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Recently my mom has been displaying very aggressive, and agitated behavior towards me. She has vascular dementia and she seems to be declining quickly. She is in a NH and has been for three months. The aggression and severe agitation is new, she is coming off of having a UTI and I know that can change her behavior but it honestly seems like the more I visit her the worse she gets.

Today when I went to visit her, her aggression, agitation was off the charts! She would usually get agitated when I was about to leave which she did today but as soon as I arrived she began screaming and cursing as soon as she saw me. She was by the nurses station and my husband quickly whisked her back to her room while I spoke to the head nurse who explained that they did a deep clean of the rooms and she has been like this all day. When I went to her room she was over the top confused and paranoid accusing me of conspiring with the staff against her. She calmed down after a while but when we went two leave two hours later she threw a fit. Yelling, screaming, swearing, the whole nine. I tried to keep my cool ( I am usually pretty patient with her) but there was no appeasing her. It was like nothing I have ever seen. I eventually had to call in the staff and had to just leave with her yelling at me while I was walking away. Any thoughts? Is this the vascular dementia progressing? I don't think it's the UTI as she has been on antibiotic for 10 days now.

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I vote it was the cleaning, the over the top today; if she stays that way and for the other, anyway, then, yes, something more, but today just seems to fit; that's a big disruption that I think the NH should have expected and planned for - plus, maybe has never been an issue for me and something glad's been brought up but hub knows I've often had issues with strong odors and have had to leave but what if you're in a situation like that and can't or at least don't know you can
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One has to be very understanding when dealing with aggressive or agitated behavior. Its a good idea to build some quiet time into their day, as well as activities to keep them occupied. Music, walks, reading, clean rooms all help.

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It sounds as if she knows she's changing and is fighting back with anger. This is so sad; I can't imagine how devastating it must be for you.
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As caregivers a lot of us are always quick to criticize the docs for over medicating old folks. But this sounds like a case that warrants some strong meds for mom to calm her down. She's miserable and angry and making everyone around her miserable. It couldn't hurt to try some meds.
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@Baba- I completely understand where you are coming from and very much appreciate the assistance.

@Partsmom - I am sure it is possible but something in my gut says no. I can't explain why other than I just don't think that is the case.

She always gets somewhat agitated when I arrive, which is usually every three days or so. I always attributed this to a rush of emotion that she can't really verbalize the way she wants. Sometimes it would be crying, sometimes excitement, sometimes agitated, some times moving through all of them at once, but never like this. She often would do similar behaviors to what she displayed today but usually I could work around it. Today there was just no way. I will definitely be looking into all the suggestions. This has to be by far the hardest thing I have done in my life to date. It had to be the hardest thing to watch someone go through.


Her confusion has been steadily increasing over the past few weeks and she is aware that she is becoming more confused.
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Could she have been reacting to the cleaning chemicals??
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Even if some of this is normal I'm always in favor of ruling out the physical first, especially in elderly women with dementia . They (my mom included) so often get written off as, " oh, that's just how they are ". But sometimes it's a UTI, twice in the past two weeks on this forum it's been a spinal fracture. And with my mom, it was a broken hip.

People with dementia can't tell you what's wrong all the time. So when they act out, you have to play Nancy Drew.
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She is not on any psych meds. But I will do as you suggest. It is difficult as my mother has always been difficult. We had been estranged four many years because of abusive behaviors so a certain amount of this is normal but again today was strictly over the top.
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I would call her doctor. Either the antibiotic isn't working or she's entering a new phase and needs better psychiatric meds.

In your shoes, I would be asking the nh doc for a full workup, blood, urine psychiatry. And if that is going to take forever, I'd call 9111 and have her taken to the ER for possible admission to the hospital. My suspicion is that there is an infection going on somewhere.
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