Can people with dementia be spiteful?

There’s an oft repeated saying here “if you’ve met one person with dementia, you’ve met one person with dementia” In other words, the diagnosis can mean almost endless differing variations on behaviors. But it always means a person loses the ability over time to make sound, reliable choices. I’m sorry your dad is there

Windy,
He has dementia. He may need to go to his healthcare provider if this is a change in behavior, since other things, like a UTI, can make the dementia confusion worse. Understand that he isn't acting deliberately. He has a disease that is slowly blocking his brains connections, and one of the areas of the brain that is affected is the one that lets us remember what we've been doing all day. If he's aware there's an issue with his memory he may be very scared. Sometimes the disease makes it so the person doesn't have the capacity to see that they are struggling, (called anosognosia) and they may resist you trying to tell them what changes you see. It may upset them. If it does, just drop the subject. Along with the memory the disease affects how a person can take in and process information and emotions, so go slow.

If we assume that his behaviors are an effect of the disease and he doesn't recall phoning you, then his behaviors make a lot more sense, don't they?
Then he's not lying, he's genuinely not able to remember those 17 phone calls, and's relying on some scrambled bits of information he can still access to try to piece together what happened. Sometimes those memories are from a long time ago. From what you're describing, he's at the point where he's going to need more help with managing his meds, finances, home, etc. Now might be the time to start looking at a downsize from his home to assisted living places that have memory care. A move now may be easier than farther along in the disease. It's also the time to get the advice of a certified eldercare law attorney (CELA) if you dad doesn't have a power of attorney signed up or a long term financial plan.
This board is excellent, and the alzheimer's assosciation also has a forum and help line:1-800-272-3900
https://alzconnected.org/categories

These helped me... (sorry-you'll have to paste the links):

https://www.smashwords.com/extreader/read/210580/2/understanding-the-dementia-experience/Medium,Arial,Black,White,One-and-a-Half

Tam Cummings assessment tools/AD checklist
https://tala.org/wp-content/uploads/2019/04/Tam-Cummings-LLC-Handouts.pdf

Teepa Snow-10 early: https://www.youtube.com/watch?v=pqmqC-702Yg

5 losses besides memory:  https://www.youtube.com/watch?v=awBm4S9NwJ0

Anosognosia: https://www.youtube.com/watch?v=5nw3YUDQJuY

Talking to a parent: https://www.youtube.com/watch?v=oiUpztj2DkQ

Stepping Into Dementia’s Reality: Advice From Teepa Snow | Brain Talks | Being Patient:  https://www.youtube.com/watch?v=EOCZInnLQd0

Careblazers-5 mistakes to avoid: https://www.youtube.com/watch?v=rO50pVUOlbE

Stage 4: https://www.youtube.com/watch?v=coiZbpyvTNg

Stage 3: https://www.youtube.com/watch?v=TIkTO4d8YyI

Moderate stage: https://www.youtube.com/watch?v=6cZTgG6kDjs

Careblazers-How To Convince Someone With Dementia They Need Help: https://www.youtube.com/watch?v=ncKhXQtnyfI

Talking to a person w/ dementia. https://www.youtube.com/watch?v=ilickabmjww

Teepa-multiple videos: https://www.youtube.com/playlist?list=PL2E2lPBsUeBjA1Utglo8q6yANAijEf8cX

You are right about that. My father in law had Parkinson’s and Dementia. We spent years dealing with that and I still feel I know nothing about the disease.

He can’t help it. He’s sick.

Your dad shouldn’t be living on his own. Just by reading what you wrote, you can see that he isn’t rational, doesn’t know what he thinks from one minute to the next, and could easily make a dangerous mistake that would cause him grave injury.

It is time to get him the help he needs. Care 24/7 is urgent, and the best place and easiest for you will be a memory care facility where he’ll have friends and professional help. Good luck.

UTI or other infections can cause delerium or make dementia symptoms worse. Sometimes a TIA also changes/worsens behaviour.

"accusing the neighbor of poisoning the food"
This is paranoia.

