Honestly, I thought about ranting about this over at the Anger Wall. I decided to step back, though, and see what y'all think

Mom has a 5x/week companion paid for by Medicaid. She started back in January, and at first we were pleased. "C" (for companion) had been with the agency for awhile, assured us she'd worked with dementia patients, and had a wealth of tricks up her sleeve re keeping Mom busy and stimulated. Together they make dinner a couple of times a week, sew quilts (Mom was a talented seamstress back in the day), do arts-and-crafts, play cards, read the newspaper, etc.

There are parameters, of course *blood boil* Because of liability issues -- and I completely understand -- C cannot take Mom out by herself unless 1) Mom has an appointment, and 2) it's via public transportation. C cannot even wheel Mom around the block by herself, never mind go up to the corner store for a change of scenery. Either hubby or I have to be with them *blood boil*

But that's nothing. Little by little C will seek out either my or hubby's company if we're both around. She'll ask us what she should do with Mom because she can't think of anything for them to do. I understand her frustration, but c'mon, she's being PAID to entertain her! And true, Mom's been on a decline for the past few months, but she can still talk and somewhat walk and makes it clear that she wants to DO SOMETHING rather than drift off to sleep in her chair. Last week when hubby and I went out for a bit, we returned to Mom sound asleep on the couch and C looking completely lost. Another time hubby saw them watching "Oprah", Mom completely confuzzled as C was explaining to her who Oprah is and what the show was about. Thankfully hubby backed off, or else he would've hit the roof -- like me, he wants C to engage Mom, talk to her, keep her stimulated, etc.

Anyway, what made me hit the roof was when, late last week, C admitted that she's bored looking after Mom. I was too stunned to react. When I came to my senses, I sympathized with her because we face the same issue on weekends, but, yeah...aren't you trained for this? You have other clients in the same boat...what do you do with them? C shrugged.

I hesitate to call C's agency because I have nothing against her personally. She hasn't done anything illegal, Mom seems to like her, and I know she's bound by the boundaries of the job description. But really, in the greater sense, what's a companion supposed to do when providing respite? What kind of respite is it when either hubby or I have to be around for transportation? What kind of respite is it when I'm trying to take a nap and C calls up to me, asking what they should do? What kind of respite? It's almost like looking after two people rather than one!

*quietly starts pulling out her hair*

I have had little luck trying to engage Mom's companions with proper house plant care and crossword puzzle solving. These are simple things to me that are crucial to her state of mind. If I take a few days off and her fern that she has had for 25 years suffers, it can't be made up.
My Bro thinks I need a break, and that would be nice, but he isn't going to do what I do while I'm gone, and there are so many little things, that make all the diff., in daily engagement and warding off depression.
It's not a lack of caring on his part, as much as taking things for granted. He can't take care of her fern properly either, and he doesn't realize that the "little" things do matter for her Health.
Maybe I am obsessing. He thinks so. But he isn't involved with her daily care, so he can't truely appreciate what she responds to, or not. I just feel that I can't keep things in the shape they need to be in , if I'm not there, for my "shift". I do worry about boredom for the team members. It can be the numbing of minds that cause real problems. Still, I appreciate, that he thinks I should take a break. He wants me to last, not break.

quote:

Originally posted by Moms_Buddy:
The bottom line is that patient care involves a lot more than just hands-on time. It's tough to find the right kind of help that is TRULY valuable assistance.

Exactly. One of Mom's old friends is at "The Club" too -- she doesn't have dementia, but she has a host of other issues -- is lucky to have a FT nurse, who is paid by the friend's children. We happened to run into them at the ER the other day. The nurse and I hit it off, so in the course of gabbing I asked her about CG's boredom issue. She said it's not unusual, in that most nonmedical agency CGs are basically housekeepers because of the lack of client interaction. She then added that Mom must've shocked the heck out of the CG, and the CG is still reeling.

I did ask the agency owner about the possibility of bringing in someone who's more experienced with ALZ. He was apologetic in replying that unfortunately he doesn't have anyone meeting the criteria at the moment, as the aides he has who do have ALZ experience are already booked solid.

*sigh*

I'm still lookin'...

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I DO LOVE the image of them quilting...

Poor aide - she's learning that this caregiving thing ain't a piece of cake and that, rewarding and important as it is, it isn't a lot of fun and is frequently boring as watching paint dry. [/QUOTE]

EM, I hear ya! I am having similar difficulties that I raved about on the Anger Wall...

The bottom line is that patient care involves a lot more than just hands-on time. It's tough to find the right kinf of help that is TRULY valuable assistance.

I'm still lookin'...

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I DO LOVE the image of them quilting...

Poor aide - she's learning that this caregiving thing ain't a piece of cake and that, rewarding and important as it is, it isn't a lot of fun and is frequently boring as watching paint dry.

Update of sorts -- hubby and I both spoke first with Mom's case manager, as well as the agency owner, as to the restrictions. Turns out that the only ironclad restriction is driving (CG or us) because of the liability issue. Otherwise it's "at the client's discretion" when it comes to taking Mom around the neighborhood in the wheelchair. The catch is that IF something happened to Mom, the agency isn't liable.

We also "talked around" the bored issue with the CG. Turns out that, for all her years as an aide, Mom is her first truly interactive client. The only other walking/talking client she has loves to watch TV, so that's all the CG does when she visits. The rest are either bedridden or too "out of it", so CG ends up either doing chores and/or their grocery shopping.

Yep, they mostly quilt and watch Oprah. I find it both amusing and surprising that Mom remembers sewing basics, and she scolds the CG if the CG doesn't line up the squares neatly. They recently made a wonderful girly baby quilt the CG will donate to Children's Hospital in Mom's name. Hey -- it beats me having to gather all the quilting/sewing stuff and donating it!

I can understand the bored part, though. That's what's troubling me. Like Cajey said, what respite is it if we have to watch over both of them? I haven't addressed the issue yet. I'm not sure how to.

*sigh*

The boundaries you describe do NOT prevent "C" from engaging your Mom in whatever activities she is capable of.

If you are having to entertain two people, you aren't getting any respite. And it sounds like it would be easier without her.

I would call the agency. AS you said, she is getting paid to do entertain your Mom. If she can't do that, she can't do the job. I would call and see if you can't get someone else.

Em boy do I feel for you and understand where this is coming from. In this "Sue happy society" there isnt much left for anyone to do here unless you hire the person on the side and not put restrictions on the C for your mom which defeats the purpose of State aid.
Is she still allowed to quilt?
If so this is an excellent task for her and Mom if its still allowed.
I can get that the poor dear is bored with all these restrictions though but shes gonna have to get over it this is the job she chose either that or go back to the agency and request another patient and get someone for you that is better suited to the long hours of CG.