Dad being verbally abusive to Carers, Company say they may withdraw care

Discussion in 'I care for a person with dementia' started by Wildflowerlady, Oct 22, 2019.

  1. Wildflowerlady

    Wildflowerlady Registered User

    Sep 30, 2019
    16
    Hi all,
    I am quite new to the forum and still working my way around how to use it but I do pop in and out to read the new posts. So late afternoon yesterday I get a long email from my sister saying dads Care Company have called her today to say that his verbally abusive behavior is now becoming a problem. Its been going on a while and they did say a few weeks back they would be monitoring him, its generally shouting but he can get up and get in their face and has recently waved a stick at one of them I assume threatening to strike out. Dad has four care visits a day is doubly incontinent and was officially diagnosed with Mixed Dementia Vascular and Alzheimer's in March 2018. We had noticed problems way before that his memory being poor etc, my dad still lives in his Council owned home with his dog and our mother passed in late summer 2016. My sister and I both live close to dad, a short drive for me and a few minutes walk for her. We have both been visiting dad on a regular basis since our mother passed in fact alternate daily visits morning and evening. At the end of June this year I made the decision to start visiting dad in afternoons due to my own partners declining health as he has Parkinson's and he also suffered a Heart Attack in May 2018. My partner of 20 years is now 76 years old and it didn't seem right to leave him especially in the morning when he needs to get showered and dressed and he was starting to have some falls around the house generally. Occupational Therapy are coming in for partner next week. My dad is 85 years old stable on his feet more so than my partner, I am 60 years old. My sister and I didn't get on never did and had no contact for over 20 years prior to our mothers passing but we worked together and corresponded, sometimes even met up etc in order to help dad I thought we were doing well and getting on as sisters do. Unfortunately my changing visits to dad did not meet with her approval but that's another story!! My sister has recently dropped her evening visit too. Its fair to say she is now the one that goes in every morning and if there before the Carer arrives gets dad out of bed. Dad now demands a daily cooked breakfast a bad habit we started following a hospital stay in summer 2017 as we were a bit concerned about his weight. We thought a cooked breakfast would help keep his weight up although he's never been very big or overweight anyway. Its something we did alternate days as previously said until end of June this year. Carer does not do breakfast unless we were/are unavailable which is very rare as sister still does it. Unfortunately at the weekend my sister was unavailable and dad apparently was very abusive to the morning carer and seems she was 'forced' into cooking him sausages having to defrost some quickly from the freezer in order to give him the breakfast he wanted. I still visit dad regularly albeit only 5 days a week not daily. My sister has a adult mentally handicapped daughter living at home but her husband is now retired so he is able to help her out more. I do appreciate and don't dismiss in any way what she does for dad and to be honest I don't know how she carries on with it all, apart from my partners illness I was also getting very depressed and struggling myself. I am responsible for dads shopping needs and take him if he wants to go as sister does not drive. Iv'e said I will still do what I can washing etc but invariably she has done it. Carer does get dad washed and dressed although if needed sister will change pad before his breakfast, again its something we have both done. Dad refuses a bath or shower so its a daily strip wash since care was first provided in late 2017. Dad is getting very irritated with the Carers coming in and out now but he honestly couldn't live at home without them and to be honest I have had doubts for some while as to how he would cope without our visits. I know what his temper is like Iv'e been at the receiving end of it a few times especially since my morning visits ended its not pleasant at all and I sometimes do wonder why I visit when he's so nasty to me. I tell myself he can't help it because its his dementia but I also think his dementia is progressing. Dad has no memory of my mother having a sister now.something he remembered a few months ago. I struggle with my sisters views and as yet haven't replied to her email thinking what to say to her. My sister is complaining the Carers are not emptying the catheter bag on every visit to dad she has mentioned it to his Care Company yesterday says so in her email and its more often than not the afternoon Carers visit but dad often refuses to let them he's the same with pad and they can't go against his wishes. I actually found 22 dirty pads in a wardrobe earlier this year and prior to that some hidden in a chest of drawers. Sister is now complaining a week later since she brought it up with me that she has noted from his Carers book that I have emptied the bag on two or three of my recent afternoon visits. My sister now infers in her email I am interfering in the Carers role/visits however she clearly doesn't think twice when she cancels his lunchtime carer to cook him fish and chips on a weekly basis!. I thought she would be happy I had managed to empty his bag without him fussing but seems she's not and has also criticized me for just making dad a tea and giving him a cake etc but surely as his daughter that would be a natural thing to do regardless of when his Carer is due. Sister is now suggesting I don't visit when Carers are due but this would leave me a smaller window in which to visit my dad to avoid them as he has a lunch call and afternoon call besides the morning and bedtime call, they can also be running late or their schedule can change. I don't believe it would have any favorable effect on dads behavior towards his Carers anyway as he can just turn nasty for no reason something just mentioned on TV can set him off. Dad goes to bed at 9 pm and Carer attaches night catheter to day bag and helps him into pajamas. Dad rarely brushes his teeth and his fingernails are disgustingly long and dirty but he refuses to let me or anyone else cut them. Since the end of June my sister and I have really struggled to get along as far as me being blocked by her on WhatsApp which we had used daily to communicate lengthy messages. After June we just sent the very occasional short text. Its only been the last couple of weeks she seemed to have settled down a bit and re-opened WhatsApp although we have just emailed. Some of my dads Carers we have got to know pretty well now and I'd have thought at the moment with his behavior the Carers would really welcome one of us being there when we can. I have had a couple of Carers indicate in the past that dad is better sometimes if we are there and I'm sure they don't mind if we are unless I'm totally mistaken. I am now thinking perhaps I should contact the Care Company myself and ask before replying to her email if my visits are causing any problems for the Carers themselves and is it possible my visits are affecting dad and his attitude towards them. I will be surprised if they say that is the case but if so I will have to re-think my visits. It could just be my sister as she is very controlling and was very upset over my changing my visits to dad. I won't go into further detail but she wasn't kind, nice or understanding to me or my partner whom she's met only twice. I want to know what is likely to happen to dad, sister says they are currently saying that they will continue to provide care for now but if his behavior continues they may have to withdraw it. I am wondering if now is the time my sister and I should have a honest chat about the likelihood of dad going into a Care Home sooner rather than later. Its not what we wanted but there is no way either of us could care for dad much more than we are doing now and I fear his days living at home are numbered now. Can anyone advise or tell me the next stage we need to be looking at and who to approach. Dad doesn't own his home and therefore he would need funding from the Local Authority as would just be his pensions and a bit of his savings to be taken into account not any large amount of money to make him fully self funding if that's the correct term?
     
