How do you care for an Alzheimer's patient when they have aggressive behavior and hit their caretakers?

my mother has had alzheimers for awhile but I don't know how long. I wasn't aware of anything until my father died feb 1 2014. then the next year my brother died who was taking care of her nov 2015. I'm the oldest but my brother was taking care of her. so when he died it was left up to me. we all became aware that something was wrong with her. I wasn't totally aware though until my brother died. my husband and I would go to help her with some things as she was living alone in a large house. I decided while she was not too far in yet with coaxing from some friends to get durable power of attney and medical power of attney and her will taken care of and have her put me on her bank accounts. I thank God for the coaxing. I live in another town 4hrs away and I began to realize she shouldn't be by herself. she didn't want to leave her home though and fought for about 2 years. as time went on she got worse. she is very demanding and aggressive in her talk. she was on no medication but about 26 vitamins. she studied vitamins and other health matters for 10yrs. I tried to get her into an assisted memory care facility and she didn't like it. the day her furniture was going to be moved to it she said no way she wasn't going to be happy. over time the neighbors and anyone who dealt with her didn't want to deal with her and she was being taken advantage of by some young boys who would come to mow her grass. I was there so often I noticed all of this. finally I managed to get her into a facility that I loved and the people there as well. I was told by them they could handle anything. within a month or month and a half when I went to pay her rent I was told maybe this isn't the place for your mom. I freaked out ...I asked why...they said she put her hand over another persons mouth and asked them to be quiet...in other words she touched them. I was told then I would be getting a 30 day notice...then later this woman was sitting in her place on the couch and she threw her drinking canister at them. it didn't hit the person. her nurse said that she had been given a different medicine and they thought it might have caused her to act like that. so they took her off and she was better acting. well, that 30 day notice still stands. I'm going to visit them this week and speak face to face figuring out what to do. I got in touch with the seniorcare people and they said that the place she is at sees her as combative. and if they put that on her record no where else will take her. she was moved in june 21, 2017 and its not aug 27, 2017. I don't think she has had time to register that this is her home and be adjusted to the medication. for a place who advertises that they can handle most anything ..what I see is they aren't. my mother is 84yrs old and is very very healthy otherwise..she walks and talks to people and feeds herself ..she can take care of herself. I feel offended and angry and totally stressed out. she is bossy and she tells people what to do not the reverse...but I was told by the place she is in that this is a regular symptom of alzheimers...I took her to a neurologist just for a diagnosis and she acted like she didn't want to do it and I told her not to mention that she was checking her for dementia of any kind that this was just a check up. when it was done the neurologist ran out of the office and I had to catch her and ask her well what is her diagnosis and she said okay she has alzheimers and some psychosis and now my job is done so I wont see her anymore and sent me to some other place and that place told me I had to get guardianship over her. I read what that was and I didn't want to do that yet. I have the other powers of attney and that was all I wanted. I don't want the government involvement in our family matter. so as it stands...what I see is that my mother did touch the womans mouth trying to get her to be quiet as she was yelling her head off as I heard it and the other was a result of the medication they put her on. so in essence they are responsible for that last behavior. she does bang on things not people and she cusses up a storm. but she does talk to her nurse a male nurse and gets along with him really well. so, we shall see. what I'm finding is that while searching for a place for mom ..of which I used them to help me with that..i discovered that these so called memory care facilities or Alzheimer places want only people in wheel chairs who are comatose. they don't want to deal with working with Alzheimer patients. one place I went to the person involved in getting you there...said she didn't want any bothersome patients or behaviors...none at all or she would throw them out...I was so upset I never went bk there to bother with them.the nurse they had though was wonderful and worked at a psychiatric unit before and would have been great. I feel hopeless at time and angry as these high cost places cant do what their advertising says they can. to me that is false advertising. they get you in and get your money which isn't cheap and then they cant do what they said. I do say its all about the medicine after having read your articles. thank you it helps me a bit.

Bonnie, hugs to you! This is an absolute nightmare. I can only imagine your distress. I sincerely hope they can come up with an effective combination of drugs.

While those drugs may work for some - for others they are hell on earth. My husband was put on Aricept -misdiagnosed with Alzheimers - had PTSD and Normal pressure Hydrocepheleus). He completely flipped out - I called Dr. and after 3 days a very nasty Dr. - after telling me over and over that the Aricept couldn't possibly have the effects I described - said "Well take him off of it and see what happens!" I did - next day after waking confused. He went upstairs. I followed. He looked at me and around our room - asked where he had been and said "I don't EVER want to go there again!" While some dementia remained - nothing like the scary stuff we went thru for 2 weeks. Zoloft seemed to take the edge off the PTSD (note he was a WWII vet and the PTSD came back after all those years - younger psychiatric Dr. hadn't even thought of it. Our internist caught it because his uncle had had it.)

