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Bookworm50 Asked June 2017

How do I deal with my mom's aggressive, combative and horrible language when she goes on a rant?

She does this quite a bit. She has some good days where she's a sweet as pumpkin pie. Then it's like another person enters her body and acts horribly to everyone around her. Mom has been in a nursing home for the past month and it got so out of hand that the administrator called me and spoke of her outburst. Mom's O.T and P.T wrote her up on a report. As well as the CNA's. I received a phone call this past Monday to let me know that they will be releasing Mom from their care this coming Thursday 6/22/17.

I don't know how to handle my Mom when she is like this. Or what should I do? Mom can go on rants for the whole day and it's just horrible! Please, I need advice from those who are and have been in this situation.

 My husband and I live with her as we wanted to help her. So we are now her caregivers.

JJGood19 Jun 2017
I found a handful of decent articles about Foul language, and Challenging Behaviors in Dementia on verywell.com
tips include:
Chose your reaction (try to stay calm, deep breath and calm) Surprisingly one of the best responses I give that seems to derail Mom from a rant is for me to apologize and say something like, "I am so sorry you are unhappy, I wish I could fix it for you." or sometimes I even say, "I am so sorry Mom, you have been through so much and lost a lot recently, I wish I could rewind time and make your life like it used to be"
Draw the line (hardly ever works for me, just makes my Mom angrier)
Roll with it (try not to take it personally, this is a big one for me)
Take a Break (although my Mom will follow me)
Redirect and Distract (this works about 50% of the time for me)

staaarrr Jun 2017
I agree with BarbBrooklyn. Have her evaluated by the geriatric psychiatrist. I definitely doubt that she is being discharged because of yelling and cussing. I hear yelling and cussing from a bunch of people at my mom's facility, including my mom. They are all still there.

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CTTN55 Jun 2017
"...they will have people coming here 3x a week to do light housekeeping, Do her laundry, help her bathe, help with meal, preparation, and help with her taking her daily medication. They are also giving her 4 hours a week for companionship as well as running errands or taking her to Dr appointments. I am so very thankful for this."

How many hours/week of care does she get? Are you on deck to do all the caregiving the rest of the time? Sounds like she needs some kind of care every day. (She only needs help with medications three times/week?)

Is there an opportunity to increase the help as her needs increase?

And I really hope she is down for the night when she goes to bed. Interrupted sleep is horrible!

Countrymouse Jun 2017
You "believe" they are releasing her because of her behaviour?

You didn't ask?

I'd have thought that BB's comment that there's probably a simple practical reason for deciding on a discharge date makes much more sense.

I wonder if you might find it a comfort to remember that your mother's changed, erratic personality, while it's mortifying and wretched for you, is nothing new to facility staff. As experienced professionals, they should recognise it for what it is - another mean trick on the part of dementia. They won't hold it against your mother or "disapprove" of her because of it. Having said that, if it does result in challenging behaviours then of course they need to find a way of coping with it; but that's not the same thing as just booting her out.

When the administrator called you about that specific outburst, thinking back over what she actually said rather than how you felt about it, was she raising an issue or reporting an incident?

BarbBrooklyn Jun 2017
Bookworm, you're not asking for an evaluation. You're asking for her to be seen by the geriatric Psychiatrist who comes to the facility. Call today and see if they can accomodate that request before release.

Make sure they've tested for another UTI.

Make sure that they've checked that there are no broken bones, fractured pelvis, compression fractures in her spine that are causing her pain.

State that it is impossible for you to manage this behavior in your home. Ask the SW about having her taken to a Senior Behavioral Unit where they can adjust her meds as an inpatient.

I really doubt her yelling and cussing is getting her "thrown out". She's most likely cone to the end of her 20 days of Rehab under Medicare and she's made as much progress as they think she's capable of. Or she's refusing therapy.

The thing is, my mom was refusing therapy. It turned put her hip had broken, unbeknownst to any of us.

Shane1124 Jun 2017
The language I heard come of of my mother's mouth during the last 6 months of her life in a NH with dementia literally floored me. She cursed like a sailor. My mother never used that language. I was able to sort of calm her down sometimes but not always.
I suppose it's part of the disease. Hopefully when your mom gets home that may dampen whatever urge they have to rant.
Good luck!

MsMadge Jun 2017
Frankly, when they're at the difficult phase of the disease there's not much you can do since you cannot reason with dementia

I have a close relationship with mom and can handle her but I went too long in not getting her to a neurologist for treatment- honoring her wishes to not take meds - like many say here - it sometimes takes a crisis before you can get help

Now her cussing is either sign of frustration, pain, or a UTI 
Of course, she'll say you're wonderful one second and then turn around and lash out at you the next 

Bookworm50 Jun 2017
Hi, MsMadge

Before I got the phone call from the NH there was no date set for her to return home. This came straight from Cathy the administrator. Then Monday I get the call that Mom will be released from their care as of this coming Thursday. I believe they are releasing her because of her behavior.

My husband and I try very hard to care for her. I am disabled and I am not able to help her with many of her needs. But God is good! She will have permanent long-term care at home. Which means they will have people coming here 3x a week to do light housekeeping, Do her laundry, help her bathe, help with meal, preparation, and help with her taking her daily medication. They are also giving her 4 hours a week for companionship as well as running errands or taking her to Dr appointments. I am so very thankful for this.

I have tried in all 3 NH to get Mom evaluated. It was all said with a no! They said I need to take her to her primary Dr. for these kinds of testing. That is exactly what I am working on doing now.

Thank you for your reply. It's much appreciated. May I ask how or what you do when your Mom starts cussing? Has anything worked?

MsMadge Jun 2017
Was mom expected to be released or are they kicking her out for this behavior?

Are you able to care for her at home?   Get a referral to a neurologist or geriatric psych before she leaves the NH 

Dementia causes some folks to swear like sailors - even on an antipsychotic, my mom can cuss up a storm - it's like she's channeling Linda Blair in the Exorcist

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