Depression vs just plain Meanness

Saya_G

I recently placed my Mother into a facility. She is having issues with being mean and hitting other residents. 

She has always had a dark side. As a kid we all learned the signs that would indicate to us that we needed to either make ourselves scarce or to be and do as she wanted and expected. Which wasn't always easy because she wasn't always consistent.

Since being diagnosed with dementia her doctors have prescribed anti-depressants for the past few years. They seem to have helped. 

My mother has ALWAYS demanded that we were NEVER to place her in a facility - she often declared that if she became too much for us to take care of her, "just leave me [her] to die!". 

Problem is that her needs did increased to the point that we can no longer do all that is needed to do to take care of her. And since we didn't see "just letting her die" as an option, we finally decided it was time to place her. 

So in her moments of clarity she is mean - we can be sitting and visiting, all seems to be going well - then her face changes and she starts being nasty (not a new behavior - just one that as adult I've not seen in a while). She is in a wheelchair due to bad knees, but she has started charging the nurses and other residents trying to force them to let her out. She has even hit/decked one of the residents (the resident did not submit a report, she didn't want my mom to get into trouble). But that resident is not the only person she has been aggressive with - at least one nurse and the social director have been attacked - they did not complain either, hoping she will adjust. 

I decided that maybe they had changed her meds, assuming depression. She is on so many anti-psychotic or anti-depression meds that I am not sure how she is functioning! That said, she still is! 

So, is the tendency to be mean stronger than the emotion of depression! Can meanness be mediated? As an 86 year old that has dementia, I do not thing counseling will help! 

They are threatening to kick her out! 

Any insights would be appreciated!

SusanB-dil

Oh, my, Saya - so sorry to hear that. 

I would check to see that the facility did not change any meds.  (i saw a post a while back that two different facilities tried to get PWD off seraquel - one in particular had not-good consequences) and also check with her regular PrimDoc and/or neurologist.  Tell doc the situation, and maybe they can change one or more meds to something that better helps.

harshedbuzz

Depression can manifest as irritability, aggression or meanness. 

My dad had a dark side- mental illness of some sort- I was more often on the receiving end of his nastiness until his dementia kicked in. Then my mom and his friends started to get a taste of the unfiltered dad. 

In the early days in MC- he was another who tried to extract promises not to place him specifically not naming a POA or creating a Trust to avoid allowing that to happen- we found he still had enough on the ball to behave if he had an audience, so we visited in the public areas.

Is your mom still in the facility to which you moved her "to be with your sister"? Did you see the same behaviors to the same degree when she was still in the facility from which you moved her? I wonder if placement in a facility that doesn't have dementia-informed care. Or if your sister is somehow triggering this behavior because of her own issues with the facility.

HB

Saya_G

Harshedbuzz,

As you are aware my sister does have her issues, but so does my mother - even when the other is not involved. Big issue with sis right now is smoking - she is driving ALL of us crazy asking to smoke. This issue with my mother appears to be separate from anything to do with my sister. 

The lay out of the previous facility has the main in and out door in area that is not in the common area of the residents. Even with that, they placed a bracelet alarm on Mom's wrist - it never had cause to go off. 

The lay out of the new facility has the main entrance central to the structure of the building. At first they did not put an alarm on her; the doors at the new facility are locked, with a pass code needed for entry and exiting.

Apparently Mom tried to exit when someone else was leaving. After that they put an alarm ankle bracelet on her. Now when she gets near one of the doors it goes off. I think the big change is that the alarm makes her feel more like a prisoner than before. 

  Still, she shouldn't be trying to beat people up to get out! From the descriptions of the incidents, it sounds like my sister hasn't even been around when my mother was aggressive with the resident and staff. Sis didn't even know that Mom had hit someone. 

I requested a list of Mom's meds, I have compared them to what she was taking before placement - I was surprised to see that not much has changed. That said, I am still going to ask for a meeting to evaluate the meds she is taking. Maybe she is taking a combination of meds that are cancelling out the benefits of another med, or causing increased aggression. 

Also to ask them to check for a UTI. I don't think this is a UTI issues, but just in case. 

Saya_G