  2. Jessbow

    Jessbow Registered User

    Difficult position.

    The carers may well withdraw of your father continues as he is now.
    Verbal is one thing, waving sticks around is another!

    I wonder if he is agitated by the changes in routine? If one of you is there and he gets his cooked breakfast, if not, then he doesn't. Can you not ask them to cook him a breakfast if thats what he wants? Defrost sausages overnight, they don't take long then.

    Does sound as thought the time for full time care is fast approaching
     
  3. TNJJ

    TNJJ Registered User

    May 7, 2019
    673
    Female
    cornwall
    Hi.It seems that both of you have a lot on your plates with the dad scenario..
    As much as you don’t want to support your dad into a care home there is only so much you can both do.(I care for my dad with VD at his home with carers 4X a day)

    I think the time has come to talk to your sister.
    You will need to approach SS for a needs assessment in order to go further.(Social Services).
     
  4. sausagedog

    sausagedog Registered User

    Aug 22, 2019
    37
    Reading your post, I would have thought that now is the time for you and your sister to seriously consider your father going into a Care Home because you may not be left with a choice in any case ...I would be ringing SS first thing today & discuss the fact the Care company May withdraw care, that you & your sister are no longer able to care (the LA have a duty of care to look after your father) and say you need an urgent care needs assessment - once you’ve spoken to someone you should get the ‘ball rolling’..let us know how it goes
     
  5. canary

    canary Registered User

    Feb 25, 2014
    10,715
    Female
    South coast
    It sounds like 4 carer visits a day is no longer sufficient and I would say that now he really would be better in a care home.
    I know that your sister probably wouldnt like it, but if the care company withdraws their support you may not have much choice.