My husband has Alzheimer's and is currently in the hospital, and has become violent (at night usually). He has caused a one-on-one aide to go to the ER with a wrist injury. Now the Doctors are telling me he is too violent to come home - he has threatened to take a pair of scissors to stab me and threatened another aide with wanting to stab him. No lock down nursing home in the area will take him, and they are telling me he may have to go away to a state hospital. They might as well sign his death warrant. He got violent really bad after he was put on Zyprexa, Ramadon and now is on Serequel. It is a nightmare I can't wake up out of. He went into the hospital on Father's Day weekend after we moved from our apartment (of seven years) to a first floor apartment. He got confused and depressed from a bad move. Everything that could have gone wrong did go wrong. Now he is on so many drugs, I don't know which one is causing him to be so aggressive. He was aggressive before, but I always managed to talk to him and get him calmed down after awhile. They Doctors want to keep him on these medications to see if he will improve, so they can dump him in the system I am beside myself. Bonnie O.

Luvida Care Solutions has been very helpful for us. 7 years ago , we came to know about Dad's Alzheimer condition. He has been living at this memory care center since then.

My husband is on 125mg. of Depakote 3 times a day. I put him in the car of Friday and took him to the doctor. the Doctor put him on Benadryl once or twice a day as needed. He was so agitated on Sat. he paced as fast as he could for three hours after chasing us down the hall when we tried to leave. They finally got him to stop and yesterday he actually was still and we watched the golf tournament on TV for a while. Today he seemed more like himself than I have seen him in a month or so. He went straight to sleep after lunch and I came home. He definitely needed a nap. They will only give him the benedryl once a day if he seems too sleepy. It definitely works! Don't think it was the Depakote that was causing the agitation. They said the levels in his blood were low and will do more blood work in a week. Thanks for responding to my post.

artforlife... ALL psychotic meds can do the exact OPPOSITE of what they are supposed to combat! When mom started the Exelon patch she went from being a funny, witty, affectionate person to a person who wandered, was EXCESSIVELY violent, and just generally NASTY! When I took her back off the patch... those symptoms remained! Please keep a VERY close eye on the meds the doctors prescribe. If you see adverse reactions DEMAND those meds be changed or deleted from his regime. You have that RIGHT! Good luck!

does Deprokote ever work in reverse? How long does it take to calm agitation. My husband has been in a facility for 5 weeks and he seems more confused and is agitated, walking, and walking...almost pacing as fast as a human can go. they have incerased the deprocote to 500 mg. twice a day about a week ago but I haven't seen any signs that he is calmer. He seems more confused. He is on Citalopram for depression too and is still on the Exelon patch. I would say he is in the later stages of the disease and cannot do anything for himself. All his words are nonsensical. he started 18 years ago with the feeling that something was not right and retired because of it. He was diagnosed about 11 years ago and at that time could not answer most of the questions they asked him in the testing and could not draw the face of a clock. We just need to get the agitation under control. Will the depakote do the trick?

There are many reasons for dementia patients to be aggressive... just as many reasons as there are moods... and not all Alzheimer's patients react favorably to psychotic medications. My mother becomes even more psychotic when she takes Lorazapam or Zyprexa or any of the others.

To be perfectly frank, the best advice I can give you is to stay out of reach when your father becomes intractable. My mother has two times a month that she is totally fractious... one week during full moon and one week during new moon. The phases of the moon really do affect dementia patients. Start tracking your father's mood swings. You will probably discover a pattern. Then, alter YOUR responses during those time frames to soothe his ruffled feathers.

Good luck!

Okay, I feel like I should start by saying,Hi my name is Ruth and I am new to this forum and dealing with dementia... LOL Seriously, I am only into 1 week caregiving at home for my boyfriends grandmother. She is angry,violent, hits, kicks calls me everything but a whitegirl... I find myself having to use extreme humor in my mind when an 85 yr old woman jumps up with her walker and comes after me saying" i'm gonna kick your ass"... I can not laugh in her face and I guess her wanting to kill me etc is exercise for her while she comes after me. What makes this hard is in 5 min she loves me,is so sorry etc just for the next horrific episode. We took her to a Neuro appt this past Mon. 4-1-13, MRI brain on 4-3-13 hope we get a result and definative dx soon!!!!!!!! Doris never showed any signs of aggression until after Monday's appt. I called the Neuro last night 4-3-13 after another really bad attack on me (she yells at her grandson but does not attack him) He phoned in some ativan today and my bf is gone to get it now . I do not know why she hates me so much??? I cook,clean,wait on her hand and foot ,dispense meds etc... What the heck???? She thinks that I am the root of everything thats wrong . Help!!!!!

