Dad in late stage dementia kicks and pinches when we change him. He is very strong and mom is getting bruised. Any ideas on what to do?

Since you have hospice involved, you should ask them to medicate your father for the aggressive behavior he's exhibiting. He's obviously upset at being touched, and your mother is obviously upset at being pinched and bruised, so, short of having him placed in a facility where they can care for him appropriately, your choices are limited. Refusing to place him is kind of like refusing to take a seriously ill person to the hospital when they are very sick. Hopefully it won't take a trip to the hospital for your MOM in order for both of you to start believing in care facilities for patients with serious dementia issues!
Best of luck!

Tartan girl I'm going to pretend that I didn't read that you and your mother are considering tying your father down while you see to his personal care, and that your mother's current method of getting him to cooperate is to yell at him.

But if those things were happening, *any* trained person involved in care of older people or people with dementia would have kittens. They are plain abusive. If they form part of the only way that your father can be attended to at home, in what way is the care he is receiving better than that you would demand for him in a facility?

You MUST get help from trained providers. This can't continue. Both your mother's and your father's welfare are suffering, and you do not need permission from your mother to seek help.

You don’t believe in placing him somewhere, but are here asking questions on what to do about abusive behavior. You want to tie him down to change him so he cant pinch or hit? He is combative and angry? What exactly are you waiting for to happen? I am not judging, just cannot understand why you do not do what is best for him AND your mother. He needs to be in a decent facility with staff who are trained to deal with such things... Your lives are being consumed and you really need to reconsider. I wish you luck in this. It is a tough journey for all to take.

What is it that you don't believe in when it comes to placing your father with advanced dementia in a facility where he can get professional care from three shifts of young, trained, rested and supervised caregivers?

Your mother yells at him to stop fighting? Maybe being touched is causing him pain? You left a job you love and feel resentment at giving up your life to care for him?

How is this abusive, resentful "care" better than being in a care home?

I'm sorry if this sounds uncaring or mean. But sometimes people get these mantras in their heads...."our family takes care of its own"....."we would never do a thing like that"...."we'll see this through to the bitter end" without recognizing or re-evaluating the costs of those platitudes.

((((((hugs)))))))))

Well, if you don't see or want to accept the need to place him in AL, you are on a slippery slope. He is abusing your mother. Your mother's well-being also should be considered, and at this point it is not, either by you or her. Possibly because you are following her lead to keep him at home no matter what, sometimes we get lost in others verbiage and can't see the forest through the trees. I hope that you can figure this out, before your mother really gets injured...then what?

Have you tried one of you distracting him while the other deals with business? I can't imagine that tying him would work out so well, if he doesn't like to be touched, restraint is going to be difficult. Have the doctors tried chemical restraints? I believe that would be the 1st line of action.

I imagine that you have tried everything, so forgive me if this is redundant, can you tell him, in 3 minutes we are going to clean you up, when the alarm goes off we are going to clean you up and you need to lay still and be nice. Then tell him as he is being positioned to get changed that he needs to be still and be nice. Do this every time and when he starts getting agitated firmly tell him to lay still and be nice. I don't know, toileting is my line, I won't deal with that for my dad and if I did, his beating on me during the process would quickly put an end to it.

I am also curious if you have tried putting a diaper type depends under his regular boxers? I can't imagine dealing with a full grown man going everywhere and only using pads. That has to add to the work load like crazy. Maybe tell him that he needs to layer up with those whitey tighties under his boxers.

I know that you are apposed to facility placement, but have you considered that your mom could very easily be severely injured by a well placed foot or the resulting fall, also she could die 1st and then what would happen. Statistically roughly 40% of caregivers die before the person they are caring for. Is it really worth losing her to his disease?

I understand your feelings about placement of your parent, and many people have given you advice, so I just say this to you.   Your father is at a stage where he requires a lot of care.  You and your families job is to love him as you have always done.  With the situation you are facing you are putting yourselves in a dangerous situation, it is also one where anger and frustration comes more easily than love.  You all need to give yourself permission to love this man and hand the frustrations of the primary care to others who are trained to deal with it.  This will free you and your family up to return to the proper relationship with him during this difficult period of his, and your lives.  You can concentrate on making memories with him and not conflicts.    I wish you luck with your decisions but you obviously care very much, you just need to give yourselves permission to show it in the best  manor.

By chance are your Tartanfirl's daughter? And you are writing for your Mom at this time?

I see from your Mom's profile, she is caring for her husband who has dementia, she had to resign from her job, and that her daughter has moved back into the house to help her along with her daughter's two youngest children, high school and college age. Am I reading that correctly?

May I ask how much formal caregiving training you, your Mom have had? Like most of us here, we have had zero training. There does come a tipping point.

There also comes a time where dementia patients needs a village to take care of them. My Mom went from home, to hospital, to long-term-care. No way could I do the hands-on care at home that was needed. I was senior age which I feel that your Mom is also a senior.

As Isthisrealyreal has noted in her post, up to 40% of caregivers die leaving behind the person they were caring. Those are NOT good odds. And how fair would it be for the rest of the family if Mom passes or becomes ill from the stress, which isn't uncommon?

Then you will need to do the work for 3 full-time caregivers daily, that's 168 hours per week, no time off. That will have a major impact on your children.... and now you will be looking at the 40% odds on yourself.

There is nothing wrong with assisted living/memory care nor with a skilled nursing home. Now a days there are even Hospice facilities where the professionals deal only with hospice patients.

Is cost a factor? If your parents are not able to budget for a hospice facility, then Medicaid [which is different from Medicare] can kick in to pay for Dad's care at a nursing home. Then Mom can once again be the Wife again, and you once again be the daughter.

Just food for thought.

"He has hospice care but we will not place him somewhere we don’t believe in doing that. We are considering using ties when we need to change him." What exactly do you think restraints are going to do for his behavior besides agitate him more??

Your father's brain is diseased and there is nothing you or your mother can do to change that fact. Right now it's your mother who is suffering both physically from the punches and kicks and emotionally from the stress of watching her husband go through this disease.

There are no happy endings here. It is time for you to help your mother make the difficult decision of getting your father the pain and agitation medication he clearly needs either at home through hospice or in a nursing home.

When was the last time your Dads seen a doctor? Aside from the dementia, is it possible that he actually does feel pain when touched?
My Mom always hated taking a shower at the NH, but she loved to sing and the aides would get her singing on the way into the shower, and I could sometimes hear her singing all the way down the hall. It actually worked sometimes to get her mind off it. Maybe you could try that?
And I have to concur with Barbs post... if your Mom is getting kicked and pinched and has to yell (to try to calm down a man who was always angry??) this is not certainly fair for her. Nor a healthy environment for grandkids to witness. Sometimes behaviors like this are too destructive for untrained people who are just trying to do the best they can, and may be better done by professionals for everyone’s sake. It’s not forsaking someone...it’s recognizing that a loved one deserves the best care possible, wherever that may be.