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We need to hire help to give my Dad relief but my mom is very attached to my Dad, shadowing him constantly. Has anyone had success with hiring help or does the loved one refuse to work with them? I'm afraid the worker will be twiddling their thumbs while my Dad continues to take my Mom walking and riding all day. Any suggestions on how to make it work?

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It will be gradual, and it will depend on building trust and rapport.

If my client's husband wanted to take her walking and riding, I certainly wouldn't prevent that! What other routines make up your parents' day?

My suggestion: sketch out a rough timetable for the typical (if there is one!) day. Identify which tasks, e.g. showering, dressing, preparing meals, the caregiver could support. Encourage your father to step back during these and to allow the caregiver to interact with your mother.

These are the starting point, then the daily schedule could develop to include other enrichment activities so that sometimes your mother will prefer to stay at home while your father is free to go out.

Don't expect it to happen all at once. If your mother calls for your father when she needs help with personal care, for example, the caregiver should first of all offer to help and encourage her to allow that instead, but not to the point where either your mother or your father becomes distressed or anxious.

The worker won't want to be thumb-twiddling any more than you want to be paying people to do nothing while your father continues to be on duty 24/7 - it's boring and embarrassing :) Any other relevant tasks that s/he could usefully be getting on with?
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Dear "HJQuinn,"

My MIL (who is now deceased) was legally blind so my FIL (also deceased) had to do everything. When he had hip surgery, they both needed help and they hired someone from "Home Instead Senior Care." It worked in their situation because my MIL loved getting attention and doted over and of course my FIL liked it because he couldn't do the cooking, cleaning and laundry.

Now in my own mother's case, she lived by herself in her home since my dad died in 2004. It did not work for her at all. She didn't like having strangers in her home as she liked her privacy. She didn't like them being around her stuff and she didn't feel like she got her moneys worth.

