How does one handle a Alzheimer patient who displays violent behavior?

OMG!!! It will most definitely get worse if you don't leave while you can. I live with my Alzheimer's husband who has been violent on many occasions - kicking me to the floor, twisting my arms till the have bruises, punching me and not letting me take a shower without barging in at least four times. I have told many professionals, and they turn a blind eye to the abuse, because it is an Alzheimer's person doing the abuse. I couldn't even get a Nursing Home in the area or within 300 miles to take him, due to his violent behavior. I love him, but I fear this won't end well. Good Luck.

You would be looking for psychiatry, not psychology. I think with dementia, doctors deal with the symptoms, not the damage to the brain itself, because the damage is diffuse and different in various patients, depending upon the type of dementia. I would think she's in the psychiatric ward because the staff there is trained to deal with unpredictable patients. I hope you find some answers and relief from her symptoms soon.

As to whether she was kicked out permanently, there is some disagreement. We initially thought so, but now, after I spoke with the director, they are saying she could come back. (I had a rather fruitless conversation with the director, trying to make her understand that it would have been helpful to know that certain behaviors would result in my aunt getting kicked out. If we had known they couldn't handle her, we never would have placed her there to begin with. And after being called at 9a.m. to "pick up your aunt right now or we are sending her to the local Psych ward", I really feel that this facility lacks any sort of understanding or compassion for families and patients dealing with Alzheimer's, so I would be reluctant to return her to them).
We consulted with the director of a memory care facility we had been considering for my aunt. That director sent us to a hospital ER, for the Psych evaluation. No one here seems to specialize in geriatric psychology, despite the fact that we are in a large city. The hospital is now saying she may have to stay there up to a week, because "it takes longer to sort this out with an older person". I absolutely understand that her behavior is awful, and dangerous to everyone around her, and needs to be stopped. What I don't understand is why this is viewed as a psychological problem, not a problem stemming from her diagnosed disease. When my father started doing crazy things after developing a brain tumor, this was treated as a side effect of his tumor, not as a psychological problem. Why is this not the case with Alzheimer's?
I really felt that putting her into a Psych ward was like putting a toddler there. Toddlers bite and hit when they can't express themselves effectively. My aunt has a similar problem,.

As to whether she was kicked out permanently, there is some disagreement. We initially thought so, but now, after I spoke with the director, they are saying she could come back. (I had a rather fruitless conversation with the director, trying to make her understand that it would have been helpful to know that certain behaviors would result in my aunt getting kicked out. If we had known they couldn't handle her, we never would have placed her there to begin with. And after being called at 9a.m. to "pick up your aunt right now or we are sending her to the local Psych ward", I really feel that this facility lacks any sort of understanding or compassion for families and patients dealing with Alzheimer's, so I would be reluctant to return her to them).
We consulted with the director of a memory care facility we had been considering for my aunt. That director sent us to a hospital ER, for the Psych evaluation. No one here seems to specialize in geriatric psychology, despite the fact that we are in a large city. The hospital is now saying she may have to stay there up to a week, because "it takes longer to sort this out with an older person". I absolutely understand that her behavior is awful, and dangerous to everyone around her, and needs to be stopped. What I don't understand is why this is viewed as a psychological problem, not a problem stemming from her diagnosed disease. When my father started doing crazy things after developing a brain tumor, this was treated as a side effect of his tumor, not as a psychological problem. Why is this not the case with Alzheimer's?
I really felt that putting her into a Psych ward was like putting a toddler there. Toddlers bite and hit when they can't express themselves effectively. My aunt has a similar problem,.

Are there geriatric psychiatrists working on getting her stabilized on medications for her agitation and aggression ? Was she kicked out permanently or asked to leave to get treatment ?

We have similar issues. My aunt was diagnosed with Alzheimer's about 8 months ago, although we'd noticed memory problems beginning 2 years ago. She's been in a retirement apartment with a full meal plan for the last 6 months, and has been making friends and participating in activities. Two weeks ago, she fell, and broke her arm and shattered her shoulder, requiring surgical repair. We had been warned by her neurologist that surgery would cause at least 6 weeks of agitation and combativeness, when we investigated possible hip replacement, previously. Our issue is that during the hospitalization, she became combative, sometimes hitting and kicking the staff. The hospital sent her to nursing care (back at her retirement home) 24 hours after her surgery, and the nursing home staff there insisted that they could handle her. Now, 6 days later, she has been kicked out. One staff member told me this was due to her hitting, another said it was because she kept trying to leave the building (it's not a locked facility). In any case, they handed her back to us, suggesting we try an ER for a Psych evaluation. She is now in a locked down honest to goodness Psych ward, for the next 3-4 days. She has already kicked and bitten people there. Having done some reading on this topic, it seems that this behavior correlates with all the stress and pain of the fall and the surgery. One article said that 50% of Alzheimer's patients in the middle phase go through these violent bouts. My question is, what do we do now to keep her in a memory care unit? What kind of facility should we be looking for that will be able to cope with these behaviors? We feel abandoned by the medical and care systems that are supposed to be helping us.

