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I am a live in friend and caregiver. She took a bad fall in February. Went through home health and healed and got strength back. Since then she quit exercises and refuses to use walker. She is back to being weak in legs and standing and is lazy. She hasn’t fallen since February. I am here in the morning and her friend is here in the afternoon. She says she can be by herself. Both her friend and I want to be with each of our own families. Last time I had someone come and be with her she yelled and screamed at me not to do that again. Home health said she is at a risk of 27% falling. Not sure if I should let her be by herself for 8 hours or get some one in. (More yelling or give her space?) She can’t drive and I know she won’t shower. Need wisdom.

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Hi, have you looked into a motion monitoring system for the hours during which your friend is alone? This type of system detects any unusual motion or behavior by using discrete motion sensors, which you just stick to the wall in the different rooms your friend uses regularly. Super easy to install, no cameras, no buttons to push, battery runs forever, very affordable. You would be notified of any issues your friend might have while she is on her own through an app on your phone. If the system doesn’t detect any movement for too long, it would send you a notification that something is wrong.
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How safe do you really feel she is? What cognitive as well as physical needs are present? Is she at risk not only of falling but say setting the house on fire because she forgets to turn off the stove? Can you have a friendly visitor to check in as opposed to someone staying? Have you asked her physician for an opinion? If you don't get someone and something happens, then what? Have you spoken with her directly about this?
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Stick with the existing plan. It sounds like you and the other care giver are not only doing a good job but you like her and you both enjoy being there.
When she hollered...the substitute did not do "like" you do. It is good she is not at a point where she "hollers" at you.
When you want to be with "your own" families it is time to get Karen the care advisor to get the family together and come up with a plan. When a caregiver has the priority you mentioned...the stress that comes from not doing what you want will affect your caregiving relationship.
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I am approaching the same scenario, I have posted before about my friend Richard, for the past 2 years we have managed with him living alone in a tiny studio apartment, I go over mornings to help him get up, collect his meal on wheels, make sure he eats, takes meds, checks diabetes meter, clean, etc. I leave mid afternoon for a couple of hours, come back and make dinner, help him to bed, go home. That was working ok. Now his status is declining, he sometimes has some confusion, and earlier this week fell twice in the same day trying to get to the bathroom when I was not there. Second time I made him go to the ER, they did not find a reason, said he was a little dehydrated. Kaiser wants us to "make do" with a home health nurse coming once a week, and a physical therapist to try and get his strength back. They will not authorize either a full time in home caregiver nor a SNF until he is completely non ambulatory/bedbound. So tonight I got him into bed, and made him promise that no matter what, he is wearing Depends and DOES NOT need to get out of bed for any reason,and he has his phone at hand and I told him I would rather he wake me up in the middle of the night than come in and find him on the floor in the morning...
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LS2234 Jun 2020
The thing with him is, he gets just a tad too much $$ to qualify for Medicaid, which would either allow him to be in the IHSS program, or in a nursing home, but at the same time what he does get just barely covers his expenses. So he is in that gray area of not really able to afford better care, but not qualifying for any programs either.
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Imho, you'll have to ignore her yelling and screaming. SHE does not get to make the decisions for her care. However, unless you have some type of formal arrangement other than being a "live in friend and caregiver," the deciding factor for the woman's care is not your own.
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Here is my take....when people start refusing to do normal things, like taking showers, that is a warning of what is to come. Do NOT let things get out of hand. I don't think she should be left alone - I would not trust her. However, let's assume you did leave her alone and she fell. She would be hospitalized and at that time arrangements could be made to put her into a facility as opposed to doing it now. And remember too, you don't want someone coming at you because you left her alone. Either get a caretaker and think about placement.
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What are the terms of your living there? Are you a caregiver because that is the terms of your housing arrangement? Does she have next of kin? Does she have a designated POA? Seems like you need to get those people involved.
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For me, pmmallory, caretaking initially was demanding yet rewarding, up until the point where the logistics, became numerous and overwhelming. I finally (and this took quite a while) admitted and accepted that my mom was in fact choosing to put herself considerably more at risk due to her irresponsibility or laziness (harsh but TRUE) and not keeping up with the balance and strength exercises as soon as the in-home occupational therapist finished her time with mom. I came to terms with the reality that at some point, she will most likely fall again. I had to accept how truly angry I was with mom, as I interpret her choosing to not do all she could to avoid future falls, was just expecting that I (or one of my 2 sisters) would stop their lives to take care of her after yet ANOTHER ortho surgery following a fall. My profound and chronic stress and anger was causing me serious damage physically, mentally, and emotionally. The only thing left was acceptance. Needless to say, I do not/cannot do the acceptance thing 7/24, but I'm getting better at it with practice! Good luck to you, and thank you for all you've done and continue to do.
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For over a year I had 24/7 for my mother
with caregivers as well as myself. My mother passed away on March 29 so now my dad is alone at 96 years old. About a week after she passed away I ordered cameras and have them set up because he is basically alone. We had more caregivers when my mother was alive and they cooked for both of them of course and made sure he took his medications. Someone needs to be there for him at breakfast lunch and supper and to make sure he gets to bed and takes his medications. We’re down to only two caregivers that come sporadically for an hour or two each day and I am there also when they are not. The cameras have been a godsend. Of course I’m still a nervous wreck because they go off by motion and he doesn’t sit still so God only knows what he did before the cameras were there. Please at least consider cameras not to take away their privacy but for your peace of mind. The camera system I ordered was Blink. We got a five camera system and it ran about $379 and with tax was $402. Well worth it.
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Momsonlychild Jun 2020
I also put cameras up for my Mom. They are great when you are not there. The alerts will bug you but again give you a sense of relief. Like you, I think they’re well worth it.
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Do you have any authority to invite anyone into your friend's house without her permission?

