Grandma is in long term care. Her dementia is escalating. She accuses staff and argues with me when I call. Is there anything I can do?

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Grandma is in long term care. Her dementia is escalating. She accuses staff and argues with me when I call. Is there anything I can do?

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Grandma is 87. I live overseas. She has no family left in California. So I'm the only person that calls and checks on her. She forgets that I'm now 36 and argues with nurse on a daily message . They call me which is around 3:30am my time and ask me to calm her down. I'm happy to help but are they meant to call me everyday when her confusion gets bad? I'm usually then on the phone with her for 45 mins to 1 hrs. She will argue and argue until she gets tired and gives up. I tried to speak to the administrator for advice on how to proceed from here. She made a comment that they need the bed anyways as she is Medi-cal patient and if she doesn’t want to stay there then the bed can be used for someone else. I'm so confused. Grandma has no family there. She can’t live on her own either. I'm constantly worried and scared that the NH will discharge her or send her to the hospital as the administrator mentioned that.
I can’t even fly there right now due to Corvid. Feeling so helpless.

Care Decisions Cognitive Decline Long-distance Caregiving Skilled Nursing Facility

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First off, don't argue with your Grandma. It is a battle that won't be won. Just listen, ask her to expand on what she's saying. Secondly, sometimes the facility may be required to call you if she's upset. I know where my mom is they have to let me know if she falls, bumps herself, found bruising, etc. They call too but I am only 2 miles away. I usually end up listening to her say the same thing over and over and over. If you need a release, turn your head and do a silent scream. There are also anti anxiety creams that may calm her down . We have given mom's place permission to use as needed, especially since we can't go see her these days. It at least avoids the 3 am calls so I can sleep and take care of myself. There are also different levels of care places provide. Your Grandma may need more hands on care where I am still the one who makes sure clothes are changed, laundry, pill box is filled but that is our level. My sister and I are fortunate that we trust the place and the people looking after our mom. Maybe that place isn't the right place for yours. Is there someone, an old neighbor or friend that you could trust to look into other options locally? I can't imagine doing it from a distance but hang in there . You are an angel for doing it!

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Speak to the Ombudsman.

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I suggest that you talk to your grandmother's doctor. Explain the situation: the confusion, the arguments, and the staff's inability to calm her down. Your grandmother may be experiencing Sundowner's Syndrome, which they should be able to deal with. She may also be confused and frustrated and not coping well from either anxiety or depression. Her doctor can evaluate for anxiety or depression and prescribe appropriate medications. I would also suggest that you talk to somebody in her area that can be an ombudsman (probably find one through department on aging in her town or county) and help advocate for your grandmother.... and be your ally.

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It’s hard, my mom was moved to. SNF in the midst of all this virus craziness. I got several calls from the nurses in the evenings asking me to talk to my mother who was combative and refusing to cooperate. They did not know her well and didn’t know this was not her normal behavior. It would take 30-45 minutes for me to calm her down.

Dr finally prescribed Adoral to calm her down, and they found that she had a nasty UTI. It’s being treated and the calls have stopped until today when she found a phone and called me rambling on about something. I just kept saying yes, I would call and complain until she was satisfied and hung up.

I told the nurses to call me f there is a problem anything I can do to make their job easier but I have to admit my heart sinks every time I see their name on the caller ID. At 93 chances are it’s bad news. At least it’s local, not an overseas call.

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You need to call the Ombudsman's office in California to ask some questions. The Office of the Ombudsman works independently as an intermediary to provide individuals with a confidential avenue to address complaints and resolve issues at the lowest possible level. The Office proposes policy and procedural changes when systemic issues are identified. https://www.aging.ca.gov/Programs_and_Services/Long-Term_Care_Ombudsman/

If she is that confused that she is arguing with everyone, I don't see how the facility can even 'assume' she doesn't want to be there or capable of making such a decision. So, how can they even be thinking about her leaving so they ccan use the bed for someone else.

You can argue until you are blue in the face with a broken brain. It won't change what they are thinking because it is real to them...just as real is the truth is to you. If they are calling you all the time to calm her down, it is clear you have pretty much become an employee for them - unpaid. The next time they call, tell them you'll talk today, but you would like for the doctor to come and see her AND they explain to the doctor how she is acting and difficult to calm her. 19, so a visit is just not possible. Remind them that you are in the same position as others in this world dealing with CovidPerhaps she should be screened for urinary infection (that causes all kinds of weird thoughts and is most common in a facility setting). Tell them to call you to give an update on what day the doctor is coming. Put the responsibility back on them. If you know the dr who visits there, contact him yourself to request a discussion after he sees her (ask facility for dr name if they use a doctor you are not familiar with).