    By all means call the care company and ask for their take on this and whether they think that you visiting is making matters worse. Im pretty sure that they wont think this, but I think it would put your mind at ease as well as giving you more information before your talk with your sister. To get the ball rolling about getting your dad into a care home call Social services and explain the situation.
     
  6. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,751
    Kent
    Hello @Wildflowerlady

    When my husband was at home with me we had an amazing care package which I doubt would be available today. We had a carer sitting with him for two hours daily, which gave me space to go out and also half an hour morning and evening to help with dressing and undressing.
    Even so, I was alone with him for 21 hours every day, managing behaviours and all the difficulties carers have.

    When my mother was living alone she was allocated daily day care, collected and taken home, Monday to Friday. Even so, she was alone all night, between 5pm and 9am and at the weekend.

    However good your dad`s care package is, try to work out how many hours a day he spends alone.

    There comes a time with dementia when people need 24/7 care and support and however distasteful it is to family members, residential care is often in the best interests of the person with dementia even if they are unable to appreciate it.
     
  7. Shedrech

    Shedrech Volunteer Moderator

    Dec 15, 2012
    8,077
    Yorkshire
    hi @Wildflowerlady
    neither you nor your sister can sustain the level of care you are providing and both of you have commitments to others
    I know what it is to have the kinds of stresses you describe between you and your sister; they eat away at you

    your dad clearly needs a high level of support that the care agency and yourselves are finding it challenging to provide
    he may actually relax more in a care home with settled routines and staff who have time to get to know his ways ... a cooked breakfast will be no problem in residential care, and they will have the time to calm your dad to deal with the catheter bag

    this gives details of paying for care
    https://www.alzheimers.org.uk/get-support/legal-financial/who-pays-care
     
  8. Wildflowerlady

    Wildflowerlady Registered User

    Sep 30, 2019
    16
    Hi Jessbow
    Carer doesn't have time to cook dad a full breakfast he has a 45 minute morning call but is always soiled and will not have a bath or shower so strip wash can take up a lot of their time. Sausages are frozen and taken out day before but this weekend breakfast needed to be given by carer on Sunday sisterasked for porridge or beans on toast mindful of the limitation of their schedule. Dad not being happy kicked off verbally and carer relented and did him a breakfast of sausages egg and beans with toast. I will post result of my contact with Care Company below so hopefully will just need to enter once for everyone to follow. Thank you for your imput.
     
  9. Wildflowerlady

    Wildflowerlady Registered User

    Sep 30, 2019
    16
    Hopefully this is correct way to add onto my original post. Thank you all for your feedback. I contacted dads Care Company and they called me back. I am told that their advice to sister was that dad needs to be reminded to be more respectful/nicer to his carers not sure how that works when his memory is bad and his temper flares. In the event his abusive outbursts continue or worsen and they find the carers cannot cope it would be them that would contact someone. I think our lack of Health and Welfare POA will have a bearing on decisions being made now. I believe she mentioned a Social Care worker would be first port of call for them and dad doesn't currently have one, she said that they wouldn't stop care just like that. Regarding the issue with my sister and her thoughts that my visits are causing problems she quite rightly said they cannot say when I visit dad or what I do when I am there and that it is for my sister and I to resolve our differences in our opinions on that. I was told that they are not aware that my visits are causing any issues with carers but if they did she would have informed me. I will politely inform my sister that I will continue to visit dad and feel free to offer him a tea etc whilst I am there. I almost feel that dads outbursts are now being played down a bit. I don't want to sound horrible as I love dad no one wants him stuck in a Care Home and be miserable but he's not exactly a Happy Bunny in his own home now. I suppose its in their interests to keep dad at home as he would need much more financial support to place him in a Care Home but in some ways I do think he needs more care than he is currently receiving as is alone for many hours including overnight. Dad has the maximum four calls per day including weekends. I don't want to come across as selfish but my life is being eaten up by dads dementia and not a hour goes by that he's not in my thoughts, a good nights sleep well that went long ago.
     
