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Often times couples need to discuss issues that typically result in some type of outburst or disruptive behavior from the spouse that has some form of dementia, particularly in the early stage. I am seeking tips and suggestions to help avoid these outbursts of rage or disruptive behavior that often times erupt when discussions get a little tense or the spouse with dementia feels he/she is not being heard in the discussion or they may feel like their wishes are not being met.

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Jinx, if you ever to reach enlightenment, be sure to post about it, so the rest of us will get a glimpse vicariously!
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i like jeannes concept. it seems she was respecting the wishes of the patient. i think you want to avoid treating them like kids. i never tried to do my moms thinking for her. i was only there to keep her safe.
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I like what Jeanne says about pseudo discussions! He doesn't have to like it. He just has to do it.

I want my husband NOT to grumble at me when I give him pills to take. I can see that he IS going to grumble, to be irritated and annoyed. If I can just expect him to grumble and let him grumble and ignore his grumbling, everyone is happier. He wants to grumble. He is getting bossed around. I can let him grumble about that.

Instead, I will "fight" with him about appreciating things that he does actually like. "You're so lucky to have a nice wife to bring you a cup of coffee." I know it's not such a great idea to try to get him to appreciate me, but now, in early stages, I want him to "invest" by being nice to me. Then, later, when he has no rational thought at all, I can remember that he used to appreciate me.

I have a distance to go before I reach enlightenment.
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If my husband's behavior had been disruptive and prone to outbursts, I would have discussed it with his doctor, as pstegman suggests. Being unhappy that I told him he couldn't do something he wanted to do or had to do something he did not want to seemed reasonable to me and I sympathized with him. If his reaction had frequently been extreme, I certainly would have explored any suggestions his doctors had.
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My husband and I lived with his dementia for ten years.

I tried not to have "pseudo discussions" with him. I did not "discuss" whether he was going to take pills before bed, whether he was going to the doctor, whether he was going to a day care program, etc. I explained my decisions if he questioned them, but I did not pretend his wishes would be met.

When we did discuss issues, I picked a time when he was most cooperative and coherent. I let him have his say. I repeated what I understood so he could correct me if I got it wrong, and so he would feel listened to. The kind of issues I am talking about are whether he would have a feeding tube, whether he would follow a certain diet, what kind of vacation we would take, what he wanted to bring to the golf pot luck. We discussed things where his wishes really would be considered and I would do my best to meet his wishes.

He did not tend to get mad when we were truly discussing something. He was more apt to get mad when I was telling him something. "The sidewalks haven't been plowed yet and it is -10 windchill. It is not safe for you to use your mobility scooter today." Then he might argue and pout. He didn't get into rages or behave disruptively.
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Anxiolytic medications are your best best in early-phase outbursts. The MD may prescribe Ativan or Xanax in low doses.
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