New Here: Dad still driving, working, making treatment decisions, but also raging....

mymouse

Hi Everyone, I am new here and just looking for support to help my brain from melting. My dad a 78, in good general health. An Engineer/Scientist who is still working in his field. Lives with wife, drives, manages finances, invests, travels, etc. He has been diagnosed with either early dementia or Alzeheimer's (depending on the md)... has seen/is working with the best providers at MGH and Brighams in Boston... He has always had a quick temper (loud, argumentative, irritable), but now has become rageful and nasty and won't de-escalate for hours (I am a pro at de-escalation, mental health professional and also been his daughter a long time)... Twice in the past 6 months strangers have intervened when he has been yelling at me in the street (in front of my small children). This degree of rage and being intentionally nasty is new. He has also begun to be a bit fiesty with the kids. He refuses to take the SSRI he has been prescribed for this because he "might" experience side effects. How can I not be angry? This is only going to get worse and he won't be bothered to take that medication (but he does take many others), just in case...

1) how do I stay sane? Not get consumed by anger? Not be consumed by grief? Not spend hours trying to have reasonable discussions with him when he is really just trying to taunt me into a rage fest. Help. I am losing my mind a bit ...
2) keep my kids safe. so far I have had to implement the rule that if he gets feisty I have to ask him to leave. This happens 1 out of every 2 visits.

(for emotional context he is my only living relative, and while we have always had a complicated relationship we have always been really close)

[His wife loves him but from an objective perspective is not a reliable ally because she has her own very specific agenda of doing everything very under the radar. Even though she worked as a geriatric nurse/nurse manager for 20+ year, and knows he has a terror of dementia (we have a family history), and had promised in front of me to tell him if she ever noticed anything, she elected not to tell my father about the symptoms she initially noticed for many Many months (before me of course since they live together). Once I noticed symptoms and told him (pretty delayed because I had newborns and was busy with that,) he said I was making it up since his wife hadn't said anything. (And yes, I have a lot of guilt for missing those early symptoms). I spoke to her to find out what her experience was, but she said she would only talk to me if I promised not to tell him we spoke, so he wouldn't feel betrayed? This delayed him getting assessed by almost a year because I was the only one saying anything. I can't imagine what she is or isn't sharing when she attends his appointments. But she isn't a great ally, because she again isn't saying much of anything about what she sees or experiences. And yes, I am judging her, but it is mostly because she is really mean,in general, and has a cover her ass mentality which is at stupid odds with my try to take care of every stray puppy POV. I can't even get a clear medical picture because they/he will only provide me with parts of the medical assessments/notes, and only by reading me snippets. Which is also mind bending because I arranged all of the providers and I have shared medical proxy with his wife. I do understand he wants autonomy. I just don't want to be screamed at for hours, either in public or in private. I am a mess. Thanks.]

eaglemom

First off welcome to the message board. I'm very glad that you found us.

First off, take a deep breath, this is a lot to take in & digest. However, the absolute most important thing is safety - certainly your kids and yourself. I don't know, nor do I need to know what him getting 'feisty' looks like to you. What I do know is that your kids shouldn't be subject to any level of his 'feistiness' period. Which means his behavior, not your rules, makes it necessary for him to not be around the kids.

You mention twice in six months "strangers have intervened when he has been yelling at me in the street (in front of my small children)." I'm so sorry that is happening to you and your kids. And the way it stops is to not be in that situation again. Yes, that means not seeing him for a time. I know that's painful, but what if in his ' feistiness' he somehow hurts you? Or you get hurt getting away from him? You have young children, and they are your priority.

I feel like I'm beating you up and nothing could be farther from what I'm trying to do. I'm trying to get you to see the picture that your dad has a broken brain and isn't helping himself. You have to protect the children and yourself first and foremost. And yes it hurts. It's wearing on you and that's not healthy for you.

Which bring me to a question. Why are you arranging all of the providers? Maybe taking one giant step back, removing yourself from his drama is what you should do. I don't mean to sound blunt, but he isn't your only living relative. What about your kids? I understand this is an emotional roller coaster, but for your health and the safety for children and yourself, removing yourself from your father might be the only answer for now.

eagle

H1235

Has he appointed a DPOA? This is the person that is responsible. I am so sorry you are having to deal with this anger. I obviously don’t know the whole story, but if you are struggling with the rage he is directing towards you consider what his wife may be enduring. When I spoke to the doctor about some of my mom’s issue she was so mad she didn’t speak with me for weeks. It was hard I can’t imagine if I lived with her or if she was physically or verbally aggressive. His wife may be in fear for he safety. If you have a medical proxy have you tried just taking it to the doctors office and asking for information. It’s often difficult for family to get a loved one to comply with restrictions or taking medications. Maybe it’s time to consider placement in assisted living. It sounds like his judgment is clearly impaired. A lot of bad things can happened if he continues to drive, handle finances, and make his own decisions about important medication. You don’t want to wait til something bad happens. I have read on here somewhere that his car insurance may not cover him if he has an accident an has been diagnosed with dementia. If he gets out of hand again you should consider calling 911. He would be evaluated at the hospital and hopefully you could request a transfer to a geriatric psychiatric hospital where they can force him to take the necessary medication. They can do this if he is considered a harm to himself or others. I hope you can figure something out.

housefinch

It sounds like he would not be accepted at a facility until his behavior is stabilized by either a geriatric psychiatric inpatient stay or at minimum outpatient management by a geriatric psychiatrist. You may not be able to make any changes for his safety like disappearing his car, etc, without him escalating to a dangerous level. He sounds like a very dangerous situation waiting to happen.