My dad, 91, who was recently diagnosed as an Alzheimer's patient, is now exhibiting a very violent streak. Shouting, screaming, spitting on food, hitting people, trying to burn things and threatening everyone around is a regular pattern nowadays. He starts getting into this violent phase almost every evening.

I am taking care of my 78 year old aunt, who can't remember things and so she gets very violent. Tonight it was a bout a possum. It's been coming in the yard a few months now. When she first saw it she thought it was a cat, that was a month or so ago. Well it ran across the doorway today, and scared the crap out of her, she ran in the house and said she seen something big. I said it was probably the possum we seen a month ago, and she freaked out and called me a liar, said she never seen it before. I tried to jog her memory and told her we seen it together, she got up and slapped me across the face and told me I was a liar.
So how to diffuse this situation? I just don't want to get beat up.
She is going toward the more advanced stages now, so when she forgets things she get very upset with herself and very mean towards me. It's hard to cope with because I hate it when she becomes nasty and angry and lashes out at me. I need help.

My sister has dementia. She is in Manor Care Nursing Home. I am told that she often reaches out and scratches an aide when the aide tries to give her a shower. What can be done to have this behavior stopped?

Is wanting and carryout household tasks and bedtime rituals to perfection and in exact order - OCD or just controlling issues? How do you tell the different in an elderly person? Their caregivers are pressed beyond normal if each thing is not precise and at the exact time.

I had this happen with my mom when I was taking care of her in Minnesota. Her boyfriend that she wanted to spend all her time with became increasingly aggitated over the seven years that she was with him, and would start yelling at both mom and me. Eventually the nursing home started limiting our visits to 15-20 minutes at a time with the workers watching. Just the slightest thing would set him off. He would misplace things or be unable to find them, then accuse others of stealing them, to the point of even calling the police. Often times I got caught right in the middle. I often wondered if they had even tried to give me something to settle him down so his temper wouldn't flare up. Finally he had a stroke and died two weeks later last year. With him egging my mom on, they were often behaving like "gray panthers", trying to get their cars back, trying to sneak out of the nursing home.

One thing is that they put Alzheimer's patients on some low dose anti-depressants and such. It helped calm my father drastically. It is said that Alzheimer's patients still grieve and physically deep within they still feel and that's why the lash out. I'm not sure, but I do know that the anti-depressants helped dad. Talk to his doctor or have your MIL talk to the doctor to help with this. A lot of new studies are helping with trying meds to help with symptoms at this point.

My father in law has been diagnosed with Alzheimer's. He is only 62 years old. He seems to get very violent with my mother in law and we are worried about her well being. I know that he would not make it in a home but I am afraid that when he gets violent with her one time that it might just go too far. He gets really crazy!! My mother in law is only 54 and still has a long life in front of her. She does not want to abandon him. She loves him dearly, we all do. We just don't know what to do.

It finally happened. My mother, diagnosed with Dementia 2 years ago, has been notified by DMV they have suspended her license. She is calling everyone to find out who did it? She plans to sue them after she gives them a thorough cussing. I have been called and denied it. I know her medical provider did this on the recommendation of a police officer. She was very verbally abusement to both the officer and my sister when she was pulled over for possible DUI. She hadn't been drinking, just driving at night. It was a terribly ugly incident but the very next day she only remembers she was stopped and politely gave him her license. I am happy she doesn't remember but her bad side can be very caustic to anyone that crosses her. There definitely is no mannual for understanding this disease. I am starting the process of legal guardianship which she won't voluntarily give up. This is definitely not the mother I knew just 4 years ago.

I knew a woman who waited until the man knocked her across the room (she was about five feet tall) before she "gave up." There's a point, no matter how much you love a person, where help is needed. In this case, the family needs to know and I'd think you should look out for your own safety.

Carol

m, perhaps I'm coming off a little harsh here, but will it hurt more to emotionally and physically separate and take care of you or will it hurt more if he has this gun and uses it (possibly unknowingly) on you?

