bhv, actually, you were saying if I snored too loud, they could wake me in the hammock and get me to tell a story about the man in the moon. You had also just opened the lodge so instead of snoring in a hammock I wrote myself snow shoeing in. I did wait for Lindylou so that I could tell her what I thought and that hit the target in the same way a lead anchor floats through the air with a thud. We always have exactly as many impressions as there are people in the room. The truth is I took a risk saying that I was waiting for her because that could have been viewed negatively. The man in the moon was put up front in that post for you, yes, but more in support of you opening the lodge and not honestly in the understanding that you actually wouldn't mind me telling a story.
The actual nuance of cause and effect doesn't really matter because in both cases the heart of the matter was trying to support, which this place and this thread are littered with. I was blessed with a very good memory. I know what it is to go through this and I will always know that. I know what it's like to grasp the rope and cling to it in desperation. I know what it's like to offer the rope and hold on with them. Pretty much everybody here does.
We worry about some like Mim and Cassie, but these experiences are probably among the most real and powerful things we've ever faced and for a pitiously long time. We do what we can, we save what we can, we struggle as we can, in one of the most overwhelming things anyone faces in life. The number of people that want to be long term caregivers in a fatal illness in the one we love - is zero.
I have some advice. Decide whether he really is a physical threat to strangers or whether he crossed the line with his wife (you). Whatever you decide about that, do nothing. For goodness sakes don't warn the social worker that he's threatened you because the presence of documented physical aggression is a deal breaker. If you don't know that he would be like that with anyone else and it doesn't happen at least occasionally, then you are creating a condition that you don't know exists - but which you can actually create without it ever existing.
There is almost certainly a level of shock within you that rightfully exists but isn't that uncommon in older men with dementia. Just ask our experts. What I recall from your posts makes me warn you that you may create a situation for fear of it happening where it is not sufficiently warranted - but where the warning of the fear of it is sufficient to prevent normal agencies from getting involved.
You are probably the only person with a minor chance of assessing the actual risk because you saw what his behaviour was. Has he shown any similar physical aggression against anyone else? Not words - physical.
Home care agencies have their own insurance. You can ask them about that but once again bringing up the idea of violence is the moment you yourself create the record of something that has never happened and is only a worry. What if she beats him with a nerf bat? Is anyone insured for that? What if he falls when the social worker is with him. Can you sue the social worker? What if the social worker is a black belt in Karate? Stop it. Just try and get some help. 74 year old men can be cantankerous shitheads. They probably already know that.
"Good thing for his survival prospects!" Ha! That's why he left when you stared him down. Who's threatening whom now?
If you ever want me to tell you a story, just ask. I'll take you somewhere for a few minutes for a short interlude in my so called life where I answer the door to the eager Jehovah's Witnesses unshaven and unkempt cackling "Is it good to eat , my precious???" (lots of cackling and hissing - think Gollom. It isn't possible to overact this scene.)
One day you're having a pretty good life with a pretty good guy and the next day you're changing his diapers and taking everything on yourself. The poop is an incredible strain on top of everything. This board always called poop the deal breaker. Give yourself a break. And remember, you're not alone. You have us. The strangest grouping of wingnuts since the three stooges met Frankenstein. Make that Frankensteen.
In the meantime - life explained in seven seconds:
Lessons on being a squeaky wheel. First give yourself credit for the level of care you are providing. Then let others know that level of care. Write it down so you don’t forget.
Toileting. You already know he needs assist.
Dressing. When he is covered with poo are you unbuttoning his shirt and unfastening his belt? Are you taking his socks, shoes or pants off to reduce and contain the ensuing mess? If so he needs physical assist undressing. I’m sure that counts as dressing. When he is finished with shower does he get dressed up again by himself? Dressing and undressing are usually used together.
Showering. Are you putting him in the shower and making sure that he is getting all the poo off? Soaping the cloth and handing it to him? Putting the water on and testing the temperature for safety. Checking and making sure he is getting all the poo off? Catching the stuff he has missed. If so he he needs physical help showering. This is much more than reminding.
Somehow, I think you are more involved in his care than you realize. Because you just mentioned because you did not shave him today he was not shaved today. I’m not asking these questions to be nosey. Just so you are aware of where you are on the continuum. Hope you don’t take this wrong. And I am carrying you in thoughts and prayers as you go through this hard time.
Thanks Lindylou. yes that helps. Charlotte also suggested writing down what I do all day and I have been working on that. In fact I printed out that discussion and took it with me. I read it just before going in to see the doctor and it helped me think more clearly and stand up straighter!
I have a bit of a dilemma when thinking about the VA. I don't really need financial help now or for the foreseeable future. There are lots of Veterans who do need that help. So, although I want to take advantage of benefits if they are there, I don't want to take away from people who really need that financial assistance. I really wanted help getting started and I learned a lot just by meeting with the Social Worker and asking the questions. And I got her list of places to interview. And I can contact her whenever I have questions. I think private pay home care will work better for me for now.
Even though it is a bit more expensive for me to see the VA for his medical care, I like the team concept so much and I like the doctor so much, I think I will continue with them. She is going to refer to neurologist and get the lab results and then the team will help me develop a long term care plan. And this will be in the system even if i move to another state. If i keep seeing her annually they will help me with the care plan as we go along. I think this is really a big thing. And even though he doesnt have a service connected injury I don't feel bad about taking advantage of this benefit for VietNam Vets who were exposed to Agent Orange.
Tricare changed contractor again. My doctor is not in their network, but paperwork may be in works. I've been thinking of changing doctors anyway. Meeting this VA doctor gave me some ideas of what to look for. Really wish she could be my doctor. Gonna ask her if she also has any private patients.
Ditto to everything Lindyloo said. Also, I don't see any reason to tell agency nurses that DH may be combative. A couple things: You can't know that, because he has not had a home aide. Who knows how he'll be? Also, as I think Wolf said upthread, home care agencies are well aware that demented patients can be uncooperative or combative--they know it's part of the dementia picture. The aide can't abandon the patient, but she probably will have been instructed to step outside to a safe location (usually her car) and call the office if she feels physically threatened.
Probably you'll need to start the aide on house cleaning, laundry, and meal prep. before she tries to help DH with the personal care. They can get acquainted with each other--she can discuss the personal care with him--just start gently with non-threatening tasks and see how it goes. You should just leave and let them get on with it. She will have a nursing supervisor she can call if she needs some wise counsel. Also be aware that it's not uncommon to rotate through several aides before you find the one that works out well. It's just the realities of home care. Even good aides (once you find one) come and go...call in sick...leave the agency...it's a revolving door in terms of staff continuity.
But this is as much for you as for him. So when the aide shows up, show her the care plan, tell her anything pertinent you think she needs to know that day--and get in your car and get outta Dodge!
VA doctors do not take private pay patients unless they work outside the VA too. My husband's neurologist only works with the VA one day a week. The rest of the days she works for a clinic associated with OHSU where she works with clinical trials too. I wish I could say I like hb doctor here but he is a lazy PA as far as I am concerned. When we first saw him he said he was experienced with AD patients. The last two years for his 'yearly' they do blood and urine, the nurse does the vitals but I have not seen him get up out of his chair to listen to his heart or anything else. I am disappointed because he had me excited 3 years ago that we had a doctor who would deal with any problems so I don't have to drive the 4.5 hours to Portland. I am considering paying for a Medicare supplement and take him to a local doctor.