My father now has dementia and it is manifesting as verbal agitation. Today he argued with my mother for several hours and then with me for several more hours when she in desperation rang for me to come round. He argued and argued and argued and was really quite horrible to both of us. He even hit us both. He’s calmer now so I’m now back home decompressing.
How can we deal with this?
I have no advice but only sympathy. My dad has Alzheimer’s and unlike your dad will only argue for about 30 minutes. Still seems unbearable.
I’ve been told to treat them a bit like toddlers – don’t engage, just agree with them. But that hasn’t helped us.
Good luck.
Would antipsychotics help?
What was the fuss about? Maybe whatever he was arguing about could have been dropped. He didn’t want to change his shirt? Fine.
UTI maybe? I’ve heard that can cause this.
I’ve heard that “calming the senses” works well. Soft music, a dimly lit room, a favorite blanket, a favorite scent. I know these might not help during the middle of an ‘episode’, but if he begins getting worked up, it could help put him in a calmer state of mind where he is less willing to get uncooperative.
My father has mixed dementia (vascular and Alzheimer’s). There were several months where he became increasingly hostile towards me. I was his primary caregiver, as I was home most of the time. I eventually moved out after he tried to hit me. My mom later told me that he’d gotten violent with her, and it degenerated into a shoving match.
Contact your father’s doctor. If you haven’t built a relationship with them, do it now. Your father is no longer able to make decisions about his care, and you and your mom will need to do it for him.
Your father’s doctor may choose to prescribe a medication such as Seroquel to your father. Interesting medication. Depending on dosage, it can be an anti-psychotic, a tranquilizer, or an anti-depressant. I’d been saying for months that my dad was probably depressed. Depression can manifest as dementia or make dementia worse.
The medication may or may not help with your father’s logorrhea, but it helped some with mine.
Try to understand that your father’s arguments, hostility, and violence stem from constant, grinding fear. His world no longer makes sense. Things move and change places when he’s not looking. People talk about things he doesn’t remember. People he doesn’t recognize tell him that he can’t drive a car anymore or do many of the things he’s done his entire adult life. If your father is like mine, he can’t express that he’s scared or confused.
When you’re dealing with this, redirection is the king of of the day. Ask him if he wants to watch a movie, eat something, go for a walk. Ask him a question he can answer about something non-related.
Hang in there.
He only saw the doctor the day before yesterday.
When my father had Alzheimer’s, he produced as much verbal agitation as he previously had, as far back as I can remember. The only added symptom was throwing things.
If your father’s behavior suddenly changed between then and now, take him back in. One of the biggest problems with dementia is that other types of illnesses can maskerade as it, and it can mask symptoms of other illnesses. A sudden behavior change on your father’s part could be a trans-ischemic attack (where he throws a series of very small clots to his brain, they occlude blood vessels and are then swept away) which can be a prelude to a full on stroke.
Also something to consider, and it was with my dad, is it possible he’s self-medicating? My dad went from a one martini in the evening to three, then gave them up when his stomach was too sensitive, and moved on to wine. He was drinking at least a bottle of wine a day, possibly more.
If he hit you why didn’t you call the police?
What the caretakers at my grandma’s old folks’ home do is not argue. They watch the person, ahum so the person knows they’re paying attention, deflect any direct questions; if they’re physically able to overpower the patient without violence then as long as he lets other people sleep / eat / whatever he can rant all he wants, if he becomes violent or the nurses can’t move him to where they need him to be (a single woman should be able to put any of the patients to bed, for example) then he may get moved to the hospital floors and sedated.
Also, make sure you/your mother get any powers of attorney needed ASAP.
Redirect. We had to constantly do this with my mother whenever she went into an agitated phase. She once smacked my husband on the side of the head during an argument. My husband’s a big guy, and could have easily overpowered her, but he didn’t. Instead he got her to calm down enough to sit down and make her a cup of tea.
phouka is absolutely correct. To the demented mind, the world is a scary, confusing place. Think of them as a small child in an adult body, and think of what a small child does when s/he is overwhelmed, overtired, hungry, etc. Then react the way you would to a small child. This was my mother’s doctor’s advice, and once you mentally stepped back from her tantrum(s) and thought about this, it was much easier to deal with her behavior.
