Disabled spouse needs in home care but keeps firing aides

Anonymous
I work full time. My disabled spouse is mentally competent, but needs someone with him full time (or mostly full time) for safety and to perform all the activities of daily living. he is very particular though, and even if he finds someone who suits him, sometimes he will get annoyed with her over something relatively minor and will dismiss her in a fit of pique as being unsuitable. The expectation is that I will, of course, stay home with him until a new aide can be hired.

I'm really tired of this dynamic. When I bring it up to him, he complains that he is suffering severely due to his disability and I should be more compassionate. As the well spouse, I should understand and have empathy for his plight; he shouldn't be forced to bear the burden of poor care.

It really isn't possible for me to just leave him to his own defenses if we have no aide. He is helpless - can't get out of bed or use the toilet or get food and water on his own. So he needs someone. The next time he fires someone without getting a replacement, I really want to just let him stew in his own juices, but I don't see how I can do that. So what can I do? He is mentally competent and arranges his own care and pays for it, so I can't just tell them he has no authority to fire them. What can I do?
Anonymous
Is he on an SSRI yet? That might help him chill out and if he has pain, sometimes SSRIs help with that as well. If he hates the idea of psych meds, the pain route may be the way to go. Had a parent who hated all care onto put on Zoloft. Then, he liked everyone.
Anonymous
Anonymous wrote:Is he on an SSRI yet? That might help him chill out and if he has pain, sometimes SSRIs help with that as well. If he hates the idea of psych meds, the pain route may be the way to go. Had a parent who hated all care onto put on Zoloft. Then, he liked everyone.


Yeah, he is on antidepressants. That's a point though, I could ask him to talk to his doctor about maybe needing to change something.
Anonymous
Time to put your foot down. Tell him that as a family you’re running out of options. There are not enough caregivers for him to be firing affordable ones you find. Remind him that you simply have to work to afford life and that you’re exhausting leave options. Since he requires constant assistance, if there is no adult in the house then staying at home is not an option. You tell him point blank that as much as you love him he will need to go to be placed in a residential home for his care if visiting help doesn’t satisfy him. He’s behaving like a child and as such needs natural consequences to learn.
Anonymous
I manage my parents’ caregivers. A lot of them really do suck. We have learned however to tell the agency “we would like to phase this one out” rather than firing them immediately.

I would not assume your spouse is being unreasonable in his assessment of the quality of caregivers. They might be pretty bad.
Anonymous
Work on him finding a replacement before letting the current one go.
Anonymous
Time for a nursing home if he will not accept the care.
Anonymous
I know the struggle with a sick person firing aids, OP. But my sick person had dementia and they couldn’t hire new ones themselves. Can you have him handle it? “I’m sorry Sally isn’t working out. That sucks that she was rough helping you into your clothes. Is it bad enough that you are going to ask the care agency to send someone else? Remember I’m in the office all week, so there can’t be a gap.”
Anonymous
Anonymous wrote:I manage my parents’ caregivers. A lot of them really do suck. We have learned however to tell the agency “we would like to phase this one out” rather than firing them immediately.

I would not assume your spouse is being unreasonable in his assessment of the quality of caregivers. They might be pretty bad.


That's a good phrase, thanks for that! -OP
Anonymous
Anonymous wrote:Time for a nursing home if he will not accept the care.


That would be incredibly expensive, though. He's not my dad, he's my husband. We're still paying a mortgage and sending kids through college... to also now add on 100,000+ (not even sure how expensive that is) a year for a nursing home would burn through our savings really fast. And, he'd still need some kind of aide in the nursing home due to his very extensive disabilities. So, that's kind of an empty threat.
Anonymous
Is a day care facility an option? You could start taking him there
Anonymous
Anonymous wrote:Is a day care facility an option? You could start taking him there


No, he is homebound.
Anonymous
Interesting - caregiver-patient conflict is a subject of study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786744
Anonymous
Honestly, at some point, you have to leave home with depends, a bed pan, water and some granola bars and go to work. And I don’t mean this to be ugly. He is going to have to realize that you need your income.

I’m the spouse that is much more likely to be disabled young. We have young kids and my husband will have to keep working. So, I am going to have to accept help ay some point from outsiders or sit around in a wet diaper for some number of hours.
Anonymous
* leave him
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