Setting Boundaries With LO Who Doesn't Think They Need Care

Bost

I joined this forum because it was the only one I could find that welcomed professional caregivers like me.  I guess I'll use the word LO instead of client though, since most people here are family of their patient.  I had a LO who needed a caregiver for meal preparation and walks around the long block for exercise.  When we went to the store for meal ingredients, I had a problem.  She didn't wait to enter the parking lot with me and the heavy grocery cart I was pushing.  She raced ahead, not even looking as she crossed the parking lot.  With the cart, I could not keep up with her.  I was worried she might get hit by a car.  I wonder what other caregivers would do in this situation?  When I asked her to wait, she was sarcastically dismissive of any concern for her welfare.  After seeing my concern dismissed, later before we got home I made a special point to request that she stay with me when we leave the store.  Her face looked angry then.  She dropped me as a caregiver that day, probably because she felt I over-reacted.  I would like to know good ways to handle this in case it happens with another LO sometimes.  I was thinking of asking the store for help out, so an employee can manage the cart.  But caregivers are expected to work hard?

ButterflyWings

Welcome Bost- 

It sounds like this client has dementia, is that right? If so, they cannot understand or respect any boundaries you may set. To keep them safe, we must adjust to them at all times. Very tough, yes, but that’s a fact of life with Alzheimer’s or any of the other dementias (and many other brain diseases or mental health challenges a client or LO may have).

(Adding something I had to learn): People with brain damage can’t keep promises even if they agree to your rules, and it isn’t just a memory issue. 

Caring, informed professional caregivers are so needed and appreciated by families like those here in this forum. I hope you consider sticking with it and learning all the special needs of dementia sufferers, and tools we must use to adapt to the disease. That will enable you to be effective and such a blessing in your line of work as caregiver.

jmlarue

ButterflyWings is right - it's almost impossible to set boundaries with a PWD. It's especially hard with people in the early stages of dementia when they don't see themselves as impaired. Attempts to "set boundaries" is rejected as your disrespect and treating them like a child. Most of the time we need to resort to subterfuge and fiblets to get compliance. In the grocery store situation, your idea of getting store help with the cart to the car is probably the best option. The alternative is to resort to subterfuge..."Wow this cart is really heavy. Can you help me push it or should we wait for help out to the car? Either option should help to keep the PWD near you and not rushing ahead of you.

SusanB-dil

Hi Bost - welcome

You did what you could because you care.  But I agree with the others, try using distraction, because you really can't reason with someone with dementia.  I do wonder, though, if it was up to her to dismiss you,  or is her family involved in her care?  If family involved, and it is still a good 'fit' for you, that you may be able to go back to caring for her.  She may have forgotten the whole incident by now.  

May flowers

God bless you for choosing to be a caregiver and I think you will find a lot of helpful tips on this board! My guess is the person you were watching will have a problem with any caregiver and will go through quite a few!

My FIL hated to be corrected on anything. Like most folks with dementia, he was convinced nothing was wrong with him and never thought his behavior was wrong. One vivid example was he used to walk the dog, but one day the dog decided not to walk with him (the dog became scared, maybe because he sensed my FIL was losing his sense of direction). I saw my FIL trying to drag the dog down the street by his collar (the dog was laying on the ground, being dragged) and I intervened. I tried to explain he can’t treat the dog that way. He got so mad! His response was first to blame the dog, then blame me.

From then on, I did not correct him, (although today I held his hand and told him  not to hit the caregiver. It may not mean anything to him but I wanted the caregiver to know I respected her). What I do is redirect or tell a story to get him to comply. You have to be creative sometimes. Asking her to help push the cart is a good one. 

Iris L.

Welcome Bost.  I suggest you take some time and read several weeks' worth of postings, also alz.org.  Study! Take notes!  Read the online reading material that is linked.  Just about everything you need to know is here.  Take a Savvy Caregiver course which is given by the Alzheimer's Association.  Read about the Seven A's of Alzheimer's Disease, especially anosognosia, which is unawareness of having dementia.  Learn the work-arounds from the members.  Read about Teepa Snow and Naomi Feil.  Post questions when you need to.

Iris L.