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My father is 79 and has always been very patient, kind and empathetic of others. In the last year he has become the total opposite: impatient, becomes angry easily. He has also begun saying inappropriate things to others that can be very hurtful. From what I have learned it sounds like perhaps early onset of Alzheimer's or Dementia. I am a Licensed Professional Counselor, so my first instinct is to talk to him and explore these behaviors in an attempt to get a better understanding of what is doing on, and if he is aware of the changes. However, I don't know if this is the right thing for me to do. I never expected this to happen, and I am completely unprepared. I a m concerned he is going to become more aggressive as times goes by, and he is becoming verbally demanding of my mother, and making her nervous. How should I proceed? Should I seek out a professional who can help? If so, what type of professional?
I am a counselor, but don't have experience with elder concerns.

I appreciate some guidance!

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As mom began declining into dementia, I kept it simple. "Mom, your brain is playing tricks on you." Light-hearted discussions, short in duration. Mom is what the nursing home where she rehabbed termed, "pleasantly confused." I've been blessed. We can actually laugh about some of her behavior together.

If I had to deal with anger and verbal aggression, as I often read on here, it would be soooo much more difficult.

I'd want to let him know that his personality is changing from that kind, loving man you know into someone who's lost his filters . . . and that his brain is playing tricks on HIM. "I know you can't help it, dad, but maybe if I tell you about it, you can be more aware of that and hold yourself back..." something along those lines. When you catch him being unkind, especially to mom, I'd gently call him on it; remind him how much he loves your mom; how much she loves him. And that his brain is telling him to say things that his heart doesn't mean.

Since his mind/brain is being effected, I'd be very inclined to not reason with him on that level . . . I'd appeal to his emotion. Can't hurt. Might help.
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If you can get him to sign a Health Care Proxy and DPOA, now would be the time to do it. We were told that one of the hallmarks of Alzheimer's is hallucination, but he does not seem to have that. What he does have is the anger typical of early dementia, at a time when he knows he is losing function. The anger seems to disappear later, when they can no longer remember what they were angry about. To me, that meek phase is the scariest of all, because it means time is very short.
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Talking to your dad when he is in a calm mood, to see if he is aware of the changes, and if they bother him, could give you some insights. If this had happened very recently I'd suggest having him checked for a UTI (which can cause personality changes in elders) but if this has been going on for a year that isn't as likely. A thorough physical wouldn't hurt, especially if he hasn't been seen for quite a while.

What kind of doctor is his PCP? A geriatrician would be ideal. The PCP may refer him to a specialist such as a geriatric psychiatrist or a neurologist, if dementia is suspected. But there may be other, treatable, causes of this change.

Depending on what your talk with him reveals, you don't necessarily have to take him to the doctor "to find out about your anger" and certainly not to "see if you have dementia." This is for a thorough checkup that he deserves at his age. In fact, maybe this is a good time for Mom to have one, too. Dad should not see this as you picking on him. Before the appointment, make a specific list of what you have observed that concerns you. Give examples. How does he show his impatience, anger, etc.? Emphasize that this is not consistent with lifelong behavior. Keep it concise and non-emotional. Provide this to the doctor before the appointment. Unless Dad has signed a HIPAA waiver for you, the doctor may not be able to talk to you about Dad, but he or she can receive information from you.

If it turns out that Dad is developing some form of dementia, no amount of counseling is going to change that. But many people do benefit from counseling about how to cope with the changes in their lives. Start networking to locate someone who is experienced in this kind of counseling.

The other thing you can do that helps a lot IF you get a diagnosis of dementia, is to learn all you can about dementia and about his particular disease (such as Vascular, Alzheimer's, Lewy Body, etc.) As you learn about it you can help bring your mother up to speed. But first try to get him in for medical evaluation.

My heart goes out to you. Seeing a loved one change for the worse is always a blow!
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