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My grandmother has been home for eight days now. Her behavior is becoming more hostile and paranoid. She is injuring my pets with her walker because she doesn't watch where she's going and has doesn't care that she's done it. She got very nasty when she tried to show me a recurring automatic charge on her statement. I had tried to assure her that such a charge wasn't happening. I am torn between recognizing what is happening to her and her feelings and my own feelings about trying to help someone stay with their dogs and not go to a NH all the while being verbally abused. Is she going to get to a point that she's going to intentionally hurt my pets, me, or burn my house down?

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I work for a NH and help with the admissions into the facility. If Gandma is being abusive now start really thinking of a placement as I can tell you that if a person with dementia has bad behaviors you will have a hard time placing her down the road. Once a facility has the person in house and the behavior progress, we deal with it but it is very unlikely to take someone who has behaviors. (like almost never) as we must keep our other residents safe. In todays world, most NH cannot afford one on one sitters for those who have trouble fitting in. Just think about it. You might want to visit a few NH that have a memory unit or dementia unit. Good Luck to you.
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MOST elders with dementia are not nasty people before that starts.
MOST elders with dementia are expressing their fears and frustrations over their very serious losses...that is, it is not about you, the caregiver, but it IS about the elder who has lost their usual sphere of influence, their belongings, their loved ones, their house, etc....they cannot verbalize it in those terms, though, they can only fight back at teh world as they see it, and it is very confusing to a demented mind.
Meds can only, at best, slow it down, if that. There really is little that modern medicine can do to stop or reverse dementias....though SOMEtimes, someone will respond to having larger doses of B12 & folic acid injections weekly.
DO get a good Doc to examine and diagnose, to see if something can be done to modify the bad behaviors!
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Change and the advancement of dementia. I also want to echo what has been said about the disease taking big jumps and escalations during changes in context. Everytime we leave for a week or two and ship grandma off somewhere, or have a friend come and stay, she seems to be much worse for the wear.

We find she is the kindest and the least agitated... just like a two year old... when everything is predictable and on a schedule. Because of this I have hired someone to come every morning to bathe, dress, breakfast, clean the room and bath, and then deliver her to day care. That way, no matter what my kids come up with to do or go to, in the morning and no matter what I have to do, to go to work, there is no Bullying Grandma to find her glasses NOW!

Friday night had become a similarly difficult time. My son would get off the bus from a football game or a track meet and I would need to go pick him up. If my daughter was out, I was always conflicted about waking grandma up and dragging her across town or locking her in the house and praying she stayed in. God help me, if he wasn't on the porch of the school and I had to go looking high and low for him with Grandma half asleep at the end of my arm...So now we have someone come from Friday 3pm to Sat 3pm to do a 24 care give shift. That way I can focus on my children and their activities.

What does this cost and how does it compare to nursing home care? Close to the same--- 748 per week plus the cost of food. And my kids and I get to live here too. And since we had a major set back that is a HUGE windfall.


Breakdown
Day Care 47 per day. --- 228 per week
Showers and rides 60 per day. --- 300 per week
24 hour shift 220.--- 220 per week

The Key... (get this insurance for you and it will protect your kids futures) She's got long term care insurance... for the types of care we choose it is all covered except for the 300 a week for rides and showers.
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I like what Chimonger said.

I would add this about how to have a dementia live peacefully in your home. Think very hard about the other people who need to live in the home and continue to function and be radical with your choices of how each room services it's purposes.

My kids and I moved into my mom's house and we realized she needed to sit in our space and also FEEL like she was part of the action. But we needed her out of the way. She had become much like a poorly designed kitchen island.... this giant object that we chased around as we tried to work with her clueless and present..

So we turned the dinning room that was next to the kitchen into a TV room with a big sofa a coffee table that was big enough to do some kitchen and homework chores. Flat Screen TV made it so the TV fit on the wall opposite the kitchen. It became a favorite place for everyone to unwind at the end of the day

The kids need a space where they could do projects and read for homework where Grandma STAYED out. So we put gates on the formal living room, rewired it for the computer and printer. Put a recliner in there with a good light and a dining room table for projects. Gave each person a desk with good lighting and a little book case. The only season we have regretted these decisions has been Christmas, as there really is no sensible place for the tree.