You should also tell the facility that when they mentioned giving the bed to someone else and allowing her to move on to 'wherever' it caused you great distress and sounded as though they didn't want her there...AND...you are in communication with Ombudsman to make sure she cannot be discharged with no where to go. NO ONE wants the Ombudsman to call them because they expect answers quickly and accurate info - they will check out what they are told to confirm they received accurate info.

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Hi
thanks for your advise . I will call the ombudsman’s office in Monday . The facility is now saying that she no longer qualifies for SNF because she is physically able and her does not require that level of care . I just don’t know what’s happening. I hope I will get some clarification soon .

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Tell them (Social Worker & Director of Nursing on conference call) you are overseas & when they call you @ 3am you’re woken up out of deep sleep & cannot make decisions then...tell them to evaluate her by geriatric psychiatrist & let him/her prescribe medication to calm her down. Under no circumstances are they to discharge her because there’s nobody to take care of her & it would be an unsafe discharge. Let them know she has no family. Lastly, turn your phone off before going to sleep & let anything go to vm. Hugs 🤗

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Hello
Thanks for responding . I did try calling the Administrator however due to Corvid they mostly are not in office so they haven’t responded to my call yet.

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Ativan deals with anxiety

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When I (on the West Coast) had my mother in a nursing home (on the East Coast) ran into this, I told the administrator that they were the experts and should certainly know how to handle the situation. Since they ostensibly are trained geriatricians and are being paid to do this job, they should be able to contend with such a situation. It is unconscionable for them to lay this trip on you in the present circumstances. Unfortunately or maybe fortunately, in the past, these places just doped the patients up. I cannot speak to this.

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Several points here. They call you at 3:30 a.m. in the morning - I'd shoot them. Tell them NO phone calls at 3:30 a.m. - call during YOUR business day time. In the meantime, shut the phone off at night or leave it off the hook. They will learn. Second, speak to a doctor if something could calm her down. Second of all, she has dementia and bad behavior so do NOT talk to her. The minute you talk to her and she starts up, tell her to stop at once and if she doesn't, hang up at once. Do not let her take your time and effort and upset and destroy you - she has no right to do that and don't allow her to do that. As to releasing her, I do not know the law but I would talk with an eldercare attorney for advice and I would contact the appropriate agencies who can provide laws and assistance. I do NOT think you have any responsibility and therefore someone has to put her somewhere. I think they are trying to frighten you because they are frustrated. Do your research so you can fight the administration with facts you know.

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Thanks for responding. Trying my best not to answer their calls . I do get worried during this pandemic so I try to be in touch with the facility and her on a daily basis . She argues to me over the phone due to her memory loss . She thinks I m 6 year old and my parents have left me alone somewhere. So she cries and tries to tell me ways to keep myself safe. It’s sad but gets complicated as there is no way I can assure her that I m fine and I m now 36 not 6.

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My mom also was calling me in the wee hours. I finally had to turn my ringer off and when I called her in the morning would explain that I was asleep. She finally understands but still occasionally calls. Tell the staff to only call if it is an emergency. As to them telling you they want her bed DO NOT REMOVE HER from care. These places would like nothing more then for insurance patients to leave so they can make more money on someone else. Make it very clear to them that she has no one to care for her. Glad you are getting her evaluated. I would ask for a geriatric psych evaluation as well. They will review all her meds to make sure nothing is causing this distress. If she was involved with a church to temple perhaps you could ask if they do senior visits once covid has passed. Good luck!

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Check with numerous Airlines. Many are still flying, so consider bringing her to your area. See what's available? You might get very lucky.

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Are you serious? You think the OP should fly her elderly demented grandmother out of the country? What if grandma doesn’t have a valid passport? Who will pay for the flight? Where will she go once’s she’s landed in the foreign country?
grandma should stay where she is. OP can’t take care of her.

