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Mom finds something wrong with every single night time caregiver. We have gone through over a dozen in a year. We have somewhat better luck with the daytime caregivers. But come night time, even if a caregiver has been there multiple times, she doesn't remember them and thinks they are going to either steal from her or she cannot understand why they are in her house sleeping. Obviously we have tried to get her to understand that these nighttime caregivers are not there to sleep but she insists on making them a bed on the couch, then proceeds to complaining about why they are there on her couch, don't they have a home of their own, if I like them so much why don't I let them sleep at my house, they don't need to watch my TV all night, they don't need to be wasting my electricity by keeping a light on all night, if the lights are off they can "pilfer" my things,.... the list of complaint goes on and on and on. She tells them they have a "smart mouth" is they try on any level to explain anything to her (such as why we don't have to turn her alarm system off 5 or 6 times, open the doors to make sure all the doors are locked and there are no crooks peeking in her windows or rattling her door!). She asks them point blank if they have homes they can go to and why they don't go there. She asks them if they are going to take her things. She treats them like children and if she "catches them" on their smart phones or ipads, she tells them it's time they went to bed. She sneaks out of her room and spies on them. It's downright crazy. Some of them have refused to come back and the ones who are stalwart and come back, she ramps it up and says they are not to come back to her house or she's calling the police. It's a mess! One of the daytime caregivers used to be a nighttime caregiver and has tried to explain to her that she too used to be there at night. Nothing does any good. As of now, she's gone through 6 caregivers this last month. The agency has been fantastic finding qualified replacements. I have gone over to her house and stayed for hours while she gets used to a new caregiver. That backfires. She thinks because I talk to them and have pleasant conversations that they are either my friends or resents that I am telling them about her and her house. If I try to get her to join in on the conversation, she glares at me and hisses through clinched teeth that I am"just showing off" and I can just "shut up and leave". When I do, she calls me ranting about why I am doing this to her....you all get the picture! We all know she has Alzheimer' s, is paranoid, delusional, OCD and is severely scared and depressed. She insists on staying in her house: "Daddy built this house for me and said don't you dare let anyone take it away from you!" She gets furious if we suggest her moving elsewhere. There was a lovely home for sale right next door to me that she could have easily paid cash for... she had dozens of reasons why she could not do that starting with, "Now why would I want to leave my home and live somewhere else?" I call her daily (sometimes 2 or 3 times), do all her grocery shopping, bills, income tax, and visit her on average 2 times a week PLUS bring her to my house for dinner every Friday night and all day Sunday. Holidays I usually have her with me at my home 3 or 4 days.


Speaking of her home...well it's a god-awful mess that she won't let anyone touch anything or clean. The daytime caregivers try to dust and pick up when she's asleep. If anyone does anything too significant she goes on a tear accusing everyone of taking and moving her stuff. Bottom line: how do I get her to calm down and accept night time caregivers? And no, I cannot let her live with me. She really doesn't want to anyway, but she does enjoy when I have her over for a weekend and wait on her hand and foot. Then she is temporarily content. And no, there is no one else in the family who can do night duty. I tried that myself until it blew up in my face with her accusing

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Wow, this is horrible!

I hope that you can get some relief. Seems like she is very agitated. I'm not big on meds but in a situation like this, I would look into something to calm her down so that she can get some rest and not be so paranoid and impossible to care for.

Hopefully, the caregivers understand that this is her disease talking. Regardless, still very hard to deal with, I'm sure.

Do you have POA? Is she still considered competent? Asking since I wonder if moving her to memory care would be a good idea. I know she does not want to go, BUT something has got to change.

Best of luck.
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againx100:
Thank you for your response. She is already on significant meds for heart, irritable bowel, and severe pain related to spinal stenosis, scoliosis and inguinal hernias. She is on a low-dose anti-anxiety med but all doctors involved say it's not advisable because of side effects related to her ailments and increased fall risk.
Yes, I do have medical, mental POA as well as Durable POA and Successor Trustee over all her affairs. Everyone involved (doctors and close family) KNOW it would be a complete nightmare to get her into assisted living/memory care. I think somewhere along the way, we have pretty much decided that her fate will be ultimately going into a hospital due to an illness or fall then winding up in a care facility. Not the best way at all to plan out for your mother, but given her adamant insistance on remaining in her home, it's the best we can do.
Therefore, that is why we have the in-home care. For about 4 months she had two night time caregivers that she actually liked. They babied her, made over her and basically treated her like a queen. All of that is great. The problem was one of them quit to take care of grandkids and the other younger one requested days. She is the one day time caregiver that mom likes now. She just will not accept anyone new at night now.
Yes, we KNOW something has got to change. Her memory is so bad, that when I attempt to explain to her how we have had multiple caregivers whom she has dismissed she has NO RECOLLECTION of that and is dumbfounded that she would say those things to someone. I guess at this point we just keep doing what we've been doing (definition of insanity!).
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Your mother is sundowning. This is a specific set of symptoms that show up as darkness falls, leading to increased confusion and increased psychiatric symptoms.

You need a geriatric psychiatrist on mom's team who understands that all else is for naught if your mother is not calm, able to sleep and let her caregivers sleep. At this point, her psychiatric symptoms are her Primary issue.

Consider a residential senior behavioral placement to get the sundowning under control.
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You must be a patient person. I couldn’t do it for someone like your mother. She needs to be put on a stronger tranquilizer at night for she will sleep through the night for you can have someone spend the night. She isn’t going to get better so I wouldn’t worry about the side affects. You have two choices, medicate her more or put her in a nursing home.
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Hi.
Oh boy! This is a hard one. Indeed!
Your probably right, hospitalization to assisted living is probably her destiny.. but not to ever wish this.