Why do you have to feel guilty? If you present symptoms and explain to his family what is going on, you have done your part and all you can do. Why delay notifying family? At that point you have attempted to get him help.

Guilt comes by accepting that guilt that is laid on us. From the sounds of it, no one is forcing you to accept guilt.

I felt really bad when my aunt died. My uncle was left behind where he had mini strokes. I knew he was declining, but I knew no one from his family to contact. I am up north in the country, he was done in Florida. I could only do what I could. I received a phone call he had a major stroke and severe dementia. He died suddenly two weeks after being moved into rehab from the hospital. I'm helpless to get my mom's jewelry from her sister and there's nothing I can do. What can I feel guilty over?

With having no legal commitment to this man and from the sound of his "disillusioned" rage, I personally, would worry more about my safety than him at this point. But that's just me.

Please keep in touch and let us know how things are going.

Thank you all for the considerate and objective responses. No, he's not on medication. He doesn't have medical insurance and I have the option of putting him on mine now that we've lived together for 6 months as a domestic partner. He's healthy almost to an unusual point where he has absolutely no ailments...ever. The frustration appears when I try to talk to him about things like wearing the same clothes over and over. Or tell him that I never said I wanted something that he insists I did. The most concerning is the nutty road rage. From the minute he starts the car, we can't make it one block down the street without him aggressively driving, cutting people off, carrying on. I've told him how upset it makes me that he act the way he does. Honestly, he's going to express road rage at the wrong person and get us seriously hurt. He thinks the next door neighbor is "out to get him" so he bought a gun. I don't think he would know how to load it but the point is that there is a phenomenal amount of rage when he's walking around in his non-lucid state.

Or punishing me by not speaking to me when I disagree about anything and then no recollection that he caused a scene or that I walked around on eggshells until he decided he would speak to me.

In a nutshell, this person cannot be reasoned with and I have no authority. I was going to attempt reaching out to his children within the next week or so when I see them in person. I don't know that I'm strong enough to see this through. It doesn't matter that I realize his memory is seriously challenged...it still hurts when we're intimate and he doesn't remember who I am or assigns personality traits to me that people in his previous relationships possessed.

The ability to detach and just co-exist with this person is a hard pill to swallow.

Now writing this out it appears I've made my decision but it will still be a while before I actually leave because the guilt of leaving someone behind that needs help is overwhelming. I'm hoping my conversations with his children go well.

Thank you all for your support and allowing me to have a sounding board.

m

Does he have children and if so, have you talked to them about this? My father tried to do all on his own and became very stressed because of it. Since the incident with the neighbor (above) my sister and I became completely aware of what he was dealing with on a daily basis. He wanted to take care of his wife of 50 years until death but this Alzhiemer's is to much for one person to take on all alone. Now our family has come together to help him. We moved Mom into a memory care unit--though not the one we wanted. She is on medication and much calmer. Most of all they are both safe and my Dad is sleeping again. It was a hard move, but best for both. My sister and I took care of the details. I was happy to do what I could for both my parents.

I wonder if you told his children then all of you, as a family, could help him together. He might still refuse to beleive he could be ill, but you would not be alone in dealing with it. Best wishes.

Inthemidst, I'm not going to tip toe around this, although the disease of Alzheimer's, dementia, etc should be evaluated. That is not your responsibility to get for him. However, you are not married to the man. I do not need to know the details of the relationship, because technically that is none of my business, but...

... marriage is a commitment in sickness and in health. If you were married, you would owe him the commitment. People choose their situations many times, and the consequences of our choices can be either healthy or destructive. The question is, which way do you really want to go?

God bless you in your decision.

Thank you so much for the "you're right" advice; it is very loving and direct, and calming and reassuring. I think it would possibly work in more extreme situations, too. I will remember it!

Otherwise, and outside emergencies, I too would be asking why this behaviour is so extreme. What medication is that person on? Could it be causing these side-effects - hallucinations, paranoia, aggression? Alcohol? High blood pressure? These can contribute too.

Inthemidst, I wonder if you both still have your own homes?

If he won't get help, you could be in danger. It's good of you to care about what happens to him, but you must consider your safety, here.

You don't have spousal responsibilities or rights. You can encourage him to get evaluated because there are medications that can help early stages of some dementias and also you could tell him that his behavior could be caused by medication interactions, an infection in his system or something else that is not irreversible dementia. Either way, a doctor's diagnosis is essential if he is to improve at all.

If he won't get help, then you need to consider yourself. I hope you do. It doesn't mean you don't care. You can still encourage him, if it's safe for you to do so.