  10. TNJJ

    TNJJ Registered User

    May 7, 2019
    673
    Female
    cornwall
     
  11. TNJJ

    TNJJ Registered User

    May 7, 2019
    673
    Female
    cornwall
    I care for dad at his bungalow with carers 4X a day as he is immobile and has now become doubly incontinent .
    I am thinking of supporting him into a home but I am ohh and ahhing over it.

    At night I’m thinking about doctors appointments etc and waking up thinking about it..
    It’s not an easy decision but sometimes a necessary one..Good luck.:)
     
  12. sausagedog

    sausagedog Registered User

    Aug 22, 2019
    37
    You’re not at all selfish. You realise your father needs MORE care & the only alternative IS a care home. There could be potential ‘safe guarding’ issues because what if he ‘kicks off’ physically be it the carers, either you or your sister. I would certainly contact Social Services and speak to one of the Adult Care Team ASAP, you can tell them exactly how it is...It is clear that you and your sister clearly cannot go on like this - at the end of the day, your dad needs to be safe and receive more care - nothing will change unless you summon up the courage and make that important call - you will be doing the right thing for your dad - good luck
     
  13. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,788
    Female
    You are not being selfish, and you are right that it is much cheaper to fund four home care visits than to have him in a care home. But it sounds as if he needs a lot of support and a care home may now be the right place for him. There is no particular reason he will be more miserable there - my mother has been in a care home for nearly two years and she is very content there. We always think people will be happier at home but the time comes when that is no longer true.

    Ring Social Services Adult Care for you area and ask for a re-assessment for your father, as he has deteriorated and you believe he needs additional help.
     
  14. DesperateofDevon

    DesperateofDevon Registered User

    Jul 7, 2019
    1,706
    oh my lovely I’m sorry to read that your Dads declined; never an easy situation. I think that “in his best interests “ are the criteria now.
     
  15. Rosettastone57

    Rosettastone57 Registered User

    Oct 27, 2016
    1,047
    It sounds to me that your father will be unhappy wherever he is. A good care home has the staff and experience to deal with him. I agree with other posters, 24/7 supervision is the way forward, with a whole team looking after him. It's not when the carers are there, it's when they are not there, especially overnight that causes difficulties.
     
  16. TNJJ

    TNJJ Registered User

    May 7, 2019
    673
    Female
    cornwall
    That is true .The nurse has come today to take more bloods on dads declining kidneys.
    I’m off to see my old mates at a residential home I used to work at tomorrow,to see if he fits the criteria.I doubt it.I think dad is becoming nursing care..(heart failure as well as a few other things)..We shall see.
     
