Lots of anger, family telling me he needs assisted living

mrahope

Over the last several weeks my DH (diagnosed 4 months ago with "mild dementia") has been having many angry outbursts.  For instance, we had to have a building inspector come to our house and he was so angry the inspector could not perform the inspection and we had to reschedule.  Then last weekend, he got so upset at my DIL (who was visiting) because she "made changes" to our house.  The changes consisted in taking down some old posters that had halfway already fallen,  He got so mad he screamed at her and knocked over a wooden dining room chair.  She left the room.  My son tried to talk to him and then DH screamed at him to "Get out!".  Today he wanted to go and get whiskey that he likes and I told him he couldn't because he's on medications that make it unsafe. He told me he didn't ever have a drinking problem (true) and I should not have told him not to drink this despite that I had told him not to  have the whiskey because of his meds.

As if this wasn't enough, I am trying to get him to go to a very good day program which is near us.  We visited the program together and he behaved politely and agreed to have a "trial day" last Friday.  When I reminded him about this on Wednesday, he blew up at me and said the people there were a "bunch of losers" and  "how could I think that he would be a "patient" there. Asked again on Friday, still no dice.

My son and sisters are very concerned about my state of mind.  I have been taking care of him all on my own.  Nevertheless, he can do all of his ADLs.  He's just so tough on me.  I often feel like crying.  Is there a way I can force him to try the day program?  Should I look at some kind of residential care?  If so, how can I compel him into it, or is there no way?

FWIW, we do have a DPOA.  Anyone experience this much anger?  How do you cope besides hiding out?  

dayn2nite2

His aggression is concerning.  You probably need to contact his physician to discuss his anger and outbursts.  Maybe he can be medicated to dampen that some.

You can force him to the day program but unmedicated he will simply have an aggressive outburst and be kicked out.  No win there.

You also cannot place him until his aggression is treated.  Does he threaten you?  Act like he's going to shove or hit you?

At this time, you need to make sure your cell phone is charged at all times and on you.  I would also keep car keys in my pocket and you might want to pack a back and put it in the trunk with a few clothes in case you need to leave and stay somewhere else.

This can be a very dangerous time.  Please don't think it's impossible for him to hurt you.  If you search "dementia murder spouse" you will find a number of very disturbing articles that are true stories.

CStrope

What tests have they done on him?  Any chance it is FTD and not ALZ? The behavior issues are what's making me ask.

mrahope

Thanks for the replies, they mean a lot.  I always keep my phone in my pocket, and I'm fortunate that my sister lives about 1/2 hour away and I have a way to get into her house even if she's not there.  Good point about the car keys, though.

As far as the testing, he's had an MRI, carotid ultrasound, and two rounds of neuropsychological testing.  The neuropsychological testing report said only "mild dementia". 

The neurologist has said he doesn't think it's Alzheimer's, so possibly it IS some other type.

Gotta say, it's just scary all around.

Dio

Dayn2nite2 is right. First and foremost, consult with his doctor/neurologist who may prescribe meds to control his anger and check for any UTI or other infections. And if your LO shows any sign of dangerous aggression, DO NOT hesitate to call 911 for help. Let the dispatcher know to send someone who's trained in handling dementia patients. I've been there.

There are differences in treating symptoms depending on the type of dementia. Is he on any medications? Frankly, I find the neuropsych evaluations questionable in finding a solution.  While it's needed to assess a patient's state of memory and cognition, it doesn't matter whether it's mild or severe dementia. What matters is getting the right medication(s) to treat symptoms. Aggressive behavior is so difficult to handle. I'm really frustrated with our neurologist at the moment because he's hung up on deciphering which dementia instead of paying attention to my pleas for a solution to ease my DH's night terrors, which can get physically aggressive. Thank goodness our psychiatrist is accessible and prescribed a much needed medication to help him sleep better through the night.

Good luck and let us know how things go.

Ed1937

Dio wrote:

Dayn2nite2 is right. First and foremost, consult with his doctor/neurologist who may prescribe meds to control his anger and check for any UTI or other infections. And if your LO shows any sign of dangerous aggression, DO NOT hesitate to call 911 for help.

I fully agree. And I would ask for another evaluation on the type of dementia.

PookieBlue

Mrahope,

My DH had angry outbursts and was uncooperative for a number of months when he entered moderate cognitive impairment. It was an awful time. That was about 3 or 4 years ago. He was so frustrated and lost and was having such a battle with his brain. There were some threats, but I would distance myself and usually after about 45 to 60 minutes, he would apologize. Many times he did not remember what he was apologizing for, he just needed to do it for himself. Over time I got better and better at diffusing the situation and distracting him. I learned what topics would trigger the outbursts and steered away from those. They occur much less frequent now thank goodness. I haven’t felt he was a danger to me for awhile.

mommafour

mrahope - My DH is sliding into Stage 6 and was having a lot of behavioral issues consisting of anger (directed only toward me) and delusions until recently. I was much like you, sleeping with my cell phone, purse, and car keys next to me at night.  I was crying several times per day and stressed to the point I could barely function.  My 4 children have been very concerned about my health and safety and pushing me to get DH into a Memory Care facility. Since he can still handle most of his ADL's, I don't think he is quite ready for such a facility but I have been planning toward an Adult Day Care program while I am at work.  I realized that he would be kicked out of that program unless we got the anger under control.  He was recently prescribed medication that has finally resolved the anger issues, after a few adjustments. DH is doing much better, which also makes ME feel much better.  Maybe medication may be a solution for your DH? I'm back on the Adult Day Care search now, although I think he may react the same way your DH has.  

mrahope

You guys are amazing!  I am not sure which way to go at present, but every one of you has given me some new ideas.  My son and I have decided to seek the counsel of a CELA, since we already have a DPOA in place.  Perhaps it is time to activate my power to get him the kind of treatment he is refusing. 

I'm not ruling out some kind of medication, either.  It might be tough though, because as a former clinical psychologist, DH thinks he knows all about these meds, and they are for "patients" not for him.  Wonder how to get them actually into him if something were to be prescribed.

But the best thing is that I don't feel like I'm alone so much thanks to all of your responses.  It also helps me to feel like so much less of a failure.  I've felt like I'm trying everything I can think of, throwing literally all my resources into solving this problem and yet I can't seem to solve it or even make it more tolerable for both of us.  I've realized yet again that we're all on this journey, wherever it may take us.