Inappropriate Behavior

nbjc

How do ytou deal with inappropriate behavior such as: Coming to dinner with no pants on —NO PANTS, peeing in the garbage can, eating with his fingers, alcoholism, I don't know how much longer I can put up with this. What can I do?

sandwichone123

Hi nbjc! Welcome to here, the place nobody wants to be. Read widely on this board, as there are many suggestions for the issues you may be facing. It's hard to know what may be going on, but I'll talk through a little.

For many people with dementia, getting dressed is just not something they can do independently any more—they need more help. Sometimes when you see a change in behavior it's caused by stress or anxiety and medications can help. Sometimes a sudden change in behavior is caused by a urinary tract infection (UTI), and antibiotics can help.

Those are a few samples of what may be going on. Someone may need to take care of other behaviors as well, such as inability to pay bills or make wise decisions, so a priority, if you haven't already taken care of these, would be to get a durable power of attorney (DPOA—allows someone else to conduct business on their behalf), power of attorney for health care (allows someone to make health care decisions and find out health information).

Again welcome! Keep asking questions and keep reading—there are people here who have coped with almost anything that comes up.

nbjc

I have the DPOA and the Health Care Surrogate. I am having trouble getting a neurological appointment for him to get a diagnosis. I will need a dx for him before I can get any REAL help won't I? Honestly, I do not know how much longer I can deal with this stuff. It's been three years and it's getting worse and worse. I have taken over everything that needs to be done. I do all the driving, the cooking, the cleaning, extra cleaning because of his bx, laundry, shopping, bill paying, banking, communictyions, maintenance. Everything.

terei

What sort of help are you looking for? Do you want to place him in a facility? Start looking for one, ideally one that you can sign up with a visiting Dr that you can sign up with so he can be assessed by an experienced Dr. and medicated if need be. Make a plan to get him to a facility and go from there. There are many postings here that describe how this can be done.

You sound at the end of your rope and need some relief. If it was me, I would get him to a MC and get some perspective. Remember, if it doesn’t seem to be working out the way you expect, you can always bring him home.

easy23

Alcoholism makes the dementia symptoms worse. I would first work on getting your DH to his primary care physician for a physical. If you can message the doctor via the patient portal or send him/her a letter before the appointment spelling out what is going on would be helpful. In the meantime, try watering down the alcohol or substituting the wine/beer with non-alcoholic versions.

My DH had a neurologist and the doctor didn't do anything to help with symptoms and medications. I got more help from a geriatric psychiatrist. Many of them do telehealth appointments - you just have to find one that takes insurance If you can't private pay.

If your husband gets really out of control, try bringing him to the ER and say that he has altered mental status. You may be able to get a diagnosis from there.

Good luck. This is incredibly hard to deal with.

SDianeL

welcome. Sorry for the reason you are here. What I learned here is that you can’t reason with someone whose reasoner is broken. Learn all you can about dementia caregiving. Read the book “The 36 Hour Day”. And search online to dementia caregiving videos by Tam Cummings or Teepa Snow. He need 24/7 care. They make clothing for people with dementia that they can’t remove. They fasten in the back. That means you would have to assist in toileting. He has forgotten where the bathroom is. Try putting night lights to mark the way, put a sign on the door, get a light for the top of the toilet tank, change the toilet seat to a brightly colored one, put toilet bowl cleaner in the tank that turns the water blue. They make disposable mats that go around the bottom of the toilet to catch any leaks. Get him on a toileting schedule, taking him every 2-3 hours. Talk to his doctor about the alcoholism. That’s not an easy fix. Does he go buy the liquor himself? Can you water it down or replace it? Come here often for info and support. We understand what you are going through. 💜