  17. Wildflowerlady

    Wildflowerlady Registered User

    Sep 30, 2019
    16
    Hi All,
    Apologies in advance for my rambling.
    So unfortunately any discussion with my sister or anyone else suggesting that dad may actually be very close to being placed in a Care Home hasn't taken place.The day after her email informing me of the call from Care Company regarding dads continual verbal aggression towards carers I received three more emails plus texts from her each repetitively going over the same issues we have had since end of June 2019. This has served to make it almost impossible for us to communicate now as I am worn down by her continual battering and criticism of me. I was leaving my partner every other morning to care for dad when some mornings I really should have been home supporting partner as he hadn't always felt well.Trying to balance dad and my partners needs became more difficult and on reflection now perhaps I should have been more open with her but I really wanted to pull my weight and give the same care she afforded dad. Perhaps knowing how she has behaved now it will have made no difference as she shows no empathy for my partner. Sister complained throughout her emails and texts as she always does as to why could I not continue to go to dad and still do him his cooked breakfast. Any discussion of where we might go from here with dad should carers withdraw didn't even come up in her latest emails/texts only what she sees as lack of care from me based predominately on my not cooking his breakfast and relieving her from her mornings at dads. My sister told me I had put her in this position and she was now left with doing dads breakfast daily rather than alternate days as before. I have no doubt I have already mentioned some of this in my previous posts but in my head it goes round and round constantly as there is no relief from her bad feelings towards me.I feel now I have had no choice but to block her calls and negative texts of which there are many to my mobile since changing visits to dad. How can I communicate and discuss what might be best for dad when she is so bent on hurting me and doing her best to make me feel that I'm letting both her and dad down. I have said that she can leave any urgent messages on my landline which will be picked up by the answering machine and of course I will return her call. I have told her her texts and calls can't be received to my mobile any longer just in case she assumes I will get them when I won't. A fourth email received same day which to be honest I said I had deleted before reading did in fact tell me to only call her whilst she was at dads in future. It all sounds so stupid on the scale of things and creates a lot of unnecessary stress. Knowing dad has dementia and living with it and its effects that ripple out to all the family is hard enough without this bickering. I wish I could call her and have a good chat but she has shouted and screamed at me before so I don't want that to happen again.To put things in perspective more my partner aged 77 yrs had a Occupational Therapist visit our home on Monday and to reiterate he has had Parkinson's since 2008 it has been confirmed now he is classed as someone with a high risk of continual falling. Partner has had around nine falls in the last 5 months. Sister unfortunately only focuses on the couple of falls she knows of which were back in June/July and throws them back in my face saying just one or two falls and you do this to our dad meaning I should not have stopped going to his early morning, but any of partners falls could have caused a serious problem fortunately only bruises so far. I haven't discussed the visit from Occupational Therapist as I'm pretty sure she will show no interest.The Occupational Therapist confirmed partner should not be left alone in the house to have his shower in the morning and definitely not walk outside of our home alone but to use his mobility scooter which we purchased a couple of months back, wheelchair for town as scooter not collapsible.. My feelings back in June/July were and still are that my partner should not have to take dads dementia problems on board when he has his own medical issues, that doesn't mean he was not supportive when I went to dad in the mornings.I think its unfair of sister to expect my partner to rush in the morning not great with Parkinson's in order for me to leave him to drive to dad and don't feel he should risk being left to shower alone in house or indeed have to wait until I return from dads to get showered and dressed himself. My partner also has Postural Hypertension confirmed again by the latest blood pressure test Occupational Therapist did and its not helped by the large amount of medications he is on for the Parkinson's and heart issue last year. Our circumstances changed but sister's inability to see it was not deliberate on my part to change my visits means that the breakdown in our relationship is affecting our ability to communicate and work together regarding dads best interests. I am on Adult Social Care list alongside sister as dads Next Of Kin but if I contact them without discussing anything with her it will no doubt bounce back on me and she will hate me even more.The way I see it dad is lonely one minute but then hates company the next, has no bladder or bowel control, does nothing for himself not even getting a drink of water, cannot control his finances any longer or be responsible for his dog doesn't walk him anymore hasn't for a long time sister does in the morning but he swears he takes the dog out when having a conversation with myself or carers. I have said I will walk him but dad says once a day is enough. Dad has become more and more dependent on others without admitting or accepting it. I do dread going to see dad as I'm always unsure as to what his mood will be like but I still visit around five afternoons a week in the hope my visit will be pleasing to him but sometimes its not. Dad goes through spells when he thinks people are out to hurt him, kill him or want him to be dead including me, whilst driving him to do some shopping last week he said you won't kill me will you? although I think some of that was because it was heavy rain on journey. I do understand its his dementia but still it hurts. Its breaking my heart seeing him like this and obviously I do wonder if my sister will totally resist the idea that dad might actually benefit from and be happier in a Care Home sooner rather than later. I know it will take a lot for her to accept it might be the best thing for dad but in the days when we did speak we both discussed that dad will likely end his days in a Care Home. I have seen in his care book that carers are still reporting that dad is getting very agitated and still being verbally aggressive to carers with continual refusing of catheter emptying in afternoon and pad checks again afternoon. I had felt the same as sister once wanting dad to stay in his own council owned home as long as possible us doing what we could to assist in his care at home. My views seeing how the dementia is affecting dad and in turn us I am swaying towards the thought of dad being placed in a Care Home. I believe sister will just continue exhausting herself physically and mentally which means she will also continue blaming me for not supporting her more and replacing her at dads some mornings to do his breakfast which if I do will then leave my partner vulnerable. I can feel myself slipping back into a depressed state which is how I had been feeling just prior to the time my visits to dad changed. I had actually had some benefit from the changes too but the constant mental battering from sister is bringing me down again. In my head I am almost wanting a crisis to happen and for dad to be placed into 24/7 care now. I hope if that happens he will be happier, settled and looked after more than he is now which is what I think he really needs. For now I see no option other than to wait for crisis or for sister to say she cannot support dad in the manner in which she is doing and then it will become clear that dads care visits are probably not enough for him to stay in his own home any longer.
     
