think it may be time for Depends for your mother in law?
I don’t think it’s necessary to go 6 days a week. Go when it’s convenient for you and allow the staff to do their jobs.
Best wishes to you and your family.
Do not do all this work -- it's literally someone else's job. Make sure you let the staff know that you won't be doing it any longer either, so they don't assume you'll be showing up to take care of it.