LO Aggressive & Emotional melt downs

SDomWalker

Hi Everyone,

i am new here and I am desperate for some insight. I have been my fathers primary caregiver since 2020. He is dealing with several terminal illnesses including Alzheimer’s. Within the last year his aggressive and emotional meltdowns has been more frequent. It’s as though someone turns a switch and he goes into attacking mode. I am the only care giver and have zero support from siblings despite asking for it on several occasions. His recent aggressive outburst was due to me trying to fix his tv which broke. When I couldn’t figure out why it was not working I told him I would bring my tv over so he can use it until I figure out what’s going on with his tv.

Despite several reminders about the plan, when I went to swap the tvs he flipped out and stated I lied about his tv being broke so that I can steal it, and give him a smaller tv. I tried de-escalating by speaking calmly and reminded him what we talked about, but he got more verbally aggressive and demanded I leave his tv. I did not feel safe at this point, so I left with the working tv. Of course when he went to turn on the tv, it was not working and since he couldn’t remember that it was always broken, he called my siblings and everyone that would listen, told them I have gone crazy, I was a liar, being evil towards him, and was trying to get him committed to a mental inside.

This was not the first time he’s had a freak out like this and each time I feel I’ll equipped and overwhelmed with trying to figure out how to support him. My therapist says getting him a regular therapist won’t help since his advanced Alzheimer’s makes it hard. But do you all know of any other resources that I can look into to help him manage these emotional outbursts? I can’t help him if I feel unsafe.

M1

welcome to the forum. It will likely take medications to control this. A good primary care might prescribe, but he may need a geriatric psychiatrist or neurologist, if he has one. I'm sorry.

harshedbuzz

Hello and welcome- I am sorry for your need to be here but happy you found this place.

I agree with M1 that medications likely need to be a part of his treatment plan. With my dad, who was already a difficult individual, anxiety upped the paranoia and crazy accusations. We saw a geriatric psychiatrist-- they're the specialists most familiar with the use of psychoactive medications in the elderly and those with dementia.

Also, kudos to you for having a therapist during this time. That's a great way to proactively "put your own oxygen mask on first" in order to take care of yourself and your dad. I suspect your therapist is correct about dad no longer having the ability (anosognosia) to recognize his own impairment and be able to take ownership of any part of this situation. He probably doesn't have the working memory or executive function skills to learn ways to reframe thinking and recognize when to implement the strategies he was taught.

It's unfortunate you don't have a village in this situation. Unfortunately, that is pretty common. You mention other terminal conditions. Is he receiving hospice services? If he qualifies, that might be a little help for you.

What's the living situation? It sounds like your dad might be living alone past a point where he should be. I wonder if a secure MCF would be safer for you both. Spending too much time alone could be part of what is driving the outbursts.

HB

SDomWalker

Thank you for your thoughtful insight @harshedbuzz & @M1 . This has been incredibly helpful. My dad is still living alone because he has refused on several occasions to go anywhere else. His social worker says the only way we can possibly override his demands to stay is to go to court to get them to determine with provided evidence that it shouldn’t be living alone. I am working on getting a bigger home so he can move in with me but without him being willing to receive support and these aggressive outbursts, I’m not sure that’s the safest option because I am alone with him.

He barely allows me to go into his doctors appointments and do things on his behalf because he is convinced I am trying to put him away and that I am evil, so the challenge will be getting him to be open to see a psychiatrist.

thank you though. This gives me wayy more information than I had before

MN Chickadee

I would add that sometimes people have to get their loved one a geriatric psychiatrist via in-patient because they are too uncooperative to go to a clinic or dangerous. This is often done via the hospital. If he is hospitalized for anything else that is your chance. Some people have to go the route of calling 911 during a rage. The EMTs would take the person to the emergency room on a 72 hour psych hold and from there you would have him transferred to a geriatric psych unit (senior behavioral health.) Very important it is a geriatric one, not a regular psych unit. These units are staffed by doctors and nurses who specialize in dementia issues and finding the right medication to stabilize them and make care possible. If you ever feel unsafe, calling 911 is a valid thing to do. Many here on these message boards have had to do that and have their loved one go to geriatric pscyh. Sometimes it is the only way to get your loved on the help they need. And PWD have hurt their families, don't take his aggression lightly. Make sure you keep your phone on you and have a safe room you can lock the door and call for help while you figure out next steps.

I would speak to an elder law attorney since it sounds like you do not have a POA for him. The attorney can help navigate getting legal authority over his healthcare and finances. You may have to file for guardianship. During the guardianship process he would be required by the court do do evaluations for dementia. I would take video or recordings of his rages so you have evidence of your reality in case he is able to showtime for short periods of time for doctors or EMTs etc.