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Looking for advice. My mom is a PACE participant and home health comes 3 days a week to get her ready for the PACE shuttle.
The home health MA had been asking my mom to stand in the shower. My mom has hemiplegia and cannot stand, plus there is no room to do it even for me as the shower is tiny with a huge shower bench in it. I have requested the MA do not ask my mom to do this and she seems to have obliged (good as this would be a big safety issue).
Additionally, the MA had not been washing my mom's backside. I retrained her recently on how to do it as my mom is standing 'prior to' getting in the shower. She seems to be complying with this (although I think she could definitely 'do better' here, I have lowered my expectations somewhat).
Today I observed the MA stand my mom up to transfer her between wheelchairs and when she stood her up she let go and allowed my mom to 'fall into' the other chair. My mom said something to her about it stating that she had 'let go of her' and the MA responded saying "That was you! No; that wasn't on me; you're the one that [blah blah]..." (gaslighting as if it was mom's fault) and also proceeded to call her "silly" trying to joke it off a bit. I know what I saw and have observed this MA tell me several things she 'has done' in terms of care that I know she did skipped/did NOT do, so I know she has an issue with lying.
If the brakes hadn't been on the chair my mom was transferring to, she would have been on the floor. Sigh. I see why some caregivers can become a bit martyr like - it seems to be true that there is no one that is going to take care of your LO the way you would. At least, that is how I now feel. At this point though, just trying to determine how much more "1:1 retraining via myself" I want to do vs. escalation, replacing the MA and/or other steps. Speaking of other steps:
Coincidentally, PACE recently approached us about my mom showering at the facility going forward as they said it's something new they're trying out (I personally think it's to save money on not using home health). I won't be able to observe it happening there if we go that route instead, but I'm beginning to wonder if that approach might be better than home health.
Any/all advice is appreciated - both with respect to 1) reporting the MA/whether to request she not come anymore (do I replace her?), and, 2) also wrt maybe discontinuing home health altogether and just showering on site going forward. I like having the help to get my mom ready for PACE so I don't have to do the showering and can get myself ready for work. No more home health means getting her up/fed/toileted/transferred/medicated now on those days.
Today I observed the MA stand my mom up to transfer her between wheelchairs and when she stood her up she let go and allowed my mom to 'fall into' the other chair. My mom said something to her about it stating that she had 'let go of her' and the MA responded saying "That was you! No; that wasn't on me; you're the one that [blah blah]..." (gaslighting as if it was mom's fault) and also proceeded to call her "silly" trying to joke it off a bit. I know what I saw and have observed this MA tell me several things she 'has done' in terms of care that I know she did skipped/did NOT do, so I know she has an issue with lying.
...
At this point though, just trying to determine how much more "1:1 retraining via myself" I want to do vs. escalation, replacing the MA and/or other steps.
Absolutely report her. How many other patients is she treating like this? You shouldn't be retraining; the MA should be handling it.
Absolutely report her. How many other patients is she treating like this? You shouldn't be retraining; the MA should be handling it.
I agree...
I hate that finding a person that does this type of role well is so difficult. And I get that no one will be perfect, that accidents are going to happen, etc., etc., but..there's just something that's different about this person. She knows when she is wrong but won't admit it. That's bothersome. And gaslighting is a big trigger for me. But even my mom knew it wasn't anything my mom did wrong.
I don't like the thought of going through a perpetual cycle of people, but I knew that is 'par for the course' with agency care. My mom will not like if she has to be replaced but I can't help but think that is the right course of action here at this point. Maybe I can tell her it happened due to some other need (i.e., shift timing or something else).
I totally understand that. My friend who had home health coming in had to do it with the first person that her mother really liked, but she couldn't do everything herself, and she needed the help. But this woman was rude to her, and also condescending to her mother who had dementia. She just called them up and told them what was happening. They replaced her without much questioning. It makes me wonder if they know their people have issues but there is such a demand that they keep them on anyway.
I would replace her. Eventually you will find better. We had good luck with our first home health aid but bad luck with our first facility. Second was better. We used what we learned with the first to make a better decision. Just move on from this one.
Looking for advice. My mom is a PACE participant and home health comes 3 days a week to get her ready for the PACE shuttle.
The home health MA had been asking my mom to stand in the shower. My mom has hemiplegia and cannot stand, plus there is no room to do it even for me as the shower is tiny with a huge shower bench in it. I have requested the MA do not ask my mom to do this and she seems to have obliged (good as this would be a big safety issue).
Additionally, the MA had not been washing my mom's backside. I retrained her recently on how to do it as my mom is standing 'prior to' getting in the shower. She seems to be complying with this (although I think she could definitely 'do better' here, I have lowered my expectations somewhat).
Today I observed the MA stand my mom up to transfer her between wheelchairs and when she stood her up she let go and allowed my mom to 'fall into' the other chair. My mom said something to her about it stating that she had 'let go of her' and the MA responded saying "That was you! No; that wasn't on me; you're the one that [blah blah]..." (gaslighting as if it was mom's fault) and also proceeded to call her "silly" trying to joke it off a bit. I know what I saw and have observed this MA tell me several things she 'has done' in terms of care that I know she did skipped/did NOT do, so I know she has an issue with lying.