Galecki78. If I am not mistaken the doctor must refer your mom. Does she have home care? Because after mom came home to live with me we had home health care through the hospital. The nurse who visited was the one that advocated for my mom after hearing about my struggles with mom. It sounds like you are a good candidate to have hospice. Is your mom living with you? Your mom sounds like my mom in her last months. Mom passed away January 9 ...almost 2 months now. Check into all the resources you have available. There are agency's out there to help you out. Area of Aging and Disabilities is a great one to check into. If your mom has an income low enough she can qualify for help. I would call her doctor and tell him/her about what your mom is struggling with and see if you can be evaluated for hospice. Insist on it. They will come out and ask some questions and go from there. Good luck and god bless.

My dad was in the hospital from a stroke then went to rehab. From there the dr "prescribed" hospice. My mother was so convinced that dad DID NOT HAVE Alzheimers. She was so in denial. Our dr told us point blank, "your dad has alzheimers. It will get worse...not better". Hospice comes in daily to bathe dad. Our hospice nurse comes once a week. All his meds are delivered to the door. They supply pull ups, bed pads, etc. My dad has a few moments of clarity I think. Most days, he does not recognize us. WE are someone familiar. But there are days when he can get a little agressive. He tries to hit us and our aides on occassion. Seldom doing any damage. Just gets frustrated. Fortunately, my mom has a lot of help in my siblings and myself. We never really set up a schedule, but we want to take care of our dad and our mom. It just ended up that one of us is there are some point every day. My sister and brother live within 30 minutes and I live just 5 minutes away. We take turns driving them and taking food, helping mom with dishes, clothes, etc. We have never considered it a chore. Just an expression of the love we have for our parents who have given us so much. Dad is still able to sleep in their bed and get in and out of the shower. We have come a long way since that first day home from the hospital. In the beginning "hospice" was almost a dirty word. And it will be scary and overwhelming at times.
They actually sent someone that first day to ask about what funeral arrangements we had for dad. They really did not expect him to make it past 6 months. But daddy has thrived (as much as one can with that life robbing disease) being at home. I don't believe had he been placed in a nursing home that he would still be with us. I would call mom's dr and ask what the protocol was for hospice. I guess it is different for every patient. For us, it has been a life saver. It has been almost a year now. Our nurse and aide are like part of our family. They take good care of my dad. But they are only as good as you expect. My dad speaks giberish too. But he has to be reminded how to use a fork, etc. It is not a disease for the faint of heart or those that do not have a deep and unconditional love for the person they are caring for. I pray that you can get help. You cannot be afraid to let go a little at a time. It is not pleasant but it is the only way to get thru it. God bless you.

Mom's doctor just yesterday told me that Ativan was not suitable for someone over 80.

My mom is also at her last stage of dementia & is starting to be aggresive. I have a question about hospice because i am not too familiar w/ dementia or heard too much until my mom. i research on the web, but i dont know what to believe.My mom is really young(only 60) and has a rare , fast progressing ,form of dementia. Is hospice a form of treatment used for dementia patients? Can anyone recommend it for their loved ones? Or it has to come from the doctors? She no longer can speak, except giberish, can barely walk with assistance & is starting to have difficulties swallowing..

My mom also is at her last stage of dementia & is starting to be aggresive. I have a question about hospice because i am not too familiar w/ dementia or heard too much until my mom. i research on the web, but i dont know what to believe.My mom is really young(only 60) and has a rare , fast progressing ,form of dementia. Is hospice a form of treatment used for dementia patients? Can anyone recommend it for their loved ones? Or it has to come from the doctors? She no longer can speak, except giberish, can barely walk with assistance & is starting to have difficulties swallowing..

I fought back tears when I read your post and the other post. I am in the same situation with 2 parents taking turns doing the same things in Nursing Home care. When I go I feel bad, when I dont go I feel bad. I can't help their behavior, there's no talking, listening, pursuasion, compassion for me or others its just about them and they don't care or cant care less how they treat me or the staff when they are in this way. I feel terrible for their mental and physical health but its not my doing therefore I'm not in control of nothing other than seeing that they are well cared for. Mom and Dad are both on hospice care now and I am so thankful for their help. Dad has been to the Hospital twice in 3 weeks and this doesn't help him at all. He's back to refusing foods, meds, andytype of help he's hitting and wants to be left alone. Alone to what??? It's in-humane to just leave him alone. Here comes the tears!

