Aggression and Refusal

amylokr75

I care for a 70 yr old woman with late stage AL. She has lately become very agitated, aggressive, angry and refuses to do the mandatory things in life such as going to the bathroom, showering and eating. She refuses help, calls me and her family that she lives with names, tell me she hates me and has even slapped my hand on several occasions as I try and help her. I am always very calm with her and her daughter has recently had to step in on a few occasions to squelch the situation.

My question is how do you make someone do the necessary things without having to go through hours of arguing just to get her to sit on the toilet or get in the shower? When I leave her house, I'm mentally drained from the constant arguing and backlash I get every single day. It makes it hard to go home to take care of my family. Any suggestions appreciated.

Unknown

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gampiano

It sounds as though she needs an rx for Xanax or another drug in that category. Family should report this behavior to the PCP or NP, as the case may be.

jfkoc

So how lately???? Maybe an UTI. I would rule that out as soon as possible.

Now re the hourwws of arguing. Neither argueing nor reasoning are going to get you anywhere. Yo are going to have to develope work arounds.

Going to the bathroom? She needs to wear something like depends. Tell her you are on the way to the bathroo and ask if she wants to go too.

Eating? Put some food out that she can eat when she is ready. Food that can be left out for a while and does not require utensils. Cheese and crackers, sandwhich...that kind of thing.

Shower? She may be afraid. Do your best to make it enjoyable..water the right temp, hand held shower head, place to sit down, warm bathroom, warm towels and always a treat to look forward to and remember she likely needs fewer showers now.

Remember to tell her "OK, when you are ready, I will check back with you later"

You will find that you are more creative than you think.

amylokr75

She is on Zoloft and all the forementioned things we're already doing. She wears depends, we set her food out such normally takes hours to consume a banana and a protein shake. The shower, she just hates, even though there's a very nice shower chair, a big walk in shower, nice warm towels, all the things.

As far as an UTI, she did have one and was treated 2 weeks ago. Her mood changed to the good for a few days, but we've recently backtracked a ton!! Sigh! We'll just keep doing what we're doing.

Marta

This is a situation where the family needs to step in and speak with your client’s physician to ask for medication to reduce the aggression and combativeness. It’s not safe for you or the family members. Specifically she may need an antipsychotic.

Iris L.

It appears that you may have to become more "hands-on" involved in caregiving. If it takes her an hour to eat a banana, she is functioning on a very low level. Can she take a bath by herself? Also, sometimes a UTI is not completely cured with the first dose of antibiotic. She may need more treatment. Pay close attention to voiding hygiene. She may be reinfecting herself if her bathroom hygiene is poor.

Ed1937

I think there's a chance that she might be infected again. When they ran a test for UTI, did they run a culture? If not, she might not have been given the best medication to clear the last infection properly. I would ask for another test, and ask for a culture with it. That's easy enough to do.

If that doesn't work, ask the doc for something to help with the aggression.

Marta

There is a new laboratory method for checking for UTI that is done by PCR - basically looking for DNA 🧬 and identifying it. It also tests for which antibiotics would eradicate the identified organism. The whole process takes 6-8 hours — same-day results instead of waiting 72 hours for culture results. Ask for “urine by PCR.”

If she regressed so dramatically in her behaviors, it may be a sign that she may not have cleared the infection.