  18. TNJJ

    TNJJ Registered User

    May 7, 2019
    673
    Female
    cornwall
    There comes a time when things you do for your parent/partner become untenable.
    Your dad does sound like he needs to be in full time care.

    As regards your sister if she continues like this I would pull away from your dads mornings (breakfast )and let her do it as this appears to be the problem and just pop in in the afternoon.
    I wouldn’t leave your partner to assist your dad.

    If your dad is refusing carers to assist him there is nothing you can do.As long as it is documented.
    There will come a crisis when there will be no choice.Personally it doesn’t sound as if that is too far away.
    I would inform SS of what is going on @email and then they will decide the next step.
    They have Duty of Care but as children we try to do our best but dementia will win out..every time.
     
  19. anxious annie

    anxious annie Registered User

    Jan 2, 2019
    174
    Hi Wildflowerlady
    please don't feel guilty as you know you are doing so much to support your dad. It really does sound that his needs are getting so great that you and your sister can't support him at home with the help of carers any longer.
    I know what it is like to have a sister on at you that you aren't doing enough and it is left to them. obviously not true. My sister did visits to mum at the weekend for meals, laundry, shopping etc, and then I went to stay ( I live 3 hours away) for 4 days each month to take over, as well as doing all paperwork, Dr and hospital visits. my sister was getting worn down, and I could understand this as she works full time too, but she wouldn't let mum have extra visits from carers at the weekend
    ( they came in the week), but she felt I needed to come up more often! In the end I just sat her down and said I couldn't do anymore as had my own family to think of too and that we would have to get more carer visits if she wasn't able to do weekends, and eventually that's what happened. Mum eventually deteriorated more and has just moved into care. She is settling well and enjoying the company and activities.
    Please don't let yourself be bullied into going round in the mornings, you have your husband to support then. Write an email explaining that you have been told not to leave him in the mornings and that you will continue to help in the afternoons, with shopping etc., but can no longer help out on alternate mornings as you did before.Acknowledge that it is too much for her to go round each morning for breakfast, but say if the carers can't come in longer to make this, then perhaps it is time for full time care. keep your email brief, just stating these facts, then ignore any replies that are ranting at you.
    Good luck x
     
  20. MaNaAk

    MaNaAk Registered User

    Jun 19, 2016
    1,372
    Essex
    Dear Wildflower,

    Yes! I remember when dad was at this stage. We had just been told that dad's Alzheimers had become severe and that he would need full-time residential care within the year. I managed for a little while with the same care company until he became more aggressive and they said they would have to withdraw care and that he needs to see a doctor. I called my local dementia friend coordinator and she sent along a dementia nurse. Dad's donepezil was increased but we also looked at other care agencies and respite care. I booked another agency, day centre and respite. The agency and day centre both failed but dad got on well with respite and after another fall I put him in the home permanently.

    I think you and your sister should start looking at homes or at least putting your dad's name down. Local authority homes are cheaper and when your dad's savings go below £23500 they step in and give a financial assessment when his savings go below £14500 the authority helps out. Dad never got to this point it may be an idea for you to get in touch with your local authority for clarification. In my opinion you need to look at a home sooner rather than later before a crisis happens.

    Good luck

    MaNaAk
     

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