Hospice has been a life saver for us. Our aide comes at different times, but she is normally there by 4:00 in the afternoon. She comes Monday thru Friday. We have developed a great relationship with Tomeka. There are days where she may finish with other patients early and she will call us ahead of time. Sometimes, we go ahead and bathe dad if he has had an accident. But they will still come to provide, diapers, bed pads, etc. All medicine is delivered to my dad's home. Mom calls about once every two weeks and all his medicine is delivered right to her door. We have a sitter who comes twice a week so mom can get out and just regain her sanity. We have tried Lorazapam, Ativan, etc for those times when dad gets a little beligerent. Does not do much good for him. I think he would have to have a horse sized amount for it to affect him. We started on this journey with one thing in mind. To do the best thing for dad. Our sitter came a few times for a couple of hours. Now she comes two days a week and stays for 8 hours a day. She cooks (at her leisure) and leaves the meal for my mom. She folds laundry and takes good care of our dad. She and our hospice aide have become part of our family. I would have no hesitation whatsoever in leaving either one of them alone with my dad. AT some point, you have to relinquish some of the caregiving responsibilities. There is no way a regular human being can manage this horrid disease by themselves.

You should better contact a psychiatrist, and also a neurologist. The first one is better suited and prepared to treat mental health patients. Also knows what medications can interact with the ones taking right now, and how to avoid possible secondary effects when the new medications are combined with previous ones. (You can make a better team if you add an Internist MD to this combo.)

Hello there!

I am a nurse here in canada and prior to taking my licensure i was able to work as a caregiver for patients with dementia and Alzheimer's disease. I had a particular patient who had Lewy Body Dementia. Lewy Bodies are abnormal protein deposits in the brain that disrupt the brain's normal functioning causing it to slowly degenerate. Its effects include degradation of cognitive functioning and degradation of motor control. Symptoms also include recurrent visual hallucinations and various sleep disorders. There are also behavioural changes, decrease in judgement, confusion and disorientation. This client was particularly difficult to manage because he was very aggressive and combative whenever he was disoriented.
It is very important for the caregivers to:
1. Establish trust and let the patient be familiar with the caregiver.
2. Create a routine. It helps dementia and alzheimer's patients to have predictable routines, especially around meal times and sleep times.
3. Modify Tasks. Break tasks into easier steps and focus on success, not failure.
4. Make behavioural changes. To help minimize the risk of fall-related injuries, you can help stabilize blood pressure. Help the patient stay well hydrated, exercise, take in adequate sodium and avoid prolonged bed rest.

My mom just entered a nursing home from an Assisted living two weeks ago. She had just entered AL last July. Her dementia got so bad that she just went downhill from the AL. Went to the hospital since she got really combative and they discroved that had a really bad UTI. She has dementia and is in a wheelchair since she was so weak from the hospital. she's just about forgotten how to waslk. Medicare cut off her NH funding after 10 days since she's combative and keeps fighting with the PT's and doesn't want to try to get better. She always sundowned around 3 to 7 at night. Yesterday I went to see her around 10 a.m. and she was totally combative threw a glass of water at me, cursed and screamed and told me to get the hell out. They couldn't get her to take her meds. Finally yesterday afternoon she took them but was still not calm. All I could do was cry, not for me but for her. The nurse told me that she was having a bad mornign and it wasn't personal. She told me to call before I go over next time so that they could tell me her condition at that time. Called again this morning and she was the same way. What do I do? Do I not visit her when she's this way? I don't want her to think I've deserted her? Any insight would be greatly appreciated. Thank you, Rita

Just a quick suggestion. I feel your pain dealing with my Mom who is displaying some of the same behaviors. Research the anti-psychotic drug, Risperdal. I have seen this used with adolescents with whom I worked for many years. It is working with Mom to calm her and help her be more compliant with direction. The Haldol did not work. The Risperdal did. It is also called; Risperidone. Geriatric doctors are familiar with this treatment. I will keep you in my prayers.

Just a quick note. Bless your heart, as I and my sister are dealing with the exact same problem with our Mom. We now have her on Depakote and Risperdal. Look up Risperdal. It is a psychotropic drug often used for teens that are struggling with psychotic type behaviors. It has helped Mom tremendously to calm down and be compliant with her care. Good Luck!

I agree this is common, and is very hard on families. I also have had good luck with depakote, I would like to know it any one has done a behavior log on your dad what time the behaviors are, what happened before etc sometimes this can be very helpful. If the times are late in the day at sundown time you could have aids with him at that time.And remember behaviors chage as fast as they come. Good luck

Thanks luvmom. I've sent an email off to his neuro already. Let's see what happens.