"He is lying about the ER".
Could be a delusion, but maybe manupulation/attention.

If his symptoms are worsening, call his Doctor to advise & ask what can be done.

If this level of paranoia & possible delusions becomes his everyday, he will lose the ability to live alone safely very quickly.

I am glad to read you found good legal advice. You are building your Father's 'team' person by person.

In my experience this sounds pretty typical. Yes, people with dementia can be spiteful and manipulative.

With my mom it isn’t voicemails but it is texts and they can be similar at times to your dad’s voicemails . She has some health issue in the middle of the night and she is dying and needs to see a doctor. Then she is angry that no one cares. Then she gets suicidal or says she just wants to die. This is followed by a note saying she is okay. Then next day if you ask her about it she says: “Oh, I was trying to reach you but I can’t remember why. Everything is fine.” If questioned about the texts she will laugh and say “I did that?”

That is just when she is anxious. However, there are times when she is angry and manipulative, too. She says she will call 911 if we don’t take her to the doctor. We tell her that is a good idea if it is that urgent and then she gets mad. She says she will get a taxi. She never does but there is nothing wrong with her and she is full of it. She faked having a stroke in a restaurant and that got her a 3 day hospital stay during which they found nothing wrong with her except that she has mental problems (anxiety and depression) as well as dementia.

Anyway, yes, this behavior with your dad sounds familiar.

You would be best served by educating yourself more about the horrific disease of dementia, as what you're describing is actually quite "normal" for someone with a broken brain.
The book The 36 Hour Day is a great place to start along with the many videos and books that dementia expert Teepa Snow has.
Your father is not doing any of this on purpose. His brain is broken and when ones brain is not functioning as it once did all kinds of crazy things can happen, as you will learn as this disease progresses.
So by educating yourself you will be better prepared and a lot more compassionate and understanding as it does.

Your dad should not be living alone.
If he has been diagnosed with dementia you can not trust his cognition to make the determination if he needs to call 911 or how to shut off the water if the sink or tub is overflowing, or how to get out of the house in an emergency.
With dementia he will not get the "cause and effect" that a phone call to you or 911 will make.
With demenita filters that allow us to live a "normal" life in society become skewed or drop so peeing in the corner of the closet is "acceptable" undressing in inappropriate locations is "acceptable" yelling, swearing, spitting, hitting become "acceptable" to the person with dementia. I do not think that he is consiously being manipulative, this is his new "normal"

By the way his visit to the ER might have been a TV show he was watching
His thinking the neighbor is poisioning him is sometimes part of the parinoia or delusions that some people with dementia experience.
Each person is different, what your dad does may be different than what someone else goes through.

Your father is not living alone in this condition I hope?
Who is responsible for your Dad?
What is his diagnosis in terms of dementia? Has there been an assessment?

What you are describing is either severe dementia, or it is severe mental illness. Please tell us more about the status of your dad's living conditions.

With both mental illness and with dementia a person is not "spiteful". They have disinhibition and are not in control of their actions. You need to find out what is going on with your father now. You listed this under "dementia" and I am concerned that he may still be living alone, which would be a danger to him at this time.

I agree, your Dad should not be living alone. I hope you have DPOA it will help in being able to place him. Hopefully, he is already seeing a Neurologist who can confirm he needs 24/7 care. A PCP can confirm it too. He will need Memory care if he can afford it. Some ALs may take him if he is in the early stages. If he can't afford a Memory care then he will need Medicaid and that means Long-term care.

If all he uses his phone for is calling you, I would "lose" it. If he is placed, he needs to adjust to his surroundings and the staff doing for him. Calling you every time he wants to complain or needs something will not help him adjust.

Good heavens---

They not only can be spiteful, they can be hateful, cruel, mean, unbending, depressed, anxious, mad, selfish and well--you get the drift.

To some degree, the dementia is just a broken brain. The person is not really able to make decisions and do what's 'right''

Dementia can also be a very sneaky disease in that it takes a person who wasn't so lovely to begin with and as the dementia progresses, the family just kind of shakes their collective heads and go "well, that's mom being mom'. And dementia is not even counted as a factor.

