Dementia Contributes to Elders' Fear of Outside Caregivers

Lisa Marie Blaskie RN, CSA, CCM

Over 50% of our senior clients have dementia related issues. ?An elder with these issues may react in a negative way to outside caregivers. ?Many times despite all the planning, the experience of the assessing nurse, the caregiver selected triggers a negative reaction to an outside caregiver. ?In these situations we advise the family that finding the right choice may mean more than one placement. ?The story below highlights the problem.

?Fortunately, after much begging, pleading and finally demanding, I got the doctor to take Dad off Haldol. After the drug wore off, Brad, the nurse, was once again perceived as he was, a wonderful nurse. If no medication can be blamed for the paranoia, the elder?s basic personality needs to be taken into consideration. We knew Dad, and we knew how he had reacted to the nurse prior to the medication.?

Not everyone will have this experience. The first thing you will most probably witness is the anger and abuse from the elder. The non-family caregiver doesn?t know what to do. Neither does the family.

It?s time to play psychologist. Is it only this particular person who upsets your elder? Maybe this person, through no fault of her own, reminds your dad of someone he feared when he was a child. With Alzheimer?s, we have to remember that people may be mentally at an age where they are young and vulnerable. If it is only one person that your elder reacts violently to, I?d kindly let the person know that this arrangement, through no fault of her own, won?t work. Explain what is going on.

If she is a seasoned caregiver, she will likely have seen this behavior before. She may not like it, but she will understand. Of course, you will already have talked with the elder and told him repeatedly that you are still the caregiver, but that you need help. You?ve told him that this person is there to help both of you and you are watching over the process. Constant reassurance is necessary. Understanding the elder?s fear and vulnerability is necessary in order for you to cope with this problem.

Trying a new caregiver may be necessary and even helpful. If, however, your elder is abusive to all outside help, I?d talk with a doctor about anti-anxiety medication or other medical therapy. For those of you who are on the receiving end of the abuse, I?d advise you to communicate with the family in a friendly way. Brainstorm about what may be frightening the elder. Try to find ways to interact with the elder in an informal manner.

Find out about hobbies and past work experience. Even your clothing may make a difference. Do you look too ?medical?? Work with the family as closely as you can. If you have a home care agency with an RN talk to her if she thinks and you think an anti-anxiety medication may help, or other medications may be causing this behavior, speak up to your doctor. However, if the abuse can?t be stopped, you need to give notice and walk away.

Contact?ComForcare Home Care Services?for all of your?elder care?needs. We are a home care agency providing quality and affordable care to our seniors, veterans and disabled in the San Francisco area. Call (415) 689-8567.

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Elder care author, columnist and speaker Carol Bradley Bursack is an AgingCare.com contributing editor and moderator of the AgingCare.com community forum. Read her full biography

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