He’s calmed back down
No, he’s not self-medicating.
What could the police do to make this situation better? Arrest him? This is a medical situation - the family needs to work with this poor man’s doctor to get him proper treatment. If it were my father, I wouldn’t want him in a jail cell. If I were really afraid of him, I’d try for a psychiatric commitment. That’s not a job for the cops.
Because he’s my father, and he would get put in a care home.
Yes, for now. The fact that you’re asking us for help suggests you think the problem may return.
This agitation is new behavior, and the doctor needs to know about it even though it has subsided, and even though the last appointment was only a couple of days ago. I get the feeling that you’re asking for help on SDMB because you’re reluctant to go back to the doctor right away. This is a serious situation, and the doctor might be able to prevent a recurrence, or to reduce the severity of a recurrence. Don’t worry about annoying the doctor - it’s part of his job to deal with things like this.
Good point.
I feel for you. Towards the end of my Father’s life, he started to make less and less sense. I became an expert at changing the subject.
My friend’s mom became more and more combative/confused/dangerous to herself and to others until everyone agreed it was time to institutionalize her. It was a hard decision but she is no longer the Mom that everyone promised they wouldnt put in a home. Its exhausting to deal with someone who is awake all night roaming and getting into trouble and sleeps all day (and hits when anyone tries to care for her).
Now when she kicks/tries to bite/tries to escape, she gets a nice backrub with Ativan cream. Better living thru chemistry and no fussing about taking pills or shots.
My sympathies to anyone having to go thru this.
Yes, definitely at least call the doctor. Even if the answer is, “This is just a progression of the disease, sorry, but you’ll have to learn how to cope,” then at least the doctor knows that the disease is progressing, and has this new symptom to put in the file. When another symptom pops up in two months, it will be documented as a continuing progression, not look like two symptoms have popped up at the same time (which would probably trigger more invasive and aggressive testing than it really warranted.)
Acute confusion and belligerence is indeed part of the progression. But, as mentioned, it can also be a sign of a stroke, oxygen deprivation or an infection (commonly a Urinary Tract Infection) that would call for a change in treatment. Best person to figure out which it is would be the doctor. If he knows he took a urine culture two days ago and UTI is unlikely, then at least he can make that medical decision for you.
For in the moment advice, yes, keeping calm and trying to redirect his attention is about the best you can do. I find it’s sometimes helpful to agree to their demand with a delay. “Of course, we can go to the store this afternoon, after we eat lunch.” If you’re lucky and keep them busy in the meantime, they will often forget your “promise” by lunchtime.
Try playing some music from his teenaged years. I find that can help to put them in a better mood sometimes. I even had one lady who was in the late stages - she couldn’t really talk anymore - who came out of her fog when she heard a certain song, and danced with her husband and told him she loved him before slipping away again. They cherished those moments, as did I. Music is powerful.
While there is not yet scientific evidence to support it (a placebo controlled trial is in the work as we speak, but the results are not expected until the end of the year), I have read some interesting and promising case studies on the addition of coconut oil to the diet of those with dementia. I would NOT recommend stopping any medications or scientifically proven treatments in favor of coconut oil, but you might want to talk to his doctor about supplementing with coconut oil in addition to his medical treatment.
Of course safety - of him and of his caregivers - is paramount. If you need a sedative to keep him from hurting himself or others, then you need it. No one wants to drug Dad without need, but sometimes there is indeed a need for it.
You have my compassion. This is not easy. Keep doing your best, and maybe find some respite caregivers or Adult Day Care in your area so you and your mom can have the occasional break to recharge and make sure your own physical, emotional and spiritual needs are being met.
Playing music would be a good idea if he were not largely deaf… 