I am concerned about the actions of my Mom (96). She has dementia and lately has become aggressive. Advice?

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I moved my Mother from her apartment in late April. We had built an apartment for her, independent of our living space, so she could have her own place. She is 96 and has been diagnosed with dementia. I cook for her for safety reasons, but she does her own housekeeping and her place is immaculate. I have to keep a close eye on her money as she had lost nine hundred dollars just before I moved her to our place.We have been doing fine, the only problem is she has lost one hearing aid and the other is outdated (we have an appointment for new aids) She sometimes misunderstands and I go through a lot of repeating....however, today she told me she was growing some geranium cuttings and I told her I thought that was wonderful and my husband would be excited about it because he has a green house etc. Mother swore at me and said she might as well go pay the high price at the nursery. I tried to start over and explain, but she became very agitated and raised a fist. She started toward me, and I thought she was going to strike me....she didn't even look like the same person....her eyes were filled with hate. I yelled her name, and it was like a shock to her and she calmed down for a minute. Then she grabbed her neck and it scared me and I asked her what was wrong....she said "YOU YELLED AT ME AND NOW MY NECK HURTS!!" I am not physically afraid of her, but I do wonder what my status is if she goes to the doctor for her appointment and says that I yelled at her.....I do not want to go through the rest of my life known as one who mistreated an elder. I am 72 years old and I have cared for more than one elder in their final days and I have never mistreated or harmed a single one of them...I love my Mother, and would never harm her in any way, but how do I handle this...can you help me? I will appreciate any help you can give to me....With Thanks
Mary

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Hi Mary,
I agree with the others who have answered your questions. First of all, her mishearing is likely a huge issue. She doesn't hear right and her mind fills in the blanks - negatively.

Next, a urinary tract infection could be a problem. They are very common in elderly people, especially women and can cause mental deterioration.

Medications can be another issue. As people age they become much more sensitive to medications and what worked for awhile may or may not be working, or could even be causing personality changes. A friend of mine told me her mother's "Alzheimer's" turned out to be caused by her incontinence medication.

A trip to the doctor is in order with a full physical. Also, her hearing aids need to be replaced. I know that this is expensive, but it could be essential to how she behaves.

Take care of yourself the best you can and please let us know how you're doing.
Carol
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Mary: I'm so very sorry that you're going through this. This must be so tough for you, like me, you're no spring chicken yourself! From what I understand, in addition to the hearing issue, this sort of agitation, not processing language is part of her worsening dementia; her doctor needs to be made aware of it. Is she on any meds for mood/behavior etc? Not processing pain correctly, not processing how one event leads to another, this is all dementia related.

she needs to be seen by her doctor and these events reported to her/him beforehand. She may need a higher level of care than you have so lovingly provided up until this point.
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Mary, ba8 has given you valuable advice. The doctor needs to be told this recent information. This sort of behavior can be caused by a urinary ytavt infection, or another infection in the body. For some reason the elderly, especially those with dementia are unable to process the pain and discomfort of many infections and injuries. Something in the brain is damaged by the tangles an plaques that stop efficient and accurate information. Get her to the doctor and request medication to help with Ber behavior issues.also mom telling the doctor that you yell at her is going to help him to diagnose her.

How long las Mom been with you?
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Mary my heart goes out to you & your family. I had the same problem with my dad. It became worse by the day. I took him to see a neurologist & that was a blessing. He put my dad on two different medications. That was over two years ago and he has changed his aggressive behavior and many threats to a happier and more passive man. My advice to you is have her be seen by a doctor. There are so many medications that can stop the irrational thinking and behavior. I wish you the best.
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No way to edit response Yes UTI are a real problem. I bought a test kit from Amazon and when behavior changes of urine burns I do a home test and call PCP for Rx and UTI goes away and good behavior returns
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Mary, Mary YOU are not the problem here! Your mother is just losing more cognitive connections and will experience outrage at any given moment. Walk away. Walk away unless she is needing assistance. Do not try and understand what is going on in her brain. But, I do know health professionals are trained (like me) to recognize when statements said by dementia patients are untrue. Do not let it worry you. Unless she has cuts and bruising, it is not a big deal when doctors question events. Just calmly explain what happened and forget it. I know it is hurtful for her to be aggressive with you and say mean things, but know that this is not your mother now. She has crossed over into another person none of us want to know. My husband is aggressive sometimes too, and I just let him rant and rave, and go do yard work or take the dogs for a walk. Maybe your mother would benefit from having a tiny dog she can cuddle and pet. It does wonders for their (dementia patients) blood pressure and will give her a reason to get up in the morning and care for another living thing. Don't fall for the "blame game" either. They are good at giving us a guilt trip, just because they can. Do not let her. Know that at 96 yrs. she will not live forever since dementia is a terminal illness, and God bless you for building her an apartment so you will have her in her last days! My hat is off to you and your husband. And keep gardening! Best wishes...
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Agree with all the postings so far. In our experience, we took MIL off of all her prescriptions which she didn't like to take anyway. Her behaviors became much less violent and her hostile outbursts reduced as well. UTIs would make her behavior worse. We also found that there are specific triggers for her hostility. We had to take her cane away during a doctor visit because she was talking about striking the doctor with it!