If the brakes hadn't been on the chair my mom was transferring to, she would have been on the floor. Sigh. I see why some caregivers can become a bit martyr like - it seems to be true that there is no one that is going to take care of your LO the way you would. At least, that is how I now feel. At this point though, just trying to determine how much more "1:1 retraining via myself" I want to do vs. escalation, replacing the MA and/or other steps. Speaking of other steps:
Coincidentally, PACE recently approached us about my mom showering at the facility going forward as they said it's something new they're trying out (I personally think it's to save money on not using home health). I won't be able to observe it happening there if we go that route instead, but I'm beginning to wonder if that approach might be better than home health.
Any/all advice is appreciated - both with respect to 1) reporting the MA/whether to request she not come anymore (do I replace her?), and, 2) also wrt maybe discontinuing home health altogether and just showering on site going forward. I like having the help to get my mom ready for PACE so I don't have to do the showering and can get myself ready for work. No more home health means getting her up/fed/toileted/transferred/medicated now on those days.
My aunt is in the PACE program. They can't get a shower person here early enough to have her ready for the bus when it comes to pick her up. She is able to stand with a walker and I had one bathroom remodeled with her in mind so that there is a bench at one end and a shower head on a hose. She has a metal walker to get in the shower with.
Have you called the social worker at PACE to talk about the issues you are having with the shower lady? I have not experienced any problems with the home care people, but I know the program is dependent on contractors getting and keeping staff.
For me it is a good program and they are now going to ad my Aunt to a waiting list to get into an assisted living facility. I don't get a day off, just the 5 hours 3 times a week that my aunt is at the facility. Burn out is a real thing.
I hope you can talk to the management at the facility your mother goes to and get things straightened out because you should have to remodel your house or let someone abuse your mother.
I totally understand that. My friend who had home health coming in had to do it with the first person that her mother really liked, but she couldn't do everything herself, and she needed the help. But this woman was rude to her, and also condescending to her mother who had dementia. She just called them up and told them what was happening. They replaced her without much questioning. It makes me wonder if they know their people have issues but there is such a demand that they keep them on anyway.
I absolutely feel every agency is so understaffed that they don't do too much about these things unless there is a major incident and/or pressure put on them to discontinue services with a particular caregiver.
I spoke directly with the agency yesterday about my concerns. They stated additional training would be given as/if needed but after thinking about it more I decided I would be requesting a replacement which I am in the process of doing now and have informed PACE about this.
On another note, I did post a local Facebook 'ad' for help. This is supposed to be for weekends though. I am looking to hopefully get 2-3 people on a sort of 'roster' that I could call for either weekend 'sit in' help, or transportation for my mom so that she and I can both start having some 'me' time.
I figured I could use the sitter when I'm staying local for shorter periods of time (say I want to just spend Friday 'out' for the entire evening) as that would be someone who just literally watches her. I am hoping however to find longer weekend support as in someone that could spend the night once or twice a month on weekends so I could get away for longer periods. That will be harder to find as that person needs to be able to transport, transfer, toilet and possibly shower/dress. On a local Facebook group of 30k people only 2 responded to my ad from last week so this is proving to be harder to find than I thought it would be considering the length of time I've been looking.
Last edited by southkakkatlantan; 04-03-2024 at 07:38 AM..
I would replace her. Eventually you will find better. We had good luck with our first home health aid but bad luck with our first facility. Second was better. We used what we learned with the first to make a better decision. Just move on from this one.
Yes; I am proceeding with asking for a replacement.
There are other things such as never wearing gloves not one time in the 3 months she's been with us (not during toileting or any other time that is appropriate), the constant reminders of things like this that I believe are caregiving 'basics' I'm not responsible for training on, along with the recent safety issue/gaslighting that just aren't going to work for us.
My aunt is in the PACE program. They can't get a shower person here early enough to have her ready for the bus when it comes to pick her up. She is able to stand with a walker and I had one bathroom remodeled with her in mind so that there is a bench at one end and a shower head on a hose. She has a metal walker to get in the shower with.
Have you called the social worker at PACE to talk about the issues you are having with the shower lady? I have not experienced any problems with the home care people, but I know the program is dependent on contractors getting and keeping staff.
For me it is a good program and they are now going to ad my Aunt to a waiting list to get into an assisted living facility. I don't get a day off, just the 5 hours 3 times a week that my aunt is at the facility. Burn out is a real thing.
I hope you can talk to the management at the facility your mother goes to and get things straightened out because you should have to remodel your house or let someone abuse your mother.
Just to clarify, my mom lives with me (not in a facility). We stay in a friend's house that I rent from so there won't ever be any remodeling to this home in the near future since I don't own it. We get by with the current setup, but it will not work long term. The bathrooms are too small, there are tubs and IMO we at least need more space and walk-in showers so a roll-in chair into the shower can be used. I do foresee burnout on the use of this current setup as it's like a game of twister for me (or any caregiver) getting my mom in/out of the shower and it's just not fun and in my mind it's likely unsustainable for the 'long term' whatever that may be.
However, where we go next is a huge question mark and a story/thread for another day as I am constantly thinking about what city we should consider, if we simply stay in the city we're in (which I strongly prefer not to), or if we only consider moving to another city that also has PACE (under consideration and I think is likely a smart move). The 'placement support' that PACE offers is a huge plus in my book so I get it and I lean towards if we leave here, moving to another 'PACE location'.
I have spoken with both PACE and now also the agency regarding the caregiver issues. I am going to ask for a replacement.
On a local Facebook group of 30k people only 2 responded to my ad from last week so this is proving to be harder to find than I thought it would be considering the length of time I've been looking.
You might consider finding your town's Reddit sub and posting there.
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