Delusions and RAGE

NanaPam

I've been taking care of my 86 YO dad for almost a year. We sold everything and moved in with him. His last neurologist  appt scored him an 8, he can pull himself together for a few minutes, but after a time he begins to just make sounds instead of words. About a month ago he began having delusions, which bring on rages like I've never seen before.  (He was a mental health professional,  and always super rational.) We're beginning the process of finding a care home for him. He's an alcoholic,  I don't feel safe around him and am beginning to lock myself in rooms rather than risk him coming up behind me.

My concern is, how do we get him into the facility? i can guarantee he wont go willingly (he still believes there's nothing wrong with him and WE are the irrational ones, all of us).  I'm envisioning him screaming and resisting while being dragged out of the house. 

MN Chickadee

Do you have power of attorney for him? You need a skilled elder law attorney if not. There are legalities regarding POA and/or guardianship that, if followed, do allow you to move a person to a care facility even if they don't want to go. From a logistical standpoint, we usually use therapeutic fibs and don't tell the person with dementia (PWD) that the move is coming or that it is permanent. The doctor wants you to stay here a while for your blood pressure or to get stronger etc. There'a problem with the heat at the house and you can stay here while we fix it. Each person is different and we find the right fibs that will get done whatever needs to be done.

*However* no facility is going to take him with the rage and behavior you are describing. He needs the care of a geriatric psychiatrist to get stable first. Some people see one as an out patient scenario, much like they see a neurologist or other specialist, but it sounds quite possible he needs an in-patient geriatric psych unit for a while to get stable and detox. The rage and alcohol piece are not something you can troubleshoot alone and requires a skilled professional. You do not want a regular psych unit you want a geriatric one which is staffed by doctors and nurses who specialize in dementia and its most challenging behaviors. Even if it is a long ways away, this is the setting you want and will be worth the distance. There a patient stays a couple weeks to find the right medications and then is released to wherever the family wants them to go, often a memory care facility. In some situations a family has to get them to the psych unit by way of emergency services. If he is a danger to himself or you please do not hesitate to call 911. EMS would come take him to the hospital on a psych hold and then you get him transferred to a geriatric psych unit (sometimes called a senior behavioral health unit) for the aforementioned treatment. Take video or audio recording of violence threats or outbursts if you can. You may want to call the Alz Assoication help line regarding resources and options in your area. It is staffed by social workers and the service is free. 800-272-3900. You may also want to talk to your local police department before doing this to get on their radar. PWD have hurt their caregivers, this is not something to mess around with. Identify/create spaces you can lock yourself into, always have your phone on you so you an call for help. Remove/hide fire arms and anything that could be used as a weapon (knives, golf clubs etc.) Please seek help asap for the safety of both of you. 

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NanaPam

Thanks for the response.  Currently,  one of my siblings holds POA, which is fine, we're working together.  I'll start searching for a geriatric psych unit now. 

He no longer drives, we took his keys (all of which are hidden in our safe), and his license has been revoked.  Of course he doesn't acknowledge that. I do buy his liquor as we're afraid of dt's, but its very well watered.

Iris L.

NanaPam wrote:

    (he still believes there's nothing wrong with him and WE are the irrational ones, all of us).  

Welcome, NanaPam.   You are describing anosognosia, a characteristic of dementia that causes the PWD to truly believe he is fine.  If you confront him with reality, he will resist and become upset.  Learn the work-arounds from the members, they know what to do.  Don't expect cooperation or agreement, you will have to work around him.

Iris

M1

Pam, if he is a danger to himself or others, and it sounds like he is, you can have him taken to the emergency room and hospitalized involuntarily. Then he will likely need to go straight from there to memory care. Good luck, i just went through this in March. I certainly empathize with how difficult it is.