So with your mom being very attached to your dad, I'm wondering if she would feel threatened by having someone else in the home who would be interacting with your dad. If you think that would be the case, it probably wouldn't work and she would be "twiddling her thumbs" while getting paid and your dad would still be doing what he's already doing. So if you think your mom would fall in this camp - I don't think you can "make" it work. If your mom were to think of it as having some company around the house then it could work. It really depends on your mom at this point. She'd have to be willing to adapt and only you'd know if she would or could.
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Start out with the caregiver doing some chores around the house that will help Dad. Laundry, light cleaning and maybe doing a few meals. During this time Mom will get used to having someone else around. She may not like it but she will get familiar with this new person.
"Shadowing" is very common. Your Dad has been there for her for years and she knows she can trust him, he is a constant for her and it might take a while for her to get comfortable with a "new face".
After a week or two Dad can make some excuse to run to the store for milk, paper towels or some other items that are "urgently" needed. Have him go out for no more than 1 hour. The next time the caregiver comes he can go out a little longer. Mom will get used to being with her new friend.
Professional caregivers are attuned to the fears, needs and "idiosyncrasies" of dementia and can somehow manage to get some people to do things that others have difficulty getting them to do.
When you hire, I am assuming you are going through an agency (may be bad assumption on my part though) ask for someone that has worked with people with dementia. And if in the first week or so there does not seem to be a rapport ask for another caregiver. There can be personality clashes as with any arrangement and the agency should not have a problem with the request. (there might be a problem if there is a request to change every week though, Dad and Mom have to give them a chance to work through minor issues) Again a professional should be able to work things out.
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I've had a lot of cases as an in-home caregiver when the client was very uncooperative because they were so dependent on a spouse. My advice was always that for a while the spouse should leave the house for the designated time that I'm there. Sometimes this has to be for up to a couple of weeks. That works. Another approach that also works would be for your dad to refuse to do anything for her while the caregiver is there. She will become cooperative if the caregiver is nice and is patient.
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it sounds like you may need more "companionship" help than nursing care. This opens the door for you. It could be college kids, retired people.
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BurntCaregiver and Grandma1954 have the answer. Going slow to let your mom get used to the new person is ideal.
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Get dad out of the house when caregiver is there. Time for dad, mom may or may not be cooperative. Caregivers are used to handling similar situations and some can figure it out. It is hard but dad has to learn to let go a bit and understand nobody will be able to care for her as well or the same way he does.
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My cousin has slowly gotten accustomed to her 2 home health care workers but it takes time. I would suggest having them come when your dad needs to go to a doctors appointment.
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Today is my first day for a caregiver for my husband and I am really nervous. I plan on leaving for a few hours and he thinks she is here to clean. He gets around really good and does not need help yet but his cognitive, language and memory is really bad after 8 yrs. I have not had a break from him in over 6 yrs and I am starting to feel it. I just pray this will work for the both of us.
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gdaughter Aug 2020
Praying with you...now go enjoy your time off and remember: Life is uncertain eat dessert first!
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L have a home care person who is wonderful. She helps me and my husband. He likes her better than me and always thanks her. When she is not here, he constantly curses and swears and calls me names. I get so upset that I want to cry. When she leaves he is hostile and angry at me and very uncooperative
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My parents and aunt at first were opposed to outside help but eventually came to love their sitters. Its takes a while and a good fit to adjust. I was able to do drop ins and check on the care. Trained sitters know how to interact with a family without being controlling.
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My mother is 84 and she has dementia.  We hired a nurse assistant and she did well.  My mother depends on my stepfather and she know her dog.  So yes it will be hard at first for your mother to warm up to a nurse but she'll get use to her.  After all she's use to her surrounding and just like with our children we are not comfortable with leaving our children with a new sitter or a daycare provider, when we have to work.  Make sure that you interview the person/persons first and that you are comfortable.  If you have siblings make sure they meet the nurse first and most importantly your father has to be comfortable.  It take a very special person to come in and care for our parents we can not be careless as to who comes in our parents home.
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Much will depend on your dad's willingness to cooperate and establish boundaries with mom even temporarily. My dad is sort of like my mom's security blanket. Her sundowning revolves around her pestering the hell out of him around 5:30 to come upstairs (and go to bed). He will actually tell her to stop bothering him, go to bed...and she will say (about bothering him) "I'm going to bother you." or similar. We have taken to locking the doors going outside in front because she would go out and refuse to come back in. So now he can go out and mow the lawn or garden without her at his elbow. She would do other things like move/hide his things, or empty the birdbath...BUT she will still try the doorknobs, and although not obviously frustrated (she just tries again between the two doors), she will peer out to see what he's doing.
We hired help through a respite program and it was useless. Mom was totally uncooperative; the help showed little initiative and was often inept (including an alleged retired nurse). In the end it was relief to stop it as it was generating more stress for me rather than relieving it. My favorite example is how I was using "my" time. Mom, in an effort to escape the aide, decided she wanted to go for a walk (which she typically does NOT want to do). Aide says great, get your shoes, I'll go with you. Mom says NO. I'm going with MY HUSBAND. And what does obedient, pleasing dad do? He take her out of the house, into the car and they drive to the mall to go walking (on a beautiful day). So we have an aide being paid $$ to do the crossword puzzle aside from when she stood outside my door to tell me what had happened making my pup bark so I could not hear a word of my important phone call. And then she went into the kitchen and her "cleaning" efforts resulted in creating such a mess I thought it was a deliberate attempt to get herself kicked off this assignment. That and some damages, all in a room that was NOT to be done per the care plan.
But all that said, the key here is your dad. He needs to physically leave. Will he? What do you really need to have done in the home? My "experiment" revealed with feedback from others here that perhaps what I really needed was a cleaning person. When I asked the aide to do those light housekeeping tasks (which was part of the care plan) she clearly was not happy. Even now, I have suggested to dad we get a TV hooked up in the extra bedroom with a comfortable chair so he could have a "retreat"...but HE insists he can handle mom and her issues. So every night I am subjected to the same BS. Her whining, his yelling/complaining (he's loud being deaf)...
All you can do is try it. I still have some faith that it just takes the right combination/connection of aide...but it will depend on your willingness to keep trying and your dad's cooperation with the plan..hope for the best, plan for the worst and don't forget to take the precaution of locking up the valuables for safekeeping.
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As a caregiver, I've been in this situation a few times. Although the patient may not remember, I'm introduced as a friend of one of the children who is just there to hang out or as the housekeeper.

I come armed with activities to distract: magazines, games, pictures/picture books, puzzles, even emptying a couple of shelves in the linen closet of towels and washcloths and having the patient help me fold them. This is all while the spouse is out "running errands", getting a much needed respite.
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Spouse has had aides since June 1st, 2020, so this is a limited reply from 2.5 months:

1. 3 aides have come and gone in that time. Each change, it took Spouse about 3 visits (3 hours each) to become used to the new one, especially regarding helping to bathe. Socializing went okay, as did the trips to the park, Spouse on scooter, aide walking.

2. Spouse now and then balked at exercising or cooperating with aide's suggestions, although not as much as I feared.

3. I need to physically leave to guarantee respite, resulting in an exile from my home for 3 hrs. each time. I've learned to sneak outdoors to use the backyard shed for privacy and it's well worth it.

4. Once, Spouse asked aide to drive him to a store and the aide did despite this not being on their plan of care. All turned out okay.

I hope this helps and good luck to you. The little breaks are invaluable. Spouse didn't quite understand what the aide was there for and I'm unsure if he does now or thinks little about it other than "oh this is the new normal."
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Llamalover47 Aug 2020
pronker: Thank you for that update, To the OP - It is IMPERATIVE that the caregiver seeks AND gets respite.
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My mom did the same thing with my dad. We never got past "we have hired someone to come in and XXXXX" Mom didn't want any and Dad didn't want to rock her boat. They eventually had to move to AL with hospice overlay for Dad and he passed away. Mom is now in memory care. You can try but don't be surprised if they somehow deep six your efforts. Good luck!
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