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My mom is in memory care. Is on meds for hallucinations. She had another hallucination this week. My mom and one of her caregivers are like oil and water. Another bedtime confrontation over the weekend. My mom doesn’t need to be directed to bed, but ultimately she falls asleep in her chair. Hence the caregiver tug of war. But I wonder if stress triggers it ???


Not sure what to do about caregivers behavior and tug of wars with my mom. My mom exaggerates , especially if she doesn’t like you. I do know they have conflict though. I don’t want to complain because ultimately, my fear, she will take it out on my mom. At previous AL when I complained about theft, my moms rent went up. Vindictiveness from director, ( not my imagination) … numerous behaviors from director… Took me 4 months to get all of my moms rent refund back They had to correct the refund 3 times, finally I said , I will take it up to another level and low and behold it got done… There was theft and then there were the games my mom played. She is with it enough not to have simply forgot…

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Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away.

You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

The above statement, "You need to change your behaviour to adapt to the dementia because the person with the disease cannot." is the BIG takeaway from this list for your mother's CAREGIVER to understand! SHE has to adjust HER behavior towards your MOTHER to get her to become compliant b/c your mother is unable to!! Perhaps a conversation with this caregiver is in order as in a heart-to-heart talk, just you and she. You can even bring her a box of cookies to express your gratitude for the care she's giving mom, then segue into how mom needs to be treated in a certain way in order for them to get along. Bring along a copy of this list for her to look over; it might be a light-bulb moment for her, you never know.

It's worth a shot.

Good luck!
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Stress is never 'irrelevant' to a person suffering from dementia!! It can always aggravate the person's situation to the point where it sure CAN cause hallucinations and other anxiety issues to worsen. The goal of care for your mother is to RELIEVE her anxiety and stress as much as humanly possible. Ativan has helped my mother with her agitation and calmed her down to the point where she's stopped furiously looking for her deceased relatives all evening long.

If there is a tug of war issue going on between your mother & a caregiver at the MC, I believe this CG is not properly trained on how to interact with a dementia patient. It's ALL about how SHE speaks to your mom; if she uses the wrong tone, that can easily set your mom off and then the bad vibes get going. Is there ongoing training for the staff at the MC? When I worked at one as a receptionist, even I had to do the training program, including watching the Teepa Snow videos on how to properly engage a dementia patient, what to say, how to say it, what to do/not do, etc. I would speak with the ED if I were you and express my concerns; if your mom lives in a place where you cannot have an honest conversation with the nursing staff or the administration, then that's not a viable place for her to live, realistically. You, as her daughter, MUST be heard and listened to b/c this is your mother and her care is YOUR #1 concern! Don't be afraid to vocalize your concerns, respectfully and w/o pointing fingers in a critical way. How YOU come off to the administration is almost as important as how this CG comes off to your mother: attitude is everything, you know?

Here is a useful list of Do's & Don'ts for interacting with a Dementia patient:
The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Continued..........
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At this stage of her dementia, stress is irrelevant. Medications don't cure hallucinations. They are an intrinsic part of her dementia and will get worse as her dementia advances. If you're unhappy about her care, you should move her to another facility.
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If you see the aide tell her you know the elderly exaggerate but would it be possible if she just leave Mom in her chair if she has fallen asleep. My concern would be that the aide pulling on Mom and Mom tugging could cause the aide to injury her back.

My MIL preferred to sleep in her recliner because of hip problems. Another thing, as a resident the aide cannot make her do anything she does not want to do.
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I can't know what is going on with where your Mom is living, and with those who care for her.
BUT, you asked if stress can increase hallucinations.
The answer is yes, definitely.
When my brother was diagnosed with probable early Lewy's dementia he had hallucinations of several different types. In fact, along with loss of smell and taste, foot tapping, and balance issues his Lewy's was diagnosed solely on his descriptions of his hallucinations without physical signs of same. At that time he made me his POA and the Trustee of his Trust. He asked me to pay all his bills and handle his mail. He sold his last little home, gave up his car, and went into care at a facility where he had an ex partner-current mate already living. And once in he was able to discuss his diagnosis with me. His hallucinations became VERY INFREQUENT over the first year there; he described himself as not having to worry about anything. Not anything. Not groceries or bills or anything else. He said it was a great relief to him as he had been aware it was getting more difficult. He felt safe.
When I discussed this with the director and the staff at the facility they said they heard this from clients and from families ALL THE TIME.
So apparently the answer is yes. Anxiety makes everything worse. For most of us.
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