Onlything I can think of is to really throw this over to her doctor.!

Call the office. Bring her in. Have a 3 person consult. Let him/her be the heavy. If doc has this knowledge of her being alone while dangerous, he may Need to come up with a answer?
Heavens. I'm merely guessing........
Funny, your mom' has some valid points bout staying in her home.
BESTof luck
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It seems that her OCD is kicking in big time since she is scared. She doesn't understand what is going on and she tries so hard to control every situation. May I suggest a visit to her general practitioner and a psychiatrist. She is not mentally competent to live alone. If she refuses all basic upkeep of the home, then it seems she is past the ability to keep her home. Her doctors may be able to prescribe medications to help her relax and even to sleep in the evenings. Maybe if she is on those medications, she will accept evening caregivers and allow her home to be maintained. If not, then it may be time for a memory care unit.
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Can you make it part of the job description that she is to be babied and treated like a queen?

That's what I would do. It has worked in the past and it may work in the future. These caregivers are getting paid to care, not sleep and not to be on their phones. More training and specific job duties!
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Maybe if the caregiver wore a uniform she would recognize them as a "nurse". I agree they should not be sleeping. Leave the cleaning to someone else.
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I have the same situation with my MIL, can't wait to read the answers.
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TRyan to engage with her to play some type of card game or board games . Redirect her thinking with something she use to like doing . In gauge with small conversation about her and her family. Make everything all about her and how she is a great woman and you would like to become her friend to help her with anything she needs. Ask her if she would like to joy in doing things like looking at magazines or books .
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Laralu,
First and foremost, you have to accept the fact that due to Mom's Alzheimers, she lives in an entirely different reality now. So trying to "get her to understand " maybe futile.
Is Memory care facility a possibility? I can guarantee she won't be happy at first, but maybe in time she will settle in. They can offer a higher level of care . Sounds like she's not happy with the caregivers either!
I understand that you want to do what's best for Mom. I've come to realize that sometimes what's best is sometimes the hardest!
God bless you for taking such good care of her. She's blessed to have you!
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Two different things cross my mind. Your mom has what is called sundowners first and foremost. Google it and read about it. She needs meds from a doctor so that she sleeps through the night while the night time person is there working and also do not allow her to sleep during the day so that she will sleep at night. If the meds do not help, then the second thing that crosses my mind is that your mom needs round the clock care. Even if she moved beside you, she would require round the clock care. If meds do not work to make her sleep all night to allow your night staff you hired to work there, then it is time for you to sell her house and move her to memory care.

I know you do not want to here either of these.....but I also am dealing with this in my own life. My mom has vascular dementia and Alzheimer's and is in moderate stages to often tikes sever stages. My father is in the very beginning stages of Alzheimer's. My fourteen year old son and I love with them to help my Dad care for my mom right now. We were able to help my mom with meds and a very strict regimen that I will not let her sleep at all during the day because she literally went out of her mind before with sundowners......and she also became violent. The meds have helped both. Obviously the meds won't work forever, so at some point she will become worse with her dementias and we will at some point in time not be able to handle her and will have to make a decision to place her in memory care. We both pray that before that day comes, she will just give up and perhaps just not wake up one day.
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BklnMom Apr 2020
Dealing with similar situation re: sundowners. What meds did you find helpful? So far I haven't found anything to help her sleep or "normalize" her schedule — Dr has her on Effexor and Halcion, neither has helped with sleep schedule. Would like to try melotonin but Dr is afraid of low blood pressure/falls. What worked for you? thanks.
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Twelve for twelve is lose, lose. Time for a different approach as this one is not working.
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Really sorry that your mother is adamant about her thought process that she thinks the nighttime caregiver(s) are sleeping when they are not. As her brain is broken, no amount of reasoning will work. She is Sundowning.
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Unless you can check these people thoroughly , Mom it probably right. There are "respected family caregivers " that are actors and cons. Very good actors and they know how to manipulate the family . Especially if the family gets "overworked" . She has lived longer probably most of the experts consulted. My point is not an answer, I know . It is a caution. The phrase " Don't listen to them, they are drunk is being replaced with they have dementia, ignore them."


I have never been allowed to sleep on the job, so I dont understand either. Who are these people?

Most people's parents have stayed alive longer than they have.

Needless to say I have had horrible things happen to my parents and they are both dead now. A power of attorney can be deadly in the wrong hands It is supposed to be a convenience .
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Don't know if this will help but might some of the time. I agree to keep her awake during the day. But to try to shift her mood play music from the past that she liked. Also give her sweet things that she likes -ice cream or little cakes. Especially in the evening. It can raise serotonin. I learned this from taking care of some one with Alzheimer's. He craved sweet things at night so I kept them on hand. He also loved chocolate ice cream so I gave him some when he was upset and also played the music he loved. It was a mood shifter.
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My is 95 with dementia, he was the same way 3 weeks ago. He had one uti he was tread with antibiotic, I call the doctor he prescribed Quetiapine 25mg.Thanks Gad he is sleeping now.
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I feel guilty to call hospice. My father is almost 96 years old physically he is doing well, but mentally his dementia is severe. The neurologist told me he does not going to give medication because of his age. I keep him at home and sometimes is difficult for me to manage.
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Maybe get some "Nanny cams" !!
You don't really even have to hide them. If night time caregiver knows they are potentially being watched so be it.
It might give you peace of mind to know exactly what is going on.
Hang in there!!
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