Hi, I'm new here! So here's the thing...

redturnip

It''s been a while that we realised that my father had some kind of dementia but none of the doctors we visited gave us official diagnosis.

However, during the last two months he got worse and 2 weeks ago he fell into paranoia and he became violent. We managed to convince him to go to the doctor and he gave us diagnosis of Alzheimer''s and medication that slowly builts up through the course of a month and he started taking right away.

Since then he hasn''t become violent again but he is on and off on paranoid thoughts and aggressiveness.

The thing is that my father used to be a hunter and he owns shotguns which I took away from him since he became violent two weeks ago.

The last couple of days he is constantly asking me to give them back to him and I always try to explain in a calm manner that the guns are gonna be fine in my possession and he doesn''t need them anyway but he is threatening all the time that he will go to the police and that he will go on a hunger strike and calls and yells at me, and my mother that lives with him. I don't know what else to say to him anymore...

Moreover my mother has herself some neurological health issues and cannot always handle this kind of behaviour. On the other hand, when I told her that he should maybe live in a residential facility, she was very negative and didn''t even want to hear it.

May flowers

Welcome, but sorry for the reason you are here. You will find a lot of support on this board.

 I’m sure they checked for this, but if not, you may want to ask about UTI. My FIL has had dementia a while, but any sudden change in behavior, especially aggression, increased confusion, unsteadiness tips us off that he might have a UTI.

My FIL had a fall a month ago (requiring surgery) and was also diagnosed with UTI at the hospital. Before his fall he was very confused and walking very fast everywhere. In hindsight, I wonder if the UTI didn’t lead to his unsteadiness.

harshedbuzz

Hello Redturnip and welcome to the message board. I am glad you found us but sorry that you have reason to be here.

Ugh on the guns. BTDT.

What medication was prescribed for your dad? A SSRI (something like Prozac, Lexapro or Zoloft) can take several weeks to become effective and is generally used to treat anxiety and/or depression which can both reveal as aggression/agitation especially in men. If it's one of the antipsychotics (Risperdal or Seroquel) you should have a sense of what you can expect from the medication fairly quickly and it could be he needs a slightly higher dose. My dad was very much like you describe your dad and he ended up on a cocktail of Prozac, Seroquel and Wellbutrin which settled him down to a point where his outbursts and behavior were amenable to validation and/or redirection most of the time. That said, the paranoia became his baseline during the middle stages of the disease and wasn't something we could completely medicate away.

One thing I embraced early on was the notion of work-arounds in the form of "fiblets". It sounds as though you might be breaking the cardinal rule of Dementia Fight Club which is attempting to reason with a person who has a broken "reasoner". This never works and only serves to make the PWD more suspicious and upset. Compounding this is the likelihood that your dad may have some degree of anosognosia which means he is not aware of the scope of the cognitive changes he has had. In his mind he is just as he always had been and any conversations about dementia or cognitive changes is going to feel like gaslighting and ramp up the paranoia. 

It sounds like you are at a place where it's time to tell dad whatever will be easiest for him to hear rather than the unvarnished truth. To that end, you could make up a story about borrowing the shotguns to do a little hunting or that they're at the gunsmith being repaired. Then change the subject. Rinse and repeat.

I would contact local LE on their non-emergency line and explain that you have secured the weapons on the advice of his doctors. Does your dad still use the phone? Some PWD lose that skill fairly early on, others don't. Chances are his threats about a hunger strike are something he would likely forget as well. 

If you feel the meds aren't enough, videotape one of these episodes to share with his prescribing physician. My dad saw a geripsych who was much more open to medication trials than the neurologist. Dad's neurologist was great for diagnosing, but offered little in the way of meaningful assistance.

If your mom capable of dad's care going forward. When you say "she can't handle his behavior" do you mean it impacts her health (as would be the case in something like MS) or do you mean she isn't using strategies to calm the situation thereby agitating him? 

Early on my mom was in denial. It took me years- about 7 for a crisis that made it possible for me to make the evaluation happen and even then she didn't want to accept the realities of her life partner having dementia and all that entailed. This meant she often treated him unkindly because she believed he was more capable than he was which meant I was called to their house to calm things down- it was a difficult time. 

Your mom might benefit from a local support group or even a therapist. I found both for my mom because when I would suggest/model strategies to manage and redirect dad's moods and behaviors she wouldn't believe it was the right thing to do or would be effective. When her same-aged peers at the support group suggested the same things, she embraced them. 

This helped, too-

12 pt Understanding the Dementia Experience (dementiacarestrategies.com)

It took my mom a long time to wrap her mind around dad going to a MCF. She felt it was her duty to provide care until the end and she resented the cost of placement or bringing in aides to help. The night wakings, incontinence and his murder-suicide ideation finally convinced her. I had come up with a couple Plan Bs in the event of an emergency that made mom unavailable to provide care- I'd toured a dozen MCF and also had a SNF that would accept him on the fly if needed. When she was ready to place, I took her to tour 3 and let her make a choice. 

Good luck going forward.

HB