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So I found an overnight caregiver I love!! I cook for my mother, send all the food with her, and she eats stuff the caregiver makes that she shouldn’t. Last week she got so impacted and I had to go over there and disimpact her. I told my mother it’s not fair that she eats things she shouldn’t and I have to deal with the repercussions of her bad decisions. She is eating things that increase her cholesterol and blood sugar after I have gotten her down on her meds and her labs are great! What do I do?

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Give explicit instructions to this caregiver about what you want your mother to eat, and not eat, and tell her not to allow anything else to pass thru the woman's lips BUT what you cook. I'd stop worrying about cholesterol and relax these diet restrictions a bit so you're not cooking so much, but that's me. I also wouldn't stand for "disimpacting" anyone's bowels, but again, that's me. If you like this caregiver, just make sure she understands your rules and things should be ok. Hopefully.

Good luck!
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All depends on her life expectancy. If she is very old, a "a healthy diet" that prevents a premature death, might be already obsolete, because her death won't be premature anymore. Then, why worry? To avoid fecal impaction, she needs to drink plenty of water, eat foods with lots of fiber or use fiber supplements, plus some physical exercise. Perhaps she could use stool softeners too. "Great labs" not always correlate with good quality of life of an old person.
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Too bad this wonderful caregiver is not feeding your mom the good food you send but feeding her garbage instead. She needs to not ASK you mom what she wants but prepare what you've provided and say DINNER TIME.

You do NOT have to deal with the repercussions. Next time, take her to the ER and maybe that horrible experience will get through to her. If she has dementia, it won't matter but it would still be better than YOU personally taking care of it. No thanks.

How old is your mom?
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I am a solo caregiver for my mom and we have had really good discussions about quality of life for many years. Really, these discussions go back to when she cared for her parents. I remember the joy my mom put into making my grandmother's favorite dessert, Lemon Meringue Pie, when monitoring her diabetes no longer mattered because she had been diagnosed with colon cancer and everything was about quality of her life, not quantity.

While you don't address larger issues of your mom's age, physical or cognitive status, or any specific health conditions, your mom does need overnight supervision, and I am presuming 24 hour supervision. She is either making the choice to eat unhealthy food which indicates she has full cognitive function and it is her choice, or she doesn't have full faculties in which case fussing at her for eating something she enjoys is ineffective. Whatever her cognitive status, her health is in decline and her quality of life is going down, too. It is time to create a clear plan for what quality of life your mom wants to have.

If you aren't already, I encourage you to work with a gerontologist or geriatric nurse practitioner, who can help guide you on managing her constipation with fluids, fiber, and movement. Address how to enhance your mom's quality of life, and let them help you focus on the immediate needs that impact your mom's overall health and well-being.

It also strikes me that you could benefit from a therapist to help you build skills to live in the moment with your mom, and enjoy your life together. It can be easy for caregivers to focus on the areas they can control (for you that might be making those meals and monitoring that blood work) to avoid being in the present moment. If not now, at some point in the future, you will need to let go - that is the sad truth of our job. Being ready physically and emotionally to do that needs support and you might find it helpful to engage that support now.

As a caregiver, you clearly love your mom and are working hard to take care of her. I just encourage you to go down a path of understanding what the most essential elements of that care is, and maybe allow yourself some joy in the food your mom is eating with the overnight staff. This may likely be the point in her life where those happy, if unhealthy, meals are meaningful to nourishing her spirit when the diet isn't as important to her body.
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I read your previous posts. I'm so glad that you hired an overnight caregiver -- I hope that YOU are not paying for this?

Back on 04/02/22, you wrote this: "It’s time for me to empower myself and be done. I have spent years in counseling. My counselor told me not to have my mother come live with me because of the sick family dynamics and how emotionally sick it had made me. I have to realize I will never get any support from my siblings, and I have to take care of myself. Giving up my life to care for my mother who doesn’t listen just isn’t an option for me. Why should I when she lies, disrespects me and does what she wants anyway… done."