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This is ridiculous behavior on the part of the NH. I agree, call the DON (at 3 a.m. her time..lol) and tell her you want the doctor in charge to evaluate her for medication. At the very least she should have Xanax as a prn medication. But there are many thing that can help. Tegretol wonders for my dad.
Are you her medical POA?

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Guilt is the worse. My own mom 91 just broke her right shoulder. She has previously broken her go, pelvic, and femur. Because of this I had to move her from CA where she was comfortable and close to my brother across the country to TN. It’s only been a week but seems like 5 months. Yesterday my brother said, just think of her as an old lady with a phone. It’s helping. But all this advise here is priceless. Yes to the facility. Yes to better medication. Yes to boundaries. It’s a sad thing for sure, but we cannot fix it alone. And what I’m learning yet again, is it’s pointless to try and fix it on the phone. I’m sorry you are

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You can request an evaluation by a geriatric psychiatrist. They are specialists trained in the management of mental health conditions. Once they evaluate her, they can recommend medications to help manage her behaviors associated with dementia. Most facilities have this speciality available to them. If due to the pandemic, the facility is not allowing consultants in, then ask the physician managing her care at the facility to prescribe something to ease the agitation. Good luck.

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If Grandma has no money, Memory care would not have been an option, its private pay.

They cannot discharge Grandma. Without family there they can't discharge her safely. The only thing I can see happen is to tell them you can't be the responsible party. Living overseas is making it hard. Ask if there is a way for the Court to assign a guardian.

The first time they called me at 3am, would have been the last. As said, this is the staffs job. She needs medication for her anxiety. The facility has a doctor associated with it. I would talk to the Director of Nursing and ask if there is a medication they can use. Its just a matter of the Dr. giving the order.

I would also ask that the staff be made aware of the time difference between CA and where ur. Give her the times convenient for you using CA time. You also would appreciate only emergency calls. Calming her down is not one of them. As her Dementia progresses, this may go away.

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Joann memory care IS NOT PRIVATE PAY! Where did you get that information from? The OPs grandma is in California. Medi-cal pays for memory care. Medicaid in most states pays for it as well. It’s not private pay.

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Set firm boundaries for accepting calls from snh asap. They are being paid & thus responsible for managing Grandma's behavior, that's why she's there. Calling you is an excuse for them to not do their job. They have access to the doctors who can assess her & possibly prescribe some meds to help grandma settle down.
You may have to speak with a doctor or social worker and ask what THEY can do to help you (being out of the country) with grandma so she can get the proper care she needs without constant phone calls. Be persistent! I've been there too.
Best wishes.

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My sister was younger with dementia, but mood stabilizers took that mean nastiness away.
Good Luck

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She needs to be seen by a geriatric psychiatrist; the facility should have one who visits other patients there.

Demand that she been seen.

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I just spoke to the nurse in charge and she said she will have the facility doctor assess her and he won’t be in until Friday . Hopefully it happens

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Is she in a Memory Care Unit? If not, she needs to be. The facility should not be calling you every night. They should be made aware of the time difference. By calling you each night, they are expecting you to do their job for them. Then, they prove they can’t do the job by threatening to throw her out. Are they saying they’ll send her to a psychiatric hospital? Maybe she needs to go. They can adjust her medications while she’s there. Do you have Power of Attorney for her? If not, there is nothing you can do. You can’t make medical decisions for her and you don’t have any financial rights for her money. Explain this to them. Turn your phone off at night. I would pursue finding a guardian for her here in the United States.

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Hello
She is in a skilled nursing facility. I went to visit her in September last year and she was not well . She was living with her sister at that time who was not well too and has since passed away . I took grandma to the doc and she was evaluated and the doc said she was suitable for snf. I don’t live there ofcourse didn’t know about memory care . I extended my stay until I managed to find a bed for her in snf.
The nursing home asked me to the be the responsible party which I agreed to . There is no one else that could do it . I m really confused what I can do and what I can’t do. Grandma signed the documents too and I signed as responsible party .

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Stop accepting the calls, and stop trying to explain things to her. You cannot expect someone with dementia to accept any reasonable explanation, and it's not your job to try to calm her down every night.

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Hi
I often tell myself that I won’t answer the call but I start feeling guilty and worry what if it’s an urgent call and she is not well or something. I know I need to be more stronger . I m just really struggling right now .

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Grandma is in long term care. Her dementia is escalating. She accuses staff and argues with me when I call. Is there anything I can do?

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