Carol

I started a relationship with someone who i believe may have Alzheimers now. We're both empty nesters and we were looking for companionship in a mate. The dating period wasn't long and I felt very comfortable taking our relationship to the next level. So, we're in a domestic union now and what I thought were "personality quirks" are actually early stages of the disease. I'm not a medical professional and he has not been evaluated (and would never consider) going to a medical professional for any reason. I'm faced with making the decision to end the relationship because I don't have any "legal" rights as a spouse but the guilt of leaving this person is overwhelming as is the desire to try and get him help. His lucid vs. his non-lucid moments are erratic and unpredictable at best. There is a strong potential for violence and that's what I fear although this person has not harmed me. He is very paranoid. I'm curious to know how others encouraged their loved ones to seek help in the beginning.

This seems extreme for even Alzheimer's behavior. The paranoia and fear are "normal" for the disease, but this horrifying chain-saw stuff and pulling a knife seems like more mental illness going on. Would she act on it? One wouldn't think so, but I'd consider a psychiatric evaluation as soon as possible (separate from her Alzheimer's, unless an Alzheimer's expert says this is part of the disease). If she has thrown furniture, etc. your dad may not be safe. She may need to be in a psychiatric ward until they can decide what to do or get her on meds to calm her. At the very least, she needs an evaluation immediately.

Carol

My father has been taking care of my mother who has alzheimer's and until this week has not wanted any help. I live an hour away so I don't see the day to day happenings.

I found out today that my mother pulled a knife on a visiting neighbor last week-end and threatened to kill her. The woman handled the situation and left safely but it brought things to a head and made my father realize changes needed to be made.

This neighbor said my Mom wanted to "take a chain saw and kill" all the people living next door. She also said she wanted to kill several neighbors and both my father and me. (Apparently she has no anger issues with my older sister.)

She also is constantly paranoid and sees many people in the house who aren't there. They steal her things and frighten her.

My Dad finally openned up to me today and said that she has thrown things at him, including furniture, and threatened him with a knife. I think this stuff is happening frequently. With the attack on the neighbor Dad has come to terms with the need to get Mom into an Alzheimers unit but right now can only get her on the waiting list. Until then she will continue living with my father in their house.

Is it possible that my Mom would act on the things that she says? Is it safe for Dad to be in the house alone with her?

I am so worried about my poor dad's world being changed, in two weeks, yet again. I will be moving him from my home to assisted living just 15 minutes from my home. I took him on a tour yesterday. He liked it until he found out how much it costs every month. He said, "we need to talk about this". All of a sudden he wants to talk about something, when he would just get mad at me or ignore me. He said he can't afford it. I said you have no idea what you can afford, and there are not other options right now. He said yes there is, I can go back to my home (1,200miles away in another state). I said no you can't, you can barely walk, and you cannot be left alone to care for yourself. I said, don't worry about anything, I am taking care of making all payments, all you have to do is relax and enjoy the activities, and let everyone else do all the work. I am worried about him adjusting, but it is a very comfortable place, where the caregivers are very happy and pleasant, and show a lot of concern and pride in their work. I'm still not telling dad that he is losing his home of 40yrs to a short sale. I think this would devastate him even more. My dad also seems to respond better to strangers, than to me. I'm not sure what to expect next in behaviors, since he has not had a brain MRI yet to determine what exactly is going on. He was diagnosed with vascular dementia with possible alzheimer's. This disease is so tricky, is the violence inevitable, or do some people not get violent at all? Could someone tell me what to expect next?

I found when dad starting getting aggressive, he would physically try to throw me out of the house. I would stand firm and just hold his hands. He would wrestle me, but I wouldn't budge with my hands down when he wasn't charging me. He would try to storm out of the house if I stepped away from the door, so I looked like a body guard. Eventually he would storm off so ticked off, and come out a minute later and ask me "Oh hi! When did you come in?" He never remembered.

What was weird, I could see it coming in dad's eyes. The key was to diffuse it before it began. So I would stand out of his line of site, but keep an eye on him through a mirror and "just appear" if he went to make a brake for it. I used to ask him for things, since he LOVES to help out. If the look in his eyes got fiery I knew I was in for a rough one.

Maybe others can offer some other options?? Now dad is in assisted living and he responds much better to strangers than to me. They know his trigger to distract him is asking him to "help" with things. He's instantly distracted because his core fiber and reason for existence is in helping. It works every time (well except for once when his world was being changed).

Hope this helps.

No matter what the anger is about or who it's towards, I always look directly in my mothers eyes, hold her hand and say "Your absolutely right. You know best." That always seem to snap her out of it. And she forgets what she was angry about.