What's changed since 04/02? Is hiring an overnight caregiver (possibly with YOUR funds?) all that you are going to do?

You are in your mid-50's with MS. You have 2 siblings who don't contribute in any way. You were annoyed because your mother wouldn't even ask them to help out.

Now of course no one can make your sibling help out. They have chosen to remain uninvolved. The real question is why don't you do the same? Did your mother groom you to be her caregiving slave someday?

If you don't stand up for yourself, no one else will.
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Uunfortunately you have no control over what your mother eats unless you are with her 24/7.

But what you do have control over is what you do when she begins to suffer the consequences of her poor choices.

Disimpacting my mother would be a strong nope from me. As for her cholesterol. She's old time to let it go. As people get old their cholesterol increases and it is actually is protective not bad.
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Other than food that has an immediate negative impact, like giving sugary foods to a diabetic, I would let it go. My wife is overjoyed that she can drop the cholesterol medicine after age 75 because Canadian medical guidelines say it is of little use at that age. Our mother was a handful for home caregivers when it came to following our orders like staying until she finished dinner - she would always try to kick them out because "she did not like someone watching her eat" or "she did not need the help".. If you have a good caregiver and this is the only problem, I would let it go, but I am sure there is more to this situation than we know.
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Have a VERY frank discussion with the caregiver.
Tell her that you are providing meals for mom and that is what she should be feeding her.
Explain that due to mom's medical condition she does have problems with constipation.
If she continues to give m om foods that upset her digestive system you will have to find another caregiver.
Now for reality....
constipation does happen even with a great diet.
diarrhea happens even with a great diet.

You do not mention mom's diagnosis or why she has a caregiver in your profile so it might be that what I say not does not apply but...
Unless there is a medical reason to eliminate certain foods I would cut them both some slack.
If mom is doing well. I would not stress much about a lot of things.
If you know that the caregiver is giving her foods that might cause constipation add some Senna or a stool softener to her daily routine. Senna is a plant based laxative/stool softener can be taken as a pill or as a tea. Increasing other things like prunes, prune juice, higher fiber in other meals just might help the constipation that she might experience if she has something that might "bind her up".
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Hi again! It's Brad from Goldstar! (I'm the good-looking guy who manages a boutique home healthcare agency in Boca Raton, FL).

There is lots of good advice, but when I read the question, I saw, "What do I do about a caregiver who is feeding my mother crap?"

If your mom was on a low-sodium diet and your Caregiver was feeding her Ramen Cup of Noodles that have 300% of the US RDA of sodium, you would go berzerk! Why aren't going berserk now???

This problem can be solved in three easy steps:
1) Fire the caregiver and hire a new one.
2) Remove all the crappy food from the house.
3) Make sure the new Caregiver understands your mom's dietary restrictions and the guidelines you have set up for mom's nutrition and/or snack time/crap time.

We live in a society where FOOD = LOVE. Seems to me that your caregiver is buying off your mom (and you also) with food she should not be eating. You've been duped!!!

In reality, in our society FOOD = SICKNESS. Our high calorie, high carb, high sugar, high salt, high fat, highly processed food is killing us! I acknowledge you for the love, compassion, and TIME you devote to your mom's health. Quit paying someone to sabotage your hard work!

That's the end of that answer, but I'm guessing there is an underlying issue that needs to be addressed in order to end the vicious circle and provide peace of mind going forward...

What is it that has you reaching out for advice rather than telling the caregiver to stop it? Obviously, you are a smart woman with good communication skills, so I doubt that's it...

I deal with this a lot... "don't rock the boat", don't stir the pot", and "it's not that bad", we can put up with X because she does Y", are things I hear from clients and their children from time to time. A good caregiver will take coaching and correction for what it is - part of the job.