H1235

The number one rule with dementia is never try to reason with them, it usually turns into an argument. First I would pick your battles. If it doesn’t matter, let it go. Next, do what needs to be done without telling him or consulting him, behind the scenes. Try distraction to get him off a difficult subject. Lastly fib. As others have suggested, water down the alcohol, tell him they didn’t have his favorite brand of beer and get him alcohol free. If he refuses to use a fork when eating, serve him finger foods. Maybe you need to get used to no pants at the dinner table 🙄. Peeing in the trash is tough. Is he doing this because he is confused and doesn’t know where he is? Is he doing this all the time or after drinking excessively? He sounds very uncooperative! Do you have a DPOA? Have you considered placement in a facility? I assume he would refuse to go (many do). There are ways to get him into a facility even if he doesn’t want to go. Most involve fibs. The right facility will help you get him in and settled, even if he is angry and protests. Keep in mind that a facility can have a waiting list. You are in a very difficult situation. So sorry.

sandwichone123

While it's great to have a diagnosis, it's not a game-changer. If you are thinking about a facility, even very peripherally, start visiting them now. They will do their own assessment before admission and do not depend on an official diagnosis.

Robert1320

https://alzconnected.org/discussion/74975/inappropriate-behavior

I worked as a nurse's aide in assisted living while I was in college.

Patients wearing no pants or clothes was not unusual. It would take 3 people to dress them.

That and his other behaviors suggest that it may be time for some form of assisted living

harshedbuzz

@nbjc said:

How do ytou [sic] deal with inappropriate behavior such as: Coming to dinner with no pants on —NO PANTS, peeing in the garbage can, eating with his fingers, alcoholism, I don't know how much longer I can put up with this.

This is going to require some serious self-reflection on your part. Not all people are cut out to be caregivers. Some can rise to the occasion under certain circumstances depending on the cooperation of the PWD, their other obligations, their prior dynamic, the resources (willing family and money) and the length of the assignment. Maybe you aren't cut out for this and that's OK so long as you make other arrangements for the hands-on care.

The solution to what you describe as inappropriate are:

Dressing him in one-piece clothing that zips up the back. Disrobing is so common a behavior, there are stores that sell such items.

https://www.buckandbuck.com/collections/mens-jumpsuits

Peeing somewhere other than a toilet is common in dementia. For many this is due to issues with visual processing cause by the destruction caused by the disease. This above style of garment will also address the relieving himself in inappropriate places. Supervised toileting on a 2-hour schedule would also likely reduce this concern for you.

Eating with fingers is often the result of losses relation to the disease. It is more of a symptom than a behavior. Sometimes this is a regression back to a point where he'd not yet mastered eating utensils but lack of social filter and visual processing can be in play as well. Many folks switch to finger foods at this point or handfeed.

Alcoholism is a disease. Is his use of alcohol long standing? Or is it more recent and related to forgetting he's already had drinks? Is he self-medicating out of unhappiness or boredom?

For my mom, who felt as you describe, this short read was very helpful in becoming a more compassionate caregiver. FTR, dad had mixed dementia (one was alcohol related) and was not an easy PWD which made it difficult for her to dwell on anything but how it impacted her.

https://www.smashwords.com/books/view/210580?im_ref=UORSb2XCjxycW4iUy0w1uwO-UkpVaxXVw1hIQY0&sharedid=EdgeBingFlow&irpid=2003851&irgwc=1&afsrc=1

you also said:

I have the DPOA and the Health Care Surrogate. I am having trouble getting a neurological appointment for him to get a diagnosis. I will need a dx for him before I can get any REAL help won't I? 

Unless your documents are springing or you need to sign him up for disability, you can still move forward while awaiting a diagnosis. It can take time to get an actual neurology appointment, and the process of testing can also take months. You could consider starting with a PCP to rule out other conditions and perhaps a geri psych for medication for mood if needed. Starting with a neuropsychologist while waiting for neurology is also an option.

That said, I don't feel like we got any "real help" post-diagnosis beyond what mom paid for out-of-pocket in the form of his geripsych for meds, an agency for in-home aides and eventually a MCF placement.

HB