Rapid decline(6)

ElleSS

For the last 2 years I’ve suspected my now 80 year old dad was started to get dementia.  It seemed ok- and my two sisters and mom did not want to do anything about it.  The last month has seen an incredible decline in his memory and he has started having rages and unbelievable paranoia.  I live about 45 minutes away and do not have a great relationship with him.  I am now worried that he might turn violent or do something crazy.  I am incredibly worried for my 78 year old mom who lives with him.  I don’t know what to do.  The rages seem a bit much for someone who for other intents and purposes really just seems to be at the early mild stages.  I managed to get him a neurobehavior appointment to hopefully get a better diagnosis but he has been fighting with me at all points.  Is this normal?  I don’t think he’s acute enough for a hospital to admit him but the situation is destroying my mom.

terei

Your mother must be prepared to call 911 if he becomes aggressive.   Sometimes the best course of action is to get a PWD to an emergency room + then on to a geriatric psych ward for assessment + meds to moderate their behavior.

If ask if his behavior is ‘normal’.  I would say it is not uncommon + yes, he may become violent and/or do something crazy.

My best advice is that if he threatens your mother at all, EMTs should be called in.  If that is the way you get him to a dr, so be it.

ElleSS

Thank you.  My sister is visiting this week and I’ve told her if he starts raging again she might need to call 911.  I don’t know if my mom would do it and I am really worried that once my sister leaves I won’t hear what’s going on.  Earlier today my 7 year old was doing her virtual piano lesson and he called me raging that people were stealing from him.  Neurobehavior appt is on Thursday.  We are looking into temporary conservatorship.

star26

My response is the same as terei. I’m so glad the appt is very soon. Don't mention the appt to him anymore. See if you can just get him in the car on Thursday for an outing (hopefully he’s not driving!) and bring him there. You can tell him in the car or after you arrive that he has a check-up. Hopefully you or your sister can accompany them so you get the real scoop and know that everything was communicated? 

It wouldn’t hurt to have one room in the house with a lock on the door and a telephone that your Mom can go to if needed. You’ve got to drill into her that she must call 911 if he’s out of control. Tell her it’s for HIS health and safety just like I assume she would call if he were having a heart attack. If you do need to get guardianship, it sounds like it might work best if the guardian is you or a sibling in lieu of your Mom. It’s no bargain for you, but you might be the most effective and proactive. 

Emily 123

Check for a UTI?

ElleSS

Due to covid precautions, they are only letting one person go with him.  Since I will likely be taking him to most of the appts in the near future we decided I should go.  The conservatorship is likely necessary- he is too paranoid and has a history of noncompliance with medication and treatment plans not to mention I’m really concerned he’ll do something crazy.

M1

Elle, have you communicated your concerns to the doctor's office so they know what your concerns are? Because of course he's going to deny everything, and it may enrage him to have any discussions in his presence. I would suggest sending a long email today (Wednesday) so it's all in writing. He may well need hospitalization, are you prepared for that? He may be so enraged by the appointment that he refuses to go or walks out, and you may need a contingency plan.  You also don't want to take him home afterwards and have him take it all out on your mom. The more you can think ahead, the better. This is very hard, I wish you the best.

Look at threads in the spouses forum from lady Texan, she has a good list somewhere of things to do to protect yourself. Your mom may need that. Maybe she'll repost it for you.

ButterflyWings

Elle,

Some people have also videotaped their LOs raging so the Dr. has an idea what is happening, should your dad be able to "showtime", and hold it together during his appointment. This can be done with a cell phone, without being obvious. It is worth practicing how to turn on the video cam when this behavior starts, even if you only catch the audio of him acting out. And coach your mom on how to do this too. It could be very important evidence of what is actually happening, to get this dangerous behavior under control.

Are there guns or other weapons in the home? I don't know what you mean by "he might do something crazy", but my DH was grabbing knives, hammer, bat, big garden tool, etc. to use on imaginary intruders at night. I had to remove EVERYTHING that could be used to attack (or fight back in his mind), lest someone get hurt or killed. (Like me or our son, awake or asleep, since dementia doesn't care).  You mention this is "destroying your mom". It seems urgent to get him a gerispych stay if you can. Good for you, for getting him to an appointment asap. I hope he goes. My DH will not anymore. =| 

**And I agree with checking for a silent UTI. Sudden behavior changes (to the bad side) often signal a urinary tract infection, I've learned here. It is like jekyll and hyde, but improves within 24 hours after the antibiotics start. 

ElleSS

Something crazy = physically attacking my mom (no history there of this but his rages are so unpredictable) or leaving and going somewhere and causing some damage.  I thought about videotaping earlier and asked my sister to get him on camera.  Most of my interaction has been over the phone and I have many voicemails of his raging.  We are very aware that he may need hospitalization and likely long term care.  I need a definitive diagnosis to ensure the conservatorship goes through and to get him placed.  He will fight this and hate us but my mom needs to get out of that situation ASAP.  I don’t know about the uti- he obsesses over his bodily functions and claims he doesn’t eat and sleeps very little.

MN Chickadee

Make sure you get word to the doctor ahead of time of behaviors so he or she has the whole picture. In the event you end up not being able to get him to an appointment even with therapeutic fibbing and finesse, calling 911 during his rage is the other course of action. They will take him to the hospital on a 72 hour hold. There they can assess him and have specialists see him to see what is going on, and then transfer to a geriatric psych unit to get him stable. Try to stress to your mom he could hurt her. It has happened. Getting him the help (diagnosis and treatment/meds)  he needs, whether via the emergency room or a clinical appointment, is the right thing to do for him. Imagine living in his world, how awful and scared he must feel. She needs to get him help for his own quality of life as well as her safety.