When you tell the Caregiver you love her and are so pleased she's there, but you don't say you love her and you are so pleased she's there BUT stop the chocolate chip cookies, you are doing your mom a huge disservice, you are reinforcing the negative behavior in the caregiver, and leaving yourself powerless and frustrated. Knock it off!!!

In reality, you don't need to fire your Caregiver, you just need to give her new directions and followup to make sure she's in compliance.

It's an easy conversation - go have it with her!

~BRAD
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I rue the day my daughter decides I cannot eat what I want. Constipation happens in the elderly. If they have a lot of fiber and stool softeners as needed they should be fine. I think that managing the dietary intake of an elder when there is no special reason (diabetes, dysphagia) is cruel.
I as a nurse was forced to see poor 90 year olds on a cholesterol free diet, many of them in dying stages, prevented from having the one things they wanted (say a milkshake) by dietary restrictions. At some point these are cruel actions when you consider what is taken from us one things at a time. Our balance, our mobility, our independent, our continence, eventually our choices, our memories and all we are and ever were.
Please try to lighten up where you can. A bit of cholesterol in diet is not going to be what kills. It will be age and disease.
I wish you the best, and your Mom a good taco bell meal with a side of Burger King. Pizza for dessert.
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CatyRay Jun 2022
Agree. See my post.
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Mom had caregivers in her home 24/7 for the last 2 years of her life (she died at 97 in Jan 2018). I, too, prepared food and put in the freezer during my monthly visits. One time, when she was having daytime care 9-9, one of the aides fed Mom a rice dish she had brought from home, and Mom was found on the floor the next day in a pool of her own vomit. After that, I instructed the agency and senior caregiver that she was ABSOLUTELY not to be given anything brought from outside. It was hard to get Mom to eat, period, so I made entrees (meatloaf, meatballs, casserole, chicken, etc.) that could be frozen in two-serving portions for thawing and heating in toaster oven. She loved sweets, so I also made batches of her favorite cookies and other baked goods and put in plastic containers in the freezer. The doctor took her off Lipitor at 92 because there was no benefit anymore. Mom loved ice cream, and she enjoyed having ice cream and cookies for dessert, even if she couldn't finish the small portions of meat and vegetables I prepared. I made fresh salads during every visit, and by the 3rd day, she was tired of them. I bought her boxes of her favorite See's candies for every occasion. I figured if that was the way to get calories into her, why not? She took a daily vitamin pill and stool softener. What older people fear is not death but losing control and independence. One of the reasons she wanted to stay in her home was that she hated the food at the nursing homes and the meal schedule during her brief visits. Let Mom eat what she wants (within reason). I should add that Mom had no chronic conditions (heart or lung disease, diabetes, Parkinson's, etc.). She had fallen and broken bones during her last 30 years of her life but managed without home care until about 4 years before her death. She had increasing problems with dysphasia, so we always had someone watch her eat to make sure she didn't choke. We also had watch her when she swallowed pills, because she would try to hide them in a napkin and put it in the trash. I don't understand why doctors prescribe HUGE pills for seniors, period. Mom had them occasionally for UTIs.
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JoAnn29 Jun 2022
She was on Lipitor for too long. I refuse to take it and Statins have been proven to cause cognitive decline. Mine is high. Yes, I could have a stroke but I also do no not want to suffer from Dementia like my Mom did for 6 years. So its a catch 22.
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I looked at your first post. You mention ur 55 so Mom is over 75?