Grandma needed more places to sit around. So we threw a canvas tarp over an old ripped sofa and put it out on the front porch. We got sturdy outdoor chairs so she could sit around while we did yard work or washed the cars.

That said my kids also needed places to sit around with their friends that grandma stayed out of. We made a little portion of the driveway that is away from the neighbors house and not particularly scenic the kids porch, with a picnic bench and some shade.

As we have done all these changes it is with the clear understanding that this disease and this age of my kids are both temporary and I want them all in my life.

To make room in our house for these spaces we realized none of us really needs too much privacy to sleep. We were like the Brady Bunch for a while with three twin beds lined up in a room. My kids never used their rooms but to dump their junk anyway. We have been very serious about locks, alarms and gates for the night as grandma was picked up by the police one night. We work hard to wear her out during the say so she sleeps at night.
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This is some really tough stuff! I never ever though of my Parents living in a NH but life happened and showed me that with all of my hearts desires and good intentions, I couldn't handle full time live in caregiving for either one of my Parents let alone both. I fully understand you wanting to keep Gma in her environment as long as you can, my Mom has been in NH care 1 1/2 yrs and STILL hates leaving her room door open although she has exprienced why it is necessary, Dad HATES the alarms and buzzers going off...even though he's usually the culprit of it. I get it that its hard and sometimes impossible to accept change and for that I have a lot of sympathy however, change is inevetible. Mom and Dad cannot live on their own and with their personality and mine...we couldn't healthly live together. They are safe, sound and well taken care of. I'm safe and sound, although when UTI's strike or another stage of dementia rises, demanding, mean, and general demise rises in my Parents my "sound" is in question.

I did what I needed to do for the best of all...Dad, Mom and me! And since we were the only ones directly affected, I sent everyone else on a one way ticket to...well you get it.

Kate47, you do what's best for you and your Gma. May your way be made clear as a crystal bell!

Blessings!!!!
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Is your grandma on medication for the dementia plus possibly antidepressants as well? In 2009 I moved to CA. to care for my 85 year old father who had early onset dementia. He was the MEANEST, most critical & unthankful man you have ever met. Refused any medications for antidepressants (his wife had passed away several mths before I got there) as well as the dementia meds. We moved him here to Irving, TX into a nursing home. Long story short about 4 months after being there (and he was put on the medications he needed to be on) he is now the sweetest man I know. Get Grandma to a doctor to be diagnosed! Good luck.
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Wow! Thanks for the all the information guys! My grandmother had a stroke and is back from rehab. We're having PT,OT,etc. at the house. Today was a shower. I was hard for me to see that she was so upset. Strange too that a shower that was nothing before is anxiety-inducing now. She loves those awful dogs of hers so I'm going to see if we can make a go of her staying home. She's lived with me for three years. She was miserable at the SNF because of the food, alarms going off, frequent staff rotation was confusing, and others hanging in the hallway in their wheelchairs was really getting her down. If it were me, I'd want to be with my pets and in my own environment for as long as I could. I'm going to read everything, hang out on this site, hope for the best. Thank you all so much.
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It is very common for elders moved to another place, to develop worse dementia, fast--it can happen within hours, and stays at that new level of deterioration, but will usually level off until the next move to a different room or facility or sudden change.
Their behaviors are not intentionally nasty, it is due to their dementia....SOMEtimes, a person is mentally ill to begin with--in those cases, it can be harder to tell where their mental ills leave off, and dementia begins.
It is very hard to keep the thought in mind that it is not about you, it is about the elder's loss of autonomy and freedom, when they are in your face with words and actions bent on harming their perceived torturers!

