Darker side of dementia

For issues specific to caring for someone with dementia.
May I start with a quote from Jenny
But with a non-family professional-basis caree 'throwing in the towel' IS an option, and please do grab it without the slightest hesitation or compunction! Just because you are extra good at coping with 'difficult clients' (!) doesn't mean you SHOULD have to do such coping!
Thank you Jenny-I will see how things progress and hang on to your words. Funny how being thrown in at the deep end changes you. I would never have seen myself as anyone involved with Dementia Care just 18 months ago but life takes unexpected twists and turns. I guess it comes back to managing your own destiny . What you actualy want for yourself has a tendancy of getting lost in the day to day coping or you just don't have time to work out what it is .
Maybe carers should adopt/adapt that saying one sees on posters sometimes, to:

"Life is what passes you by when you are busy looking after someone else"........

With your difficult client, do you see any 'redeeming' features about her, and is she ever nice/pleasant to you about anything at all? Does she say 'please' and 'thank you' to you at any time? What are her family like towards you? Polite, courteous and appreciative, or are you just some 'female' who does 'menial labour' for their relative?!!!

I wonder what she was like previously - as in, there are folk in this world who treat any kind of 'hired help' with shameful contempt. This may be especially true in very old people who were raised in a far more class-obsessed society. 'Being rude to the lower orders' (!!!!) was perfectly acceptable......
Hi Jenny to answer your questions
From client- no signs of politeness or appreciation 90% of the time although there are ups and downs on the rudeness scale.

Family so far highly appreciative and supportive and pleasant

Client history- formerly a caring role so it would seem current demena is purely down to Dementia
very glad to hear that the family is polite and supportive of you!

How 'near the edge of your tolerance' are you to this 'cantankerous' client? Given your responsibilities in your private life with your dad, I don't see why you should put up with any more hassle from a client in your professional life!

if she's causing you aggravation and stress, I'd just walk. Keep your energy for your private life!!! Because everything you've posted in the past about the stresses there are quite enough!!!

The whole dementia thing is so tricky from a moral point of view (just as all MH conditions are), but given your personal circumstances with your father I'd say you've got quite enough on your plate!!

All best, Jenny
Henrietta, dealing with dementia is not easy and if you are going in as a professional care worker then you will be getting her at her worst - she will resent you (a stranger - even if shes met you before) going into her home, she has probably forgotten that you are going to come, she doesnt understand why you are there, you are expecting her to submit willingly to personal things that no normal person would entertain and she probably cannot remember or understand that she has dementia and needs you there. No wonder she is rude to you - she doesnt want you there, because in her eyes she can cope perfectly well by herself! :o

BTW, her previous experience of being a care worker herself is probably making it worse, because inside she is probably thinking - "are you making out that I am one of those poor old souls like I used to attend to who cant do anything for themselves and have to have people in to do it for them? I am not like that, there is nothing wrong with me and I just wish you would leave me alone"

Yes, you can certainly say that you do not wish to go to her, but the majority of people who need care workers in are people with dementia and the numbers of them are likely to increase dramatically over next decade or so, so you are likely to have many more similar people on your books. Rather than refusing them, would it be a better solution to have dementia training? A good Care Agency should be willing to send you on courses.
Hi

Yes I've had Dementia training and a further course is planned for me. I am open minded right now as to where this is going-one thing I have learnt is that I shall know when enough is enough and in trhe meanwhile I shall report every tiny detail!
Henrietta, what do her family say she was like before she developed dementia? Maybe she was always rude to the 'hired help'.......

Have you ever tried saying to her 'Please don't be rude to me, I am not rude to you, am I?'. She might still have a shred of 'moral awareness' left beneath the dementia (assuming she didn't always treat the 'hired help' like dirt that is!!!)(if she did, then there is no hope for the situation and if I were in your situation I'd walk out and leave her to it!)

After all, not all people with dementia are rude and cantankerous, so it doesn't necessarily go with the disease automatically.
Hi Jenny

Yes I've asked her politely not to take out her frustrations on me as I am here to help, and I've said -"Please don't shoot the messenger, I'm just doing my job. "
When I was told off for being quiet and also for coming up with boring conversation, I said- "Please give me a break here , I've tried being quiet and I've tried chatting and nothing I do is right is it? " Mostly all met with grunts , sighs, and slamming things down,
Going back to the original thread that started this conversation, I think when more of the person is s till there in the early stages as in this lady , we tend to see the person more than the disease which makes it all together harder to cope with . I have a few days off now so we will see how things go when I return to work .
Rudeness and nastiness is a feature of early/mid-stage dementia. Before I realised that Mum had dementia she started being really nasty to a longstanding and very good friend of hers. I talked to her friend and she was very upset and showed me a letter that mum had written to her - it was horrible and I was appalled. When talking to Mum she said "M(her friend) and I dont seem to be able to get along now, we are constantly falling out - I dont know why. I hope we can still be friends." When I reminded her about some things she had said she became angry and maintained "I would never say something like that to her". But she had.

She had forgotten that she had said these things and once we knew that she had Alzheimers everything made sense. She also has never understood that she has dementia and while she was at home was always convinced that she did all of her own shopping, gardening and housework; that she ate and drank, took regular showers and changed her clothes. In reality she was doing none of these and could not understand why she needed help. Ive tried explaining things to her and come up against the same grunts, sighs and shrugs.

Trying to reason with her or use logic will, as you and I have discovered, never work. They have lost the ability to reason and it tends to make everything worse. They cant remember the details of previous meetings and conversations, so when you say "I have done this" and "Ive tried that before" all you are doing is reminding her that she cant remember things. M is still her friend and if Mum is grumpy and rude when she arrives M says something to make her laugh like "Ooh, grumpyboots today - and I was going to get you a cup of tea too!" Dont be upset when she doesnt say please or thank you or show any gratitude - she doesnt understand why she needs you. Distraction can work wonders when she starts to become rude. Dont ask her questions - she will have trouble knowing the answers, which is frustrating for her (and us). Chat about things you have seen and done and try and involve her in the conversation. If it doesnt work or upsets her - change the subject. Pay her little compliments (oh, your hair is so lovely and soft. Shall I brush it for you?).

Hope you have some nice days off :)
Crocus - I completely agree about the not being able to reason, let alone remember!

That's why I think that, in a grim way, dementia is the ultimate 'Get out of jail - ie, moral responsibility - free' card.' They can behave how they like because 'they' are not there any more. (ie, there is only the illness, not the person)

Whilst your advocacy of patience and forebearance is admirable and "ideal", I personally would say that unless you love the person with dementia, it's not going to be possible (without emotional conflict) to be so. And yes, a professional care-worker could cope probably, simply because they don't actually 'care' what behaviour their caree presents with because they can distance themselves from it all. (I'm a sort of halfway house with my MIL - I put up with some of her behaviour and 'cosset and coax' her, but can be pretty callous about it as well and simply 'not care' that she is unhappy and frustrated)

But I would say with Henrietta, because she has her own personal care responsibilities for her father, although yes, she is a professional care-worker for this lady, the combination of her already stressed personal life with a stressful client, would perfectly justify her 'throwing in the towel' when it comes to this lady.

Henrietta - hope you have good time off, and maybe it will help you assess whether you do or do not want to go on with this difficult and stressful client. Do NOT feel 'obligated' by her family or your employers to keep looking after her if you'd rather not! You've got quite enough on your plate as it is!!