Coping with agitation

Efi

Posted in the wrong forum.. newbie here.

 I am currently caring full time for my father who has moderate dementia.  His partner (not my mother) is away on a 2 week overseas vacation with her friends.  He has pronounced sundowning and gets severe agitation in the evenings. His partner is not answering his messages (phone calls, texts etc.) which is causing increased agitation.  It escalated to a punch in my shoulder tonight because I was cooking something in the manner his partner does.  

I fortunately the punch was not that hard so there were no injury.  I am looking for insight into how to deal with this situation and try to keep his agitation at a manageable level.  She returns in 4 days. 

PickledCondiment

Unfortunately, dementia sufferers do not cope with change or any disruption to their routine.  You may not be able to do much other than endure until the partner returns.  Has your father had an official medical diagnosis of dementia?  If not, getting an evaluation with either a dementia specialist or neurologist is the first step. Then an Rx to help deal with the agitation might prove beneficial.  Sadly, without medical intervention the physical aggression will likely continue and escalate as the disease progresses. My LO has Lewy Body Dementia and medication has been vital to keeping the level of aggression under control.

Efi

He has diagnosis of “dementia”.  I do not have access to his medical records so do not know if there was a more precise diagnosis.  His partner has the POA and has not shared much more with me.  We are grinning and bearing it. I think meds are out of the question right now given I don’t have any medical powers.  

If we could finger out his triggers that would be a great help.  He is starting at a high anxiety level with her gone so he escalates rapidly.  It does not help that we are in a one bedroom condo sleeping on an air mattress.  Doing our best to do right by him.  

Merla

harshedbuzz

Efi-

The others have addressed the issue of agitation, but I feel compelled to offer an opinion on the living situation. 

What is the nature of this relationship? A PWD is very vulnerable to a partner who is not a spouse taking advantage of them financially before abandoning them when the relationship no longer works for them or their partner's money runs out. Many families have been horrified to learn their LO is out of money and that decisions were made by the partner that have disqualified their LO for Medicaid. Often the person who was previously caring for the PWD feels a sense of entitlement as they've been doing the scut work that has allowed the adult sons and daughters to live their lives free of caregiving. It can get ugly.

JMO.

HB

​fesk

I'm sorry your father is having these issues and that it is so difficult to deal with. It seems the only thing you can do at this time is try to identify triggers, redirection, validate his feelings and try to calm him with other means - aromatherapy (try lavender in a diffuser), activity to use some of the excess energy, music, etc. Have you tried any of these things to manage the behavioral issues?

Quilting brings calm

You don’t mention if his partner is a spouse or a non spouse.  Your profile states that his partner  has been in denial and has the POA.     Are you and she on the same wavelength is to his continuing care?   You’ve just joined us this week because you’ve been with him while she is gone.  Has the sundowning and aggression been a problem before  her absence - is it the reason for her absence?  Is she not answering the phone or internet messages due to the time difference, phone or internet service or cost issues, or did she need a respite to be a true respite?  Constant calls do not make for a true respite. 

There are medications that can help.  Her having the POA does not stop you from taking him to the ER due to his agitation and his having struck you.   A Geri-psych evaluation could be needed.  

You need to become better informed about his medical situation.  If they are not married, people will advise her to turn him over to you for continued care. 

Efi

​fesk wrote:

I'm sorry your father is having these issues and that it is so difficult to deal with. It seems the only thing you can do at this time is try to identify triggers, redirection, validate his feelings and try to calm him with other means - aromatherapy (try lavender in a diffuser), activity to use some of the excess energy, music, etc. Have you tried any of these things to manage the behavioral issues?

These are great suggestions.  The aromatherapy makes me smile as that is so not his personality. He does get activity and has an exercise class (part of dementia social program) that seems to calm him more than his daily walks.  As I write this this I have calming music and today is better. 

Efi

harshedbuzz wrote:

Efi-

The others have addressed the issue of agitation, but I feel compelled to offer an opinion on the living situation. 

What is the nature of this relationship? A PWD is very vulnerable to a partner who is not a spouse taking advantage of them financially before abandoning them when the relationship no longer works for them or their partner's money runs out. Many families have been horrified to learn their LO is out of money and that decisions were made by the partner that have disqualified their LO for Medicaid. Often the person who was previously caring for the PWD feels a sense of entitlement as they've been doing the scut work that has allowed the adult sons and daughters to live their lives free of caregiving. It can get ugly.

JMO.

HB

Appreciate your point of views and you make explicit thoughts in the back of my head. 

  They have been together a long time (20 ish years) at the same time I do feel she resents me as I live far away.  Fortunately, most of his income is pension (Private and government) so she can’t get his money.  She does have all the powers of which does concern but he is not at a level of cognitive functioning where he could change these arrangements. My dad has an open invitation to live with me and my husband but his partner seems to be blocking that move. 

It is starting ugly right now.   As she seems to think my role in staying with him while she is on vacation was to block him from contacting her while on holiday. Tonight I empowered him to contact her.  His agitation went way down and boy was she pissed. Not my role to ruin what time I have left with my dad policing him to make her vacation more fun. 

They have 

Efi

Quilting brings calm wrote:

You don’t mention if his partner is a spouse or a non spouse.  Your profile states that his partner  has been in denial and has the POA.     Are you and she on the same wavelength is to his continuing care?   You’ve just joined us this week because you’ve been with him while she is gone.  Has the sundowning and aggression been a problem before  her absence - is it the reason for her absence?  Is she not answering the phone or internet messages due to the time difference, phone or internet service or cost issues, or did she need a respite to be a true respite?  Constant calls do not make for a true respite. 

There are medications that can help.  Her having the POA does not stop you from taking him to the ER due to his agitation and his having struck you.   A Geri-psych evaluation could be needed.  

You need to become better informed about his medical situation.  If they are not married, people will advise her to turn him over to you for continued care. 

The partner is a non spouse but they have been living together for almost 20 years so would be considered common law.  I assumed the common law trumped my rights but you raise some important points so I definitely will get better informed about my rights. We are not on the same page about his continuing care as I think he needs to be living with me or a structured environment as he doesn’t get enough socialization and needs more stimulation.  She has made zero effort to get him into day programs He has the income for a decent facility at the same time I think it cuts into her standard of living if he goes to a facility.   

The sundowning is not new and has been generally manageable. Mostly just talking through his contestan worries and some delusions (nothing terrible like people out to kill him).  The agitation is new and started as this vacation approached.   I though we could manage it and it just escalated when she didn’t contact him (I get the need for real repite  at the same time I should not put in a position of him getting violent when I am viewed as the reason she is not contacting him.). I know there are medications and did not think I could get them even through anER visit without medical POA.  

Thanks for the suggestions. 

Iris L.

I see a lot of red flags which have already been pointed out.  While she is away, figure out a financial plan.  He will need funds for future care.  If he has enough for self pay, you don't want him to have it lost or spent on other things, like overseas vacations.

Iris