As the first step, always look for the underlying medical condition first. A UTI or other medical issue may be the root of the problem. Plus the hearing issue...the faster you get those replaced the better. Less frustration on her part could well result in less expressed frustration, hostility, and violence.

However, there is a point in which she may need medication to help calm her. This is tricky in terms of finding what works if you have to go this route. Also be aware that if you (or somone else reading this post) need to add a drug or a drug regime to address psychotic or violent behaviors, many of those psychotropic drugs have black box warnings for elderly patients with dementia or Alzheimer's. There's not a lot that works safely or necessarily all that well, depending on the patient. Experts in the field have told us that in only a few more years, there should be more options for dementia/Alzheimer's treatment. Most of us need help today and cannot wait!
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Sad to say, it seems to me that mom has lost much of her cognitive ability and thus in effect "does not know" what she is saying. Thus there is no being logical with her.....Perhaps a good thing to say when she gets aggressive is "you may be right" and just roll with it...(I see folks with dementia daily at the nursing home where I visit my loved one and they truly do not know what they are doing for the most part..)
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I just want to comment about the poster here who feels that she and her dad and doing a good thing by having discussions in front of mom, or on the speaker phone, so that she can hear. Patients with dementia cannot process complex language or follow cause and effect (often). So while it feels to you (and this would be true of a disabled, but not demented patient) that you are being open and above board, all SHE's getting is that the conversation is ABOUT her (which it is) and she can't follow it, so it's a secret. At least in my mother's case, it's better when we siblings discuss her care out of her earshot and tell her what she can understand. Right now she's in the hospital and she becomes unglued about all sorts of things that she is overhearing.
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Thank you all for your enlightening answers. Took Mom for her hearing test with high hopes that they would suggest new aids for both ears...the audiologist gave her the full test and said her hearing loss was severe and there was nothing more to be done to help her. He cleaned her one aid and sent us home.....the cleaning helped, but not much. When difficult times are reaching a crescendo, I am trying to give her a little quiet time so she can "regroup" before I say or do anything. Sometimes it works and sometimes I get an ear full! But I can live with it. We have a doctors appt. coming up so perhaps we can get some progress there...The last trip to the doctor Mom played her little game...on the way there, I said to her that we had to ask the doctor about her dizziness every morning and how it takes until noon before it subsides. When we were at her appointment, I mentioned it to the doctor and she asked Mom if she had been dizzy....Mom threw her head back and she said "Heck no, never!" She likes to pull a shocker now and then. I felt like the doctor was seeing me as a proxy hypochondriac.
I took her to the new Mental Health building that is being built next to the clinic and will be opening in our area this fall. It is a huge building with an inside walking track, and private rooms for clients who can still manage the basics. She seemed very impressed with the look of the place, and I plan to take her there when it opens so she can see the inside. We have her name on a list for occupancy if a room opens up. As of right now, they are all filled....I very gently suggested that if she should find she isn't happy in her apartment, perhaps this would be a good change of pace for her and that she could come visit with us any time....she seemed to think that sounded good...at least at that moment.....I just love her so much and I want the best for her...I set up a sewing machine for her and she has been a lamb for the past week...she needed a purpose...don't we all...thanks again, and I am so glad you are all here...... Mary
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