Physical Violence

Ohh... no no. That is never acceptable! When this happens, need to call 9-1-1. Tell them about her diagnosis situation and have her taken to geri-psych. There, they should be able to get the right meds to calm her down and dial back that aggression.

Quitting your job will not solve the problem. Her brain is having trouble correctly identifying what's going on. He needs to learn not to press her on things, but she also needs additional medication. Many medications can be crushed or the tablet can be opened and added to food. However, she may need to be stabilized with a geri-psych hospitalization before those solutions will help.

He needs to make plans and not include her, than bring her on board with "fiblets," answers that fit into the story in her head rather than trying to get her back the reality they used to share. She may need placement, but the behaviors will have to be controlled before that can happen. If they are far from you, they shoulld be moved closer unless you really do want to quit your job and move there to become their caregiver.

He should not ignore the violence and should lock up or get rid of all the weapons in the house including kitchen knives.

It’s my first time posting on here. I’m just kind of looking for someone with similar experiences. My mom is violent. Don’t quit your job. Sometimes work is a good distraction from the reality of losing my parent. My dad is my mother’s caretaker and he was resistant as well to her diagnosis. We also had to remove knives from the house or lock them up. Ask your provider for a liquid medication that you can slip into her drink. Your dad has to be well to take care of your mom…as much as it sucks we had to adapt to my mom’s reality. Instead of trying to convince her that no one was in the house I just had to chase out the “intruder”. It saved me time and earned her trust at least for the moment. Sometimes you have to meet people where they are. I don’t consider it lying to my mom when I feed into her hallucinations because it it real to her. I look at it as more of compassionate care, like when I kiss my baby’s boo boo. My kisses don’t heal skin but they make them feel better.

@dreamofstars

I am so sorry you are dealing with this.

There are 3 approaches to this situation. Quitting your job and financially impacting your own retirement isn't one of them.

The first is solving the dad-problem. So long as he is triggering this behavior by pressing on a person with a diseased brain, this will continue. She's likely showtiming for you— this is when a PWD holds it together for friends, doctors and family who aren't with them all the time. If you were to become her 24/7 caregiver, you'd likely become the focus of her ire should you need to prompt her to eat, shower, dress or anything else.

The second is the medication problem. Check with the doctor/pharmacist about medications that can be crushed and hidden in her food or beverages. Behavior is communication— she's telling you she needs help.

The third approach is the hail Mary. You could document her behavior with a video recording on your phone and have her transported to the ED for admission to a geri psych unit for medication management. From there, assuming she is doing better, she could come home or be transported to a MCF.

HB

"But he's very resistant to lying or doing things behind her back."

The goal is for her to be safe and calm. Her brain can't handle discussions that require her to process or decide abstract things.

Discussing things, reminding her of events or prior agreements will just cause her to react emotionally. She won't understand or remember cause & effect. And there can be visual changes, drain crystals can look like coarse salt.

That's why a lot of people place their loved ones- to get them in a controlled environment where actions aren't as dangerous as in a functional home.

It is one of the losses of dementia that as the patient moves farther from who they were, caregivers need to do the same and place distance.

"Yes dear", " Let's watch a show", changing topics takes the place of shared discussions. The partnership has changed. It's lonely. And unfair.

And your Dad may not be up to that type of "role playing" , not everyone can handle being with & yet separate from a close loved one. The caregiver has to act almost like an employee saying Yes to the patient -boss and then doing work a rounds , when for years they got to perhaps set the tone and have their opinions acknowledged and obeyed .

The other advise you've received is great , esp on meds.

@dreamofstars said:

But he's very resistant to lying or doing things behind her back. I am going to try to talk to him more about this somehow hopefully away from my mom some time this week.

and

she needs to be medicated but I'm not sure how to handle that. I don't feel comfortable sliping medication into her food and neither does my father at this point.

You've gotten some great advice.

Behavior is communication. Full stop. Your mom is struggling mightily with confusion and anxiety that she no longer has the cognitive skills to process effectively.

There are best practices in dementia care that include joining her in her world because she doesn't have the reasoning ability to join yours. It includes validating her feelings and her reality. And it means telling her what brings her comfort rather than what is comfortable for you.

In some PWD, medication for anxiety is needed to dial back the anxiety enough that the above strategies work to be effective.

None of us here looked forward to a day when we would have to tell our parents and/or spouse lies to get through the day. It was very difficult for many of us to take the leap that went against everything we were taught and the standards to which we keep ourselves, but it is what is best for our LOs, so we got on with it.

I know my mom struggled a lot with the concept of fiblets. She was in denial regarding how impaired dad was and she felt lying was disloyal. So, every evening for a time, he would hit the evening sundowning hour and she would respond honestly to his barrage of demands, and I would get a call to come put the fire. It got old fast as it was completely unnecessary. I finally got her to an IRL support group that told her exactly what I had but she listened to them as peers. That might help you both see this differently.

Not to infantilize a PWD, but the kind of behavior you are describing is something seen in the later stages of the disease progression. Stage 5— "Catastrophic Reactions— may be easily annoyed, agitated, verbally or physically aggressive if asked to perform an ADL, IADL or answer questions" (from DBAT) This scale puts the cognitive and reasoning abilities at the same level as a child between 8-12. If I had a child that age, they would not be deciding whether they wanted to take a necessary medication or not. YMMV.

HB

One thing I would say is that to the extent you can get medical assistance, especially geriatric psychiatric or mental health support, I cannot recommend it enough. My mom was moved into MC and many things built up during her adjustment phase to where she was physical with staff. This was completely unacceptable and they tried to manage it as best they could. Things came to a head one day and she was completely out of control. The MC unit called 911 and mom was in our local Emergency Department on a psych hold for days before being transferred to a geriatric inpatient facility for more than a week. To say this was traumatizing for all of us (self, father, sibling, mom) is an understatement. I say this knowing that getting your LO to consent to psych care may add another challenge to an already challenging situation. I wish you luck and I'm sorry you're dealing with such a stressful situation.