My MIL is the latter category. She was NEVER 'nice' but always had a sharp barb to stick you with when she felt you needed it.

Her kids have been caring for her for quite a long time and the other night I made some off hand comment about her (VERY OBVIOUS) dementia and my DH came right back with the statement that SHE DOES NOT HAVE DEMENTIA.

I looked at him and said "you HAVE to be kidding me? you can't see how she acts, talks, etc. and think it's OK? just the way she is?" He argued that since a Dr had not diagnosed her as such, in their opinions, she was 'fine'.

They tend to do that only because their minds is running rapidly and their reality isnt the actual reality my client tells me about events thats she claim is happening but isnt cause im literally with her everyday and my grandmother would do the same so they really dont actually mean to do what they are doing its iffy cause if an person was manipulative before the dementia you can definitely be certain those characteristics are going to show up as well as other habits.

This is called CONFABULATION.

His malfunctioning brain is "filling in" the information and memories he has lost by creating preposterous stories. That doesn't mean he's deliberately lying, but that the void created by the missing information and memories cannot be tolerated by the brain and it will literally make stuff up to "explain" these gaps, even if it makes absolutely no sense.

Please look up CONFABULATION in dementia to see if it matches what you seem to be experiencing.

Absolutely they can be spiteful but "they know no what they do." My Mom cared for her aging parents alone and had to work full time (my dad died young and her only sibling lived on the other side of the country). My grandpa actually hit her one day when she was at their house helping them with bills and such. She had to put him in a nursing facility after that (where he picked a fight with another resident and broke his arm in the fight). She had put up with the verbal abuse from him but drew the line at physical abuse. Plus she was concerned about him hurting my grandma. He really did not realize what he was doing. Dementia is such a sad illness for everyone involved.

My mom can exhibit behavior that might seem spiteful but it's her way of struggling to cope with what she has lost. She is aware that there are things she can no longer do, or do well. If you are with her (on the phone or is person) when she becomes aware that she's made a mistake she will often be short or show anger. It's not personal, it's just her grief. I'm not suggesting that it's easy to be on the receiving end of it. It's not. I try to remind myself often that she's upset at the disease. It's taken far more from her than it has from us (her children).

You have my compassion. Seems like others have already responded helpfully. Just want to share my sympathy. I'm going through the same with my husband.

My mother with vascular dementia has turned from a nice lady into a spiteful unhappy person. She is in a memory care home. Every visit, I take a lot of passive-aggressive insults from her and she will not cooperate with the care workers. Just remember that this is not the person you knew, it is a person with dementia.

Really? If you read any of the posts here, you will know that people with Dementia can be spiteful, mean, violent, and manipulative.

Part of the reason that caregivers are so exhausted is because of having to deal with these behaviors. They "lie", because they are in a different reality. They are agitated because they are scared. They hallucinate and have delusions.

My mom was so agitated that she would scream, hit, and bite.

If he's living alone, he CAN'T anymore. It sounds like you are expecting him to make rational decisions. He CAN'T because he has Dementia.

You need to join the Alzheimer's Dementia Caregiver's FB Support Group so that you can learn about this disease:

https://www.facebook.com/groups/dementiacaregiversupportgroup/?ref=share&mibextid=NSMWBT

I took guardianship of my brother after a brief stayin ICU with a short stay in a nursing home and then another hospital stay because he was refusing to take his medication for any of his medical issues. Both my husband and I had financial and medical POA’s and the nursing home suggested legal guardianship. It has been a nightmare. There is a lot of paperwork you need to maintain for yearly reports, not to mention the costs of getting the actual guardianship. If possible I would recommend staying with POA’s and away from the legal guardianship. But again this has been my experience, perhaps it would not be yours. My best wishes to you.

When my father was in AL he knew they would not send him to the ER over constipation so he would tell the aides there that he fell and hit his head so they would have to send him. Then once there he could talk to them about constipation. I don't believe our elders are as confused as they would like you to believe.