By "live in friend and caregiver" - do you mean you hold a paid position whereby you have accepted any sort of formal or professional responsibility for this lady's welfare?

Without one of both of the above, you simply don't have the right to make this decision on your friend's behalf, and "let her be by herself" doesn't come into it. It's just not up to you.
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If she is able, physically and mentally, to get to the bathroom by herself and to get out of the house in case of emergency or fire she can probably be left alone for awhile. It would be too bad if she fell, but it sounds like someone is coming in at some point every day, so she would be discovered in reasonable time.
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No, I would not leave her alone for 2 hours, get another person to support those time. I have 3 caregivers for my mom at 94 years old with dementia.
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CBD Oil under tongue 30 min. Before care giver arrives. That person is your cousin and just helping out or to clean the house
Worked very well for my friend
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Davenport Jun 2020
I like your ideas, beej : ) Except for the fact that my mom wouldn't buy the 'she's my cousin' piece : )
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I see that several responses mentioned dementia, but I don't see that in your post? I suggest a life alert for her. I also believe that medicare will pay for help to shower twice a week.
Does she have family?
Best wishes.
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Wow! You are a good friend! She sounds a bit unstable neurologically. Can she be convinced to see a doctor to check out her mental health? I’m not ill, but I’d love to have a caregiver to help me during the day when I am too lazy to do anything.
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The fact that you are questioning this means that you really do not think she she should be alone.
This is called " Listening to your gut"
Listen to it because gut instincts are usually right.
She has dementia, she can not make rational or safe decisions.
She accepts you and another person to help her. I am thinking that she gets upset with someone else because she does not know them and if a person is in early or moderate stage of dementia she may still be trying to hide that fact and it can be exhausting to do so. The person that takes over for you and her other friend should have another caregiver come in while you are there so she gets used to this new person. Once she is comfortable with her "new friend" she might be less resistant to allowing this "new friend" provide care. In order for her to get comfortable you should run an errand leaving the other to take over for a bit until you get back. Do that increasing the length of time you are gone.
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MumsHelper Jun 2020
I agree. Eventually she will adapt. I had started this with Mother a couple months ago, and although she didn't go toddler on me, she gave me the silent treatment for a couple days. LOL. After a few times, she just accepted it. Sometimes I bring her a treat like ice cream as a peace offering.
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Agreed, if sit in chair, food and drink so she can reach it, a bathroom appliance made for women, and a garbage bag, tv, remote and pillow (if she tires of tv and wants to nap) all set.
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As a live in do you mean you spend the night getting her ready in the morning and then someone comes in the afternoon. When do you return? When is she alone 8 hours?

You could try an Alert pendant. If she falls the motion of the pendent hitting the floor will alert the operator connected to the device.

But I think that is the least of your problems. Your friend suffers from a Dementia. I bet you are finding you can't reason with her. Short-term is being effected plus being able to process what is being said. Her fall may have escalated her Dementia. So what I see is her Dementia being why she should not be alone. Does she have family? A POA assigned?

Since she hasn't had therapy in a while, you or a family member could call her doctor and request therapy again. Just be aware, that your friend will get worse because of the Dementia and that 24/7 care will be needed eventually. If you and other friend don't feel that you can provide that care, decisions for placing her will need to be made.

So should she be left alone...only you and other friend can determine that. Maybe set up a camera when ur away so you can see what she is doing. Does she pretty much just sit in a chair and watch TV? Can you leave snacks and something to drink near her?
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Your profile says that your friend has dementia. Her having dementia means that she can't think things through logically. She may not realize her condition. People with dementia have cognitive and physical symptoms. I'd read a lot about what they encounter. Often, it's confusion, loss of initiative, poor balance, weak limbs, lack of coordination, depression, agitation, etc. People who have dementia have brain damage. They often are afraid and confused. My LO would ask me what was real and not real. She needed a lot of assurance that she was okay. People who have dementia are not necessarily lazy. Their brain is not working properly and they may not be able to stay mobile for a lots of reasons, including the brain damage.

Are you the Healthcare POA and Durable POA? If so, I'd request a full assessment to determine the level of care she needs for her mental and physical safety. They need to know the kinds of things she is not doing for herself.

FIRST, as a caregiver for a person in her situation, I'd also get a consult with an attorney to find out what your legal duties and responsibilities are.
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What exactly does "I am a live in friend and care giver mean"? Are you paid? Are you a roommate? Is there a lease or contract in place?

If she's yelling at you, you shouldn't tolerate that ever, even if you have a lease or contract. Yelling is not acceptable. You have a life, and you are entitled to live it.

She says she can be by herself and so I don't understand why you shouldn't take her at her word. You are not responsible for 24/7 care, which is impossible.

Your friend sounds unstable and your living situation sounds precarious, and could turn bad at any moment. I would start looking to move out and find your own space. Rent a room with a bathroom. Since the pandemic started, people who used to make money renting out rooms are desperate.

I think you should start planning for your own future. If she were to fall, and could not return home, what's going to happen to you?
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Your friend can fall at any time, even with you or other help there. In fact, it’s likely and more likely as time goes on. Being with her all the time is giving her the illusion that she’s living independently when that’s not true at all. You can’t plan for every possibility and you can’t help someone who doesn’t want help. Back off your time with her. It’s the only way she’ll see her need to make changes and get further help
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Daughterof1930 Jun 2020
I’m amending my response as I didn’t see the dementia part of the equation. She can and likely still will fall, but she can’t be responsible for her own safety or decision making abilities with dementia in the picture. Still, your friend will need more help than you have to give. I hope you can be a help in putting that plan together
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