It is far better to find a facility that can take them in, so they have full time care.
DO explore what the rules are for "Estate Recovery" in your State.
SOME States even go after family members to repay the State for welfare care and benefits given, if the elder's estate has gone away--just understand those liens can be contested, particularly if by going after family would cause them to become welfare recipients.
You have observed the dysfunctional behaviors, and your gut instinct tells you, as well as other posters, and probably Docs could too, that this will get worse, not likely better.
If you are bent on keeping your elder with you in your home, or even if you need to buy time until a facility can be found, it is a good idea to make some changes in your home, if you intend to tough this out:
---Make sure dangerous items are locked away from elder access [meds, weapons, kitchen utinsels, etc].
---Make sure your private papers, and important papers of your elder, and any special items, are locked up.
---Have alarms placed on doors, so you can hear if your elder or child tries to use the door; you might also need locks they cannot open.
---You might need alarms and safety gates at tops and bottoms of stairs.
---Remove any rugs that are not stuck firmly to the floor.
---Install safety grab bars to tub edges, and/or onto the toilet--we located some removable items and other elder care items, at a free or donation only medical equipment recycling warehouse in a city nearby.
---Some folks need to add grab railings to walls in hallways--those can cost more, but you can be creative, with items from Home improvement stores you can install securely.
---Remove or rearrange furniture to allow a walker or wheel chair to maneuver.
---It is possible that your elder fears your pet might trip them, and might just be striking a "first blow" to a perceived threat...you might need to confine your pet to a part of the house your elder is not navigating in, for safety of both.

It is impossible to prevent them telling flagrant lies to anyone who will listen, far and wide, and the only way to even attempt to protect yourself from those kinds of threats, is to create documents and paper trails showing otherwise. SOMEtimes abuse accusations are true--
but far too often, the abuse is perpetrated ONTO the caregiver, by the elder, while the elder denies and tells lies to others.
Document it--log all comments and occurrences on a daily calendar.
IF the elder gets physically abusive, call 911 and report it every time.
If you get injured or bruised, go to your Doc and get that documented as part of your healthcare.
Your Doc needs to know what stresses you are under, too...elder care of a demented elder, definitely affects your health badly.
Get counseling, and try to get your elder to come along for joint counseling--they likley will refuse, but if they do go, your counselor should be able to tell what the elder is up to, at least after a few visits. Well, maybe several...
Make sure you are truthful about injuries to you by your elder.
Understand, at some point, you are no longer able to safely care for your elder.
If you are getting hurt, or your elder is getting hurt, it is out of your hands
...find a facility for your elder before you need one!

