verbally abrasive client

LMTFSOP · December 2023

I met a new client today, I noticed she seemed very lost and uncomfortable. She talks in her sleeps and in fact just sleeps very poorly. She has called me so many terrible names, things i dont feel comfortable even typing out. While shes in and out of sleep shes constantly saying very crass statements and words that i am struggling being here just listening to her talk. i feel terrible for her and know this is a part of the illness so i definitely do not hold on to it but I am feeling incredibly discouraged but i will say that doesnt effect the way i care for her in any way. I love what i do and know its so needed for these families. But this 12 hour shift is just tearing me down mentally in ways i never could have imagined. I need advice

terei · December 2023

It sounds as if your client is in misery also…If I was the family, I would be investigating have her medicated to calm her. JMO

Iris L. · December 2023

Have you been trained for care of the person with dementia? What exactly are your duties for 12 hours? Does someone else take over for the next 12 hours?

Do not take what she says personally. Read a lot of threads and also the online reading material.

If this behavior is a sudden change in her usual temperament, she may be experiencing a silent urinary tract infection. It is called silent because there is not the usual pain on urination. A "nuns cap" can be used to collect a urinary specimen from the toilet.

Iris

LMTFSOP · December 2023

> @terei said:
> It sounds as if your client is in misery also…If I was the family, I would be investigating have her medicated to calm her. JMO

They have her on many meds including pain and anxiety medication and it didnt help at all

LMTFSOP · December 2023

> @"Iris L." said:
> Have you been trained for care of the person with dementia? What exactly are your duties for 12 hours? Does someone else take over for the next 12 hours?
>
> Do not take what she says personally. Read a lot of threads and also the online reading material.
>
> If this behavior is a sudden change in her usual temperament, she may be experiencing a silent urinary tract infection. It is called silent because there is not the usual pain on urination. A "nuns cap" can be used to collect a urinary specimen from the toilet.
> Iris

I have been trained but this client was far past the stages that ive been taught in. I would never take anything personal, i understand and give them my best care 100% of the time no matter how distressed i may be feeling inside. I can absolutely separate my feelings from reality of the situation. i love what i do so so much.

now the UTI is interesting but she doesnt show other signs but ill be keeping that in mind! thank you for the advice

LMTFSOP · December 2023

I also hurt my back in a pretty significant way taking care of her. I am not sure if shes forgetting that she can stand or if shes just on the downhill with her muscle strength but she could hardly get up and when she did it was with much help. Im not weak but getting someone from a recliner to a standing position that almost all dead weight was incredibly difficult. I tried a belt to help get her up but as i said she wasnt standing hardly at all that i became worried it would hurt her. i feel like she needs a hoyer to assist to getting her to her commode. any thoughts?

Iris L. · December 2023

If she cannot stand it must be determined if this is due to a new, acute condition, such as a silent uti or other medical problem, or is it disease progression. In the last stage PWDs are non ambulatory. You should not allow yourself to be hurt lifting your patient. Your supervisor should have guidelines for non-ambulatory patients. I hope other members with experience with PWDs in this stage will chime in.

Iris

LMTFSOP · December 2023

https://alzconnected.org/discussion/comment/191704#Comment_191704

Thank you for the advice tomorrow ill be talking with my supervisor about some of the concerns i have and what i saw.

CatsWithHandsAreTrouble · December 2023

If she's fairly progressed, maybe you can talk to the family about getting her on hospice. PWD being on hospice can give them a little extra care and sometimes help them "rebound" in a way and thrive for a little more and graduate from it. Hospice can also help provide equipment. I know of chairs that can move into somewhat of a standing position that might be able to help standing your client without overstraining your back. I'm not sure if that is something hospice can supply and perhaps some can. I only say that because we asked our hospice team for fall mats, something I thought was pretty common in dementia care, but they said "we don't do that."

Good luck with the meeting with your supervisor. I hope you two can figure something out together.

Are you able to cut back your hours with this client? You might need to give yourself more time in between shifts of caring for this particular person for your health.

verbally abrasive client

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