The 'paranoia' is a feature of advancing dementia; and attention seeking is a feature of Narcissism. Becoming spiteful can be the manifestation of a trait already in a person's personality that they may have been able to cover up ('mask') in the past but with advancing dementia is out there for all to see, full-blown. As many have observed and stated, dementia is almost like regressing into childhood; some traits may be charming but others are like the totally self-centered personalities of very small children. The ER trip was a ruse, again the attention seeking and akin to how some elders placed into care residences agitate to be taken back home, where they are still miserable; it is the brain losing function and fear takes over. Perhaps have your father evaluated for anxiety; meds may help him regulate his impulses better. All the best for all of you.

YES. And then some.

Google / read Teepa Snow's website. She is the leading expert in dementia.

It is to your benefit to prepare yourself for any / every response and learn to put some emotional distance between you and your dad. This is hard to do although with education in how the brain changes / cells die, it will help you to develop compassion - come from a place of compassion instead of - or along side - of hurt and grief.

Gena / Touch Matters

Well let's see. I was about 60 years old when my mother with moderate (formally diagnosed) dementia called me to come over to her apt in AL. She had something to tell me. She proceeded to spitefully tell me such a foul story about my father, that I was flabbergasted. She wanted me to hate him, finally, by divulging a secret about his past she thought I didn't know. I had already deduced this secret, so it didn't blow my mind. What DID blow my mind was that she had the ugliness of spirit to plan this whole thing out with the hope of making me hate my DECEASED father.

Nice try ma.

So yeah, people with dementia can be VERY spiteful.

Sadly, dementia can bring out the worst in a person. Dementia behavior is a very individual thing. There are many similarities between dementia patients, but not everyone shows all the same behavior. To add to the confusion, those behaviors can come and go. It really is a “moving target.”

So to answer your question, yes, they can be spiteful, hateful, lie, vindictive, childish, petty, mean, violent and downright scary. They can also be loving and sweet. Their brain is dying and their behaviors can change on a dime.

Your father may need more care than you can provide. Can you hire home help so he’s not alone or would you consider a facility? Something to start thinking about.

Turn off your phone when you are unable or unwilling to answer it. "No" is a complete sentence or hire an answering service and instruct them how to screen the calls and limit your exposure to Dad's mental illness.

Sounds like this family member is attention seeking and making it up as he goes along, especially if he does not remember. Let’s take the loving kindness approach:

non issues for you, there is an underlying issue for him - is he living alone? Has his Dr said he is sundowning? Perhaps Dr can prescribe something for sundowning and something that will help him sleep. It may be time to look at memory care if neither of these help. Is there a durable power of attorney, it will need to be activated for decision making.
you can seek advise from the social worker at the local Senior Center. Also, legal aid may be available at the Senior Center. Start with his Dr.

Check out this link about paranoia, and subscribe to Dr. Kernisan's blog: https://betterhealthwhileaging.net/6-causes-paranoia-in-aging/

To answer your direct question, " can dementia patients be spiteful?"
Yes, and many other negative, unpleasant behaviors often manifest during the disease process including becoming not only verbally aggressive/ abusive but also physically.
Please remember that a dementia patient does not cognitively process conversations normally nor remember short term conversations.
They also, depending on stage of dementia, become fearful and, are really not capable of making safe and sound decisions for self .
Be sure that you have POA paperwork and other decisions making authority assigned so that you can make appropriate decisions for his safety. Speak with his PCP about these behaviors you are observing and, begin to look into options for his ultimate, if not already, 24/7 care.
Practice good self care.....you will need it !

Windy2022: Per Google, "Dementia can cause behaviors that may present as meanness. Someone with dementia may suddenly seem like they don’t care about your feelings. They may snap at you, doubt your intentions, resist your efforts to aid them, or say hurtful things."

Disclaimer: Not my authoring.

When I was a live in caregiver with my mother who has dementia, she "threatened" to call 911 almost daily, as a manipulation technique to get a lot of attention, even though there was nothing that required urgent care. She also had multiple daily complaints about all kinds of wrongs that neighbors and relatives had allegedly done to her.