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MIL had a brain injury and stroke 20 plus years ago resulting in partial paralysis on dominate side. Her spouse (her primary care giver ) died this past December leaving myself and husband to take that role. As we work 40 plus hours a week we need all the help we can get. She is getting more and more aggressive in addition to needing ever growing assistance with personal grooming. She has refused the introduction of home health care persons before (more of a territorial type thing).

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It maybe time for LTC. If she is low income, you maybe able to get her help with Medicaid. No healthcare worker will care for someone aggressive. If this is new behaviour Mom needs to be evaluated for meds.
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Is there medication for aggressiveness associated with aging illnesses?
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Eloise1943 Mar 2020
Yes there are medications. My husband was being awful and more than I could handle. The doctor put him on 25mg of seraquel at nite and it instantly helped both of us😊
some Drs feel it has risks but I believe in quality of life. It has allowed me to keep him in our home where I know he is happier. I hope you are able to get the help you need.
blessings to you
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A caregiver should not be subjected to this behavior. Look into placement for her. Speak to her doctor about the behavior. Ask to speak to a social worker to help in moving forward.
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my2cents Mar 2020
The behavior would be the same in a facility as it is in the home toward caregiver/cna/nurse, etc. Perhaps it would be best to get in home caregiver (if relatives are trying to keep her home for now) and tell the person about behavior during first visit. Sometimes you just need someone with thicker hide and experience in how to deal with a patient who is trying to run off the hired help.
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YES to appropriate medication.

Can you invite a “friend” (psychiatrist, psychologist, social worker specifically trained in geriatric assessment) to “visit” with you at home and converse with you and MIL? A trained person can deftly identify a lot by casual questioning and conversation. If MIL should act out while examiner is present, her conduct may reveal useful information for treatment planning.

Although my LO had already been admitted to a memory care unit, her visit from a kind and empathetic member of a geriatric psychiatric group made the difference between night and day for her. She had been taking an antidepressant previously, but the medications recommended by the specialist allowed her to function much more comfortably, and significantly reduced inappropriate hostile behavior.

It would also probably be good for you to start assessing local resources for residential care, especially if you begin seeing escalation in her negative behaviors.

So hard to see a dignified LO begin this process. You and DH aren’t alone. Hoping you find some solutions that will be helpful for her.
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I'm very sorry for your MIL's loss, and you and DH must be too. This is an extremely difficult time for all of you.

It sounds as though her being cared for at home is becoming unsustainable. That her spouse was able to support her there for all those years is admirable, but it doesn't commit your husband and you to attempting the same.

Who is the legal decision-maker for MIL, herself or someone else?
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You can try medications it may take a while to find the right one and the right dose but they can help.
If she is needing more assistance is this something that you will be able to provide and continue to provide.
If MIL can comprehend (I do not know how severe the dementia is) can you explain to her that she has 2 options. 1) accept caregivers that will come in and help her out as well as helping you out. or 2) You can not care for her is the best, safest manner and you will have to look for either Memory Care or Skilled Nursing facilities for her.
If she can not comprehend these concepts then you have to make the decision.
Is it safe for you to continue to care for her
Is it safe for her for you to continue to care for her.
Is your home set up to properly care for her
Do you WANT to care for her.
If any of these answers are no then really the only safe option you have is to look for Memory Care or SNF (skilled nursing facility) that she can move to.

Sometimes if you say that the care giver is for YOU the person that is needing the care is more accepting. The caregiver can "help" the person while doing laundry, light cleaning, making a meal.....

As to looking into facilities or hiring caregivers the expense should be on the person requiring care not you. If that means application for Medicaid you might also want to put a visit to an Elder Care Attorney on your list of "to do's". Even if funds are not a problem it is a good idea to consult with one.
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MIL is probably frustrated and confused with the changes. She "acts out" trying to control the situations. I suggest you talk to her doctor about anti-anxiety medications or mild sedatives. Once you have her on those, you can introduce changes - home health care aides. If she doesn't do well with home care, she may need long term care facility.
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Whether she is in your home or in a facility, you would benefit from speaking to her doctor/neurologist about her behavior. Her history of brain injury and stroke can account for her behavior not just her paralysis. Sometimes brain injured patients benefit from medications like beta blockers to help regulate and slow their heart beat which in turn can calm them. My dad couldn't tolerate the beta blockers in combination with his anti-seizure medications and eventually, his cardiologist agreed to an off-label use of a pacemaker and implanted one. Somehow, regulating dad's heartbeat improved his behavioral issues like the beta blockers would have done. It was a vast improvement for him and my mom.
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Can you speak to her town's elder case worker and social worker?
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skipperdude Mar 2020
Not even for sure of who these individuals would be or location
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skipperdude, your town or county has senior services available. Here is a link. https://www.co.augusta.va.us/government/senior-services Hope that this helps.
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