{{{hugs!}}}
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My Dad is 91 and is a stage 6 with vascular dementia. He has no short term memory and has recently lost most of his long term memory. Most days he thinks I am his wife or somedays he doesn't know who I am at all. We have good days and bad. I have a Yorkie who he calls a cat and tries to hit with his cane. He can be nice, but can also be very nasty. I have had him for 2 years. I do have someone who cares for him during the day. My weekends and me time are gone, but I know I am doing the right thing. Baby proof your house, it is basically like having small kids again. Lock it up put it away. She if she can get into an adult day care at least it will give you some free time for you and the pets...Good luck
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You should be concerned especially because she is abusing you and your pets.
Has she had a diagnosis of dementia and where was she before she came back to your home? The paranoia may be caused by something else. The Alzheimers Assn has been excellent with providing help (you can call 24hrs a day, and so has this site and members. She should also have a thorough exam by a qualified doctor to rule out other issues. My Mother took care of my Dad as he was getting worse, not bathing, not knowing the the bathroom was and not remebering people or things. He had a 3 day a week home health aid , several different ones, and they could not get him to bathe. My Mom did her best to take care of him and still cook and take care of the house, but at 90 years old and almost blind, it was making her a nervous wreck. The kids would periodically ask her if she was ready to let him go and she wasn't for a long time as he was her husband and felt she was the one that should take care of him. Then, she finally decided it was time to place him, the kids all agreed, and we all drove him there and helped him put away his belongings. I miss him so much and cry everytime I go to see him, but I truly believe he is where he belongs. My brother and sister hardly ever go because it is hard for them and they want to remember him the way he used to be. I go about every 10 days and take my Mom. I want to spend as much time with him now as I can.
Make sure you lock all meds, matches, dangerous items, all doors, and remove any scatter rugs.. I sincerely hope that God gives you the grace to deal with this sad situation.
I think you will reach a point when you know when it is time for your loved one.
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What courage you have asking the question! Aging is hard enough without adding dementia. I suggest that you start looking online at as many of the dementia related web sites as you can find and jot down some notes on the behaviors listed. Then, sit down with the people already living in your home, or by yourself and decide if you want this in your home for the next few years. I found on my journey with my mother's Alzheimer's and dementia that people rarely tell you the truth from the medical community and Alzheimer's/Dementia support groups. The behaviors get worse not better. I can give you a list of ways to distract the behaviors, diminish and control the behaviors and live with the behaviors, but you have to decide first if you really want to take this journey. It would be a gift of love for the person your grandmother was taking care of the person she has now become. It would not be easy. Do you want your grandmother to be the main/only focus in your life for the next few years? Let us know what you decide and understand that the members in this group have been or are in your shoes and we are here to support you.
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I think that it is important to look at things realistically. When I first started writing and reading the advice of others, I so desperately wanted my mom with me but in a few short months her dementia has helped to see that she is in the best place and though I am still concerned about her future. I feel better knowing that she really can't hurt me. Although she tries being states away!!!! She has managed to turn my family against me and anyone else who will listen to her. She has made nasty remarks to me via phone, to my daughter about me, she has hurt me in so many ways. Just think what she would do if she was with me and the dementia said on any given day that she didn't want to be with me. I think I was struggling with letting go of my MOTHER, but I have realized that this woman is not my MOTHER, the disease has taken over and some where in there is my MOTHER, My MOM, whom was my best friend. I still love her but its different. Best wishes to you.
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I do hope you can take the advice of the above posts. If it comes to a nursing home; that is not the worst thing in the world even though many think it is. It is good you are thinking ahead before things get out of hand. Just keep in mind that they are safe in a facility and there is a lot of interaction with people. Nursing homes these days are far superior than the past and the majority of jobs is in these facilities now as there are so many facilities to accommodate all the elderly as the numbers increase..

It is not worth living in fear; as shortmama said "trust your instincts" - what I've learned is they are never happy no matter where they are - just do the best you can. That is really all any of us can do. They often don't like the NH home, well we don't like being abused on a daily basis - it is unhealthy for all concerned. Take care.
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I always remember the old rescue swimmer advice I got during lifesaving: if the victim drowns you, no one gets saved. If it's already crossing your mind that this is getting out of hand, start looking for a new place for her to live. You will still be taking good care of her: you just won't be jeopardizing yourself or your home and loved ones (no matter how many feet they have) to do it. OR find someone who can be with her everyday. But know that, even then, having the person in your house means you will not have the level of peace and relaxation you are used to and need from time to time.

We can all want the best for the people we love. But sometimes life's circumstances change what the "best" looks like. It's easy to see that you don't give the car keys to a 13 year old, or let your child eat only candy. It's harder to see when the person you care for has been independent and now can't be. And the person being cared for may hate the decision. But so does the 13 year would-be driver, and we live with that -- because we know what's best. It sounds like you know what's best, even if grandma would disagree.

It's great that you are seeking advice. Good luck!
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Let me start with this,... If you are afraid something will happen, then go with your gut instinct. If Gma is mean now, its not going to get better. I know shes your elder and weve always been taught to be respectful, but you may have to let her know her behavior is not ok. Is there anyone else that can help ? a social worker to evaluate ? a family memebr that can observe if this is normal for Gma ? Has she had a physical to rule out a urinary tract infection? does she dose her own meds ?
Dementia is a wicked thing. You look at them and think " oh this is Mom, or Granny, and I love her soo much", then they start saying the nastiest, inappropriate things, like theyve become posessed, or regress and start callin you Mom and acting childlike.
I used to say my Mom was like a child with a shotgun. Looks innocent, frail and weak, until she became anxious or mad, then all hell broke loose. Unfortunately she heard me say that phrase once, and started telling anyone who would listen that I was afraid shed shoot my kids.. Well come to find out , she did have not on but 3 guns in my home.. there honestly were some days I was afraid for mine and my kids safety.... BTW,,, moms in a nursing home now, she hates it, hates me, but shes safe.... good luck to you
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