Spouse with dementia “fires” aide

Rescue mom

DH screams at aide(s)—only if and when I’m not here—to go away and get out of the house.

For context:  For a couple years he really dislikes other people, even longtime friends, at the house. If friends came by, he might last 5 minutes, then he goes to another room. Even kids and family, if more than one, he leaves. I can talk/visit, he refuses.

Fortunately, when I’ve had to be away for hours/days, kids helped.

 But—I’m getting to the problem— they’re not as available as they were, and neither are friends.

I’ve tried hiring several people, all ages, all with dementia experience. Told DH  “I need help around the house,” and he seems OK with that. (We’ve had Housecleaners for years). Even after after 4-5 visits, DH will not interact with them in any way, nor stay in same room. (Ditto for longtime housecleaners, except I’ve managed to be here.)

 I’ve tried gradually being less present, space-wise, while the person does some “light” housekeeping-type chores nearby. He still will not be in same room/space as them, nor interact in any way, on any topic, even after several visits.

So I finally decided, they’re here, and can see that he doesn’t hurt anything.  At least he’s got eyes on him.

But when I leave the house, he starts telling/yelling, at them to get out, “I don’t want you here” “ I don’t care what she told you…” “leave me alone..” etc. A couple of them taped it. A couple said they couldn’t stay around after being ordered out, and one said he scared her yelling.

Has anyone else dealt with this at home, with a spouse? Should I just expect it will take longer to “get to know” somebody to the point I can leave? Since he doesn’t like old friends here, I’m not optimistic. Should I tell them to stay, just out of sight,  no matter what he says?

 ANY other suggestions? I’m beyond frustrated, I feel like a very literal prisoner. And just finding good helpers is hard, regardless of his cooperation.

Just Bill

I hired someone to watch my wife for 6 hours. It was a trial by fire for her. She was fine until she wasn't and had an "episode". She hallucinated that there were two other people upselling services like cleaning and cooking for more and more money. That wasn't true but the person rode it out. After the first of 10 calls from my wife I texted the caregiver and asked if she had this ? She said don't worry I have this. Next I get 3 calls from my wife apologizing for making a mistake. When I got home they were walking the dog and hugged goodbye. That was my first experience maybe I got lucky. They will both be tested again Saturday I am hoping it goes well. If people have experience with dementia patients getting yelled at is par for the course I would think. Deflecting and diffusing a dementia patient is an essential skill set that maybe is inherent in people and can't be taught. The woman I hired is just so sweet and you can tell she is a nurturer and truly cares. But if I get a call and she says "I quit" it wouldn't surprise me. I would keep trying until I find the right one. I used care.com and there seems to be an infinite supply of people wanting to do this kind of work.

harshedbuzz

You are a prisoner and the warden calling the shots has dementia.

My dad was not an ideal candidate for a day program, so in-home aides was the only option. We introduced them around mom's TKR and it went sorta, kinda OKish. I think he tolerated them in part because I told him the other option was a rehab for her and that I'd send him, too, to make sure she was doing her exercises. I also told him the aides answered to ME and that he could not fire them.

He didn't like mom leaving and he didn't like most of the aides. There were a couple older ladies who were hard and pushy, there were a couple with accents he couldn't understand and then we found Chris. She was about 30 and was a very pretty younger version of my mom with a very laid-back demeanor who would sit and listen to his stories. Unfortunately, she was very popular and had few available shifts.

TBH, this was one of the reasons my mom agreed to MC for dad. She was trapped and neglecting her own care which had dire consequences. He adjusted more easily to MC than he did having most aides in the house. 

HB

Stuck in the middle

I agree with HB.  I have seen this behavior in people my mother cared for, and it didn't improve.

Some diseases take no prisoners, but this one does.  As I see it, you can both be prisoners at home or he can remain a prisoner somewhere else while you go free.

Sorry I don't have a good answer.

Lynne D

My HWD has two caregivers for respite care. One is just magic with him. They connected through music. The other he does not like, but she is experienced with dementia and tolerates him. I believe he may just want me to stay, and he threatens to leave and refuses to interact with me when she comes over. He started by retreating to the bedroom when she came over. She will coax him down for lunch. Today he told her he loves her. 

I think someone experienced with dementia would hang in there with you. Perhaps the issue is just finding the right person who will stick around long enough for him to get used to. You need respite.

Does it really matter if he dislikes other people and tells them to leave? 

Paris20

I hired a wonderful aide for my husband. He attacked her verbally every day. Then, one day when she was trying to help him up the steps, he pushed her away and they both went flying down about 8 steps. I thought she’d quit right then and there but she stuck with it. She and I really enjoyed talking to each other and remain friends. My husband had a stroke and is now in a good facility since he is now seriously handicapped. However, I really did fear for her physical safety and rarely left them alone. In his new abode he has continued to yell and curse the aides whom he must depend upon for care. At least it no longer happens every day. I think he just doesn’t want to be around people he hasn’t known for a long time. He can no longer build new friendships and he feels threatened. Depending on the aides is frustrating but he occasionally admits he needs them. He cannot express his feelings. He simply lashes out. A few times he really scared me.

Rescue mom

Lynne, you hit the nail on the head and I have to bite the bullet (sorry, cliche OD). But your question is easy to answer.

No, at this point I don’t much care if he “likes” them.  Hopefully, he would/will. But so far none will stay while he’s yelling at them to get out. Three aides were very confident he’d soon accept them, after a few visits. Nope. He did not, and they quit. (Demand for such help in my area outstrips supply, so I paid more than going rates, but.) They all had clients on hand.

All had years of dementia/Alzheimer’s experience. But they all ended up saying they hadn’t had a client like that. But I think their previous charges were more frail and/or less mobile, and more accepting of help, or at least unable to protest much.

I think I “just” have to keep looking, maybe there’s a person for him somewhere, some day, some time (before it runs out). 

The Alzheimer’s mind continuously amazes me. On one hand, they know, or can do, so little. On the other, they can manipulate masterfully. He can showtime great for maybe 10 minutes, or until the other person realizes his responses are rote/universal, and sometimes nonsensical. People still say he seems fine, after a 5-minute encounter.

I have and am looking at MC, but I can’t quite do that yet. Even some of those people who met him briefly questioned whether he was “at that point yet.”