Dear Family Advisor

My mother, who suffers from dementia and alcoholism, wants my sister and me to be her caregivers, so she keeps sending away the one we've hired.

Last updated: Jun 09, 2008

My sister and I hired a caregiver to come into our mom's home once a week to cook, clean, drive, and generally keep things going. We have taken over the management of our mom's money, as she couldn't cope with it anymore, and we did a careful budget so that we could afford this. However, my mother is very upset about it and keeps sending the caregiver away when she arrives. Sometimes this is because she's just confused and upset or drunk, but last time she was shouting at the caregiver that she couldn't afford to pay her.

I think the problem is that my mother wants my sister and me to do the care giving ourselves because it's more comfortable for her and keeps us coming to her house. At first we tried, but we have full-time jobs and families and couldn't manage. Plus, my mother is a very difficult person, and it's hard to be around her. We hired the caregiver in desperation. How do we get our mom to accept that she needs (and can afford) a caregiver once a week?

As difficult as it may be, you must insist that your mother allow the caregiver into her home. Don't budge on this. On some level, she needs to grasp that you and your sister simply can't do her household shopping and chores. When you're there, don't pick up the slack or do work that a caregiver could be doing. If you do, she'll keep this up. Given her issues, you can't reason with her, so don't try.

You also need to find a caregiver your mother can't push around. There are caregivers and Certified Nursing Assistants with years of experience who can handle your mom with humor, kindness, and a good dose of firmness. The caregiver works for you and your sister, so it doesn't matter if your mother sends her away -- it's her responsibility to stay and do her job. Go through a reputable agency so you know that the caregiver is bonded and insured. It's worth the money.

Some caregivers just have a knack for winning someone's heart. It may take time to find the right one, and that person will need to have a thick skin and enough patience to let your mother rant until she settles down, but it will be worth the time you all put into it. A good caregiver will also have tricks to diffuse the situation and distract your mother with food, television, or a conversation about her life, career, or children.

You or your sister should plan to take off a couple of days and be there the first few times the caregiver comes. You can help her get acclimated and help your mother get comfortable with a new person coming into her home. You may also need to be there to unlock the door if your mother doesn't answer it.

In the meantime, consider the possibility that, whether it's rational or not, your mother may fear that you'll visit her less if she accepts a caregiver. While you don't need to spend your time attending to her household needs, I hope you do still plan to spend time with her. You might even point out to her that hiring a caregiver allows you two to spend your time together doing something you both enjoy. Hopefully, she'll even become less difficult if she can be at ease with this setup. If not, just know that you're loving her by doing what's right for all of you, and by taking good care of yourself.