Fslack I totally agree with you. There are many of us that do not have the financial means to care for our loved ones as they should be cared for. Especially those with Alzheimer's or Dementia. It's outrageous how expensive the care can be to where alot of us caregivers contemplate giving up our occupations and do give them up in order to care for our loved ones because financially, there is just no other way. It's a sad state our elders are faced with in this country, I don't even begin to think about when I get there. Wow!
And what you mentioned about the doctor's not wanting to sedate the patient, only to the point of stopping the behavior, that has not been the case for my dad. When I have had to admit him, they are so quick to shot something through his IV to sedate him. In my perception, it is so that they do not need to deal with the bad behavior. But they tell me it is so that he does not "harm/hurt himself." Yea, OK! So why don't you send that some shot home with me to use when he gets like that again & we won't be here occupying a bed.
Sandiosandi, don't give up or give in. Ask millions of questions if need be and be firm about what you need for you father and the type of care he NEEDS, not what they only have to offer. You will find a good fit for him, just keep at it, it will come.

PS if your dad cannot swallow pills, as my MOm cannot, ask for the depakote in the 125 capsules, They are called sprinkles, I empty them into her prune mixture or you can put it on food but I prefer to make sure she gets every spec of it and the prune pudding I make keeps her more regular.

NO, the depakote doesnt knock them out once they are used to it. At first it seems to but then it levels out. I recommend you ask your neurologist or Dr for it, its fabulous and when my Mom went to daycare it was the drug of choice for most of them, safer than seraquel, etc. My Moms been on it for a long time and I give 250 mg at breakfast and 125mg at night. The dr said 1,000 mg a day is normal but no way does my Mom need that much, trial and error. I have tried to wean down to 125 in the morning and within 3 days she is a royal crab again. I now skip sunday nights and all is perfect. I had students in my class when I worked on it, the ADHD kids who needed calming down, it didnt make them sleep! lol. Write me anytime, I also have my Mom at home with me and left my job now to take care of her.
Luvmom

Sandiosandi, I am having the same issues with my dad, but I have him living at home with me and a caregiver during the day while I'm at work. It's like a boxing match sometimes & we're on the defense. He's in the advanced stages of Parkinson's disease with the dementia. I've been back and forth with his doctors and back again. I think their getting tired of me, but I'm not giving in or giving up. Something has got to help level him out.
Luvmom, does the Depakote make your mom drowsy or knock her out? My dad has been using Quetiapine, but I keep telling the doctors that all it does is dope him up and make him sleep all the time. That's not functional or any way to live. I will ask his doctors about this.
Hang in there Sandiosandi, prayers, prayers, and more prayers to all caregivers.

Oh thanks, I thought your Mom lived with you too, sorry. Good luck to you and your Mom, I know its hard but getting your Mom to laugh still are such treasured moments. My Mom loves to be sang to and just to put her head on our shoulders, touch is everything and I think that helps the grieving process because we do all we can do and feel good about it. Unlike, siblings who come a few times a year, lol
Luvmom

Hi Luvmom, I am fortunate to live in a large city suburb where the Hospice is simply amazing. I know they are not all the same. Hospice sends an aide daily for my mom, a social worker twice a week and a nurse weekly, offers me grief counseling (and brother do I need that!) and has a doctor, a neurologist, supervising her care in the facility she's in, which is not a Hospice facility. I can only imagine that what any Hospice can do you for is limited by where you are and how well the Hospice is staffed. Mine does supply all sorts of things, including her own supply of pain medicines on site, since I have a Do Not Transport order in place for her. Their supplies, paid for by Medicare I believe, have cut the monthly bills for her medicine/supplies down to around $20 from way bigger numbers.
I know you can purchase blue pads and such in quantity for much lower prices. If you know others locally with similar problems, you might do a co-op thing.
There are so few solutions out there for us right now, we have to think out of the box to come up with our own!
Sending you hugs,
Fern

fslack, I think that was me who mentioned Depakote, what a life saver!!!! The neurologist told me it calms the brain. She slept alot at first for a couple of months and then she was normal again. The depakote stopped those violent behaviors in their tracks and she not only acted better but when I asked her she admitted that she felt better. I would assume my Mom is in 7th stage, but she isnt totally bedridden, I get her up with a lot of coaxing and we walk small distances with two hands, maybe 5 feet, but we do it. MY question is to you is that I tried Hospice, she qualifed but they only had one person who would come "when they wanted" to bathe her and it was afternoon time, or when they could. My Mom needs to be bathed as soon as she wakes up as she is all urine, they did me no good. Do they supply diapers, bedpads? Thanks again.
Luvmom