I would just have a nice talk to the caregiver. Explain that Moms sugar and cholesterol numbers are high. She needs to eat what you cook to keep her numbers within normal range. If your Mom is a diabetic, its important that the CG watches ur Moms sugar intake. Tell the CG that not controlling diabetes can cause further health problems. The Heart and kidneys could give out, she could lose a leg. Cholesterol too needs to be watched to prevent strokes and heart attacks. If the CG says but she is cooking what Mom wants and she won't eat what u send, then u need to have a talk with Mom. Telling her that if she wants to eat the way she wants, thats OK. But, if she has a stroke, heart attack, loses a leg, kidneys start to fail, etc...you will not be caring for her. She will go to a LTC facility to be cared for. If that is what she wants, then eat the way she wants. Its her life. She deals with the consequences.
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Make a list of what foods your mother cannot have, and give it to the caregiver AND the agency.
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Here is the thing. You can provide all of the good foods in the world. And you can tell the caregiver to feed her those foods. But your mother still has freewill. Believe me...I would love for my diabetic FIL to get a clue and eat healthy foods. But he's 89 with a sweet tooth. And as he says "it's my life, I get to make the decisions". (Although after a few times of trying to tell him what he was going to eat....he wasn't quite as nice about it). Yes, you can leave the foods. But you can't force-feed her and neither can the caregiver. We have to pick our battles and we can't make them do the right thing for themselves no matter how ridiculous we think their decisions may be.
If you can get the caregiver on board that is the direction you want to go. But you can only really win that one if YOU are paying the caregiver. We have a bath aide for FIL that comes 3 times a week courtesy of the VA. HE isn't even paying for them but they are being paid via his services so he calls the shots. So no matter what we want the bath aide to do, no matter how logical, unless he agrees, they can't do it without his permission. (We had to fight him to get him to allow them in the bathroom for example, and then to allow them to actually bathe him. Even though he agreed to have them, when we ask them to do something he has to agree period) So hopefully you can work with the caregiver to make some headway.
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I do agree there comes a time when our LOs should be allowed to eat what they want but...in moderation. I watched a friend of mine die from being a juvenile diabetic at a time when diabetes was where you peed on a strip to see what ur sugar was. In her 50s she survived a massive heart attack. Her 60s brought an amputation of a leg. Then her kidneys went. Dialysis did not work for her even the last ditch effort. She became wheekchair bound. She passed at the age of 63. I am not saying she did not cheat occasionally but she ate right as far as I know. If a person has this desease and does not take care of it, too many other health problems arise.
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That would be an easy one for me. I would tell mom if she continues to eat the things that cause her to become impacted, I would not deal with it again. Add that job to the caregiver's duties and watch how fast it changes.
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boehmec Jun 2022
I’d also tell the caregiver she has to deal with it…
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Next time, decline to disimpact her. If she has to pay a nurse to do it perhaps the repercussions will come home to her.

As to what the caregiver is feeding her: who decides what your mother eats? If it's your mother, don't blame the caregiver.
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What's your retirement package look like? Where would you like to go? Did you volunteer to be a "Disimpacter?"

Have you had her evaluated mentally and physically? How many people would go through that process and not swear off all the sin-filled foods?

P.S., this is why I don't eat while reading this forum.
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I feel this question is difficult to answer without more information. How old is your mother? Does she have health issues that are expected to end her life soon? If so, I agree with the several posters saying let her eat whatever she wants. In the last days there is little point in being strict about diet. If she could have some years yet of quality of life, it would be worth a conversation with her about choices, given that you’ve already found that what she eats is affecting her health. In the end it’s her life, her choice, but choices have consequences. I do NOT think you (OP) should have the consequences, though. I would not be willing to perform the procedure you referenced, particularly if I know it can be avoided. I might try laxatives/stool softeners, if that has negative effects it would be time for professional care. Mom’s rights don’t override yours.
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I prepare my mom’s meals and leave them labeled in the refrigerator. That way, caregivers don’t have to cook or prepare dishes for her. But I also allow some forbidden food items every once in a while. When done in moderation, it’s ok. Her caregivers are aware of her diabetes. If her blood sugar gets extremely high, her behavior gets awful. And that scares the caregivers, so they are very careful about her meals.
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Exhausted55: Make sure that the caregiver KNOWS that your mother is to eat the healthy meals that you've provided.
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Give her new caregiver a diet to follow with strict instructions about what foods are not allowed.
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