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For context, I'm the granddaughter of the elderly woman in question.


My mother and I live with her, and we need her house (long story involving divorce and a lot of other setbacks, including my mom having to quit her job to take care of my grandmother). We actually pay all the bills but she doesn't believe that, since she thinks her husband, who has been dead for several years, "took care of all of that" before he died. Her name is still on the house and everything.


Today, my grandmother, who likely has some form of dementia (she's also Japanese and does not speak English well/cannot hear well, which seems to make people reluctant to diagnose her with dementia) and who has historically been verbally abusive escalated to attempted physical violence. She tried repeatedly to hit her with a backscratcher while my mother was trying to help her off of her wheelchair onto the couch.


She's threatening to make every second my mother has with her hell, and has been telling me that I'm useless/never do anything for her. This is worse than it's ever been before. What can we do? She has had C. diff and almost had her kidneys fail, so we're worried about the cost of finding a group home for her especially with the history of C. diff - and she probably won't want to go anyway. She has repeatedly stated her intentions to "die in this house".


I just don't know what to do and am worried any action would somehow be seen as elder abuse, even though she's the one abusing my mom. Any suggestions or thoughts would be really welcome.

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Some forms of dementia include combattiveness. It will get worse. It does require emergency psych evaluation when she starts hitting and hurting for your protection. It may take several trials of medications including some hospitalizations. Nursing home may be in the future.  Even if she goes on Medicade, you can live in the house but will need to pay taxes and utilities but once she is gone you will lose the house.  Start planning for long term issues and begin to look for jobs.  Even you will need to self support in the future
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Honestly, the fact that my mom has to be the one to tell her to not do something or to do something (take meds, don't eat so much candy because you're diabetic, you can't get up on your own without supervision, you can't sit on the toilet any more because you're completely incontinent and cause a mess, etc.) is probably the biggest contributing factor.

We're taking her to her infectious disease doctor tomorrow, so we're hoping he'll test again for a UTI and see if it's just outlasted the Macrobid she was on before.

Sadly, GM isn't the type to forget - she remembers grudges forever, and that seems to be a trait that outlasts the dementia and Alzheimer's altogether. There's also, according to my mom, a very Japanese thing where she expects her child to do everything she says, to never contradict her, and to always tell her she's right no matter what. So it might be partly cultural, and there's not much to be done about that.

She's a difficult case, basically.
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ghostbird - Question. What happened RIGHT BEFORE your grandma started getting angry and hitting your mother? Did you mom say/do anything to contradict grandma?

I am not blaming your mother or you. Don't get me wrong. When my 81 y.o. Alz. mother told me something that didn't make sense. or something untrue, I used to correct her, and boy did that get her all worked up and ANGRY. She told me i was lying or I was losing my mind/memory. In HER mind, she was absolutely right about everything. I eventually learned to just go with the flow, just agreed with her so that we wouldn't argue. She usually just forgets what she said a few minutes later.

When my mother got angry, she yelled and cried, and that really upset me and made me feel really bad. The only blessing was that she forgot we ever had an argument 20 minutes later.

So, try to go with the flow, agree with grandma, don't force her to do anything she doesn't want to. Try again in a few minutes. and you may find her more cooperative.
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I know some UTIs are very resistant. It sounds like you and mom are doing the best you can with that.
Perhaps a geriatric psychiatrist would be a good call. A “specialist to help elders feel better”.
Ask her doctors what you can do to make it easier for them to diagnose her appropriately due to the language barrier. Perhaps there are questions you could have prepared and answered that the doctor could then reconfirm with GM.
All elders seem to have the ability to “ showtime”. Geriatric doctors are very aware of this. So there might be a level of protection for mom if GM is seeing drs who are more sensitive to elders and their manipulation of events.
Ghostbird, make sure your mom is getting breaks from caretaking. It’s very hard. We all have a breaking point. Don’t put up with dangerous behavior for both their sakes.
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She has had a history of chronic UTIs, but we just took her to her urologist last week and she was put on medication for, apparently, a bladder infection (we're not very happy with her urologist admittedly - he didn't test for a UTI a month or so back even when her urine was very, very cloudy, and her GP later diagnosed her with a UTI). We thought treating the bladder infection would be good, since any behavior even vaguely close to this has been almost always due to a UTI, but now I'm not sure.

My mom does not have PoA, and my GM is not the type to give it up willingly. We'd have to go for guardianship if anything, and I don't think she's there yet. I don't want to tell Mom we need to get that ball rolling until I'm certain we can get guardianship.

Will do on watching Teepa Snow, moving objects away from her, and keeping a log/getting video when possible.

Thank you so much for all these suggestions. I've been trying to not panic and having any process is helpful.
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Ok. I thought Barb said call 911 to take GM to hospital for a checkup since she’s acting out. I wasn’t thinking police.

But here are a few other thoughts.

First of all, if your GM is in a wheelchair I would remove all objects from her reach that she might use as a potential weapon. No backscratchers if she is going to become abusive.

If this is an escalation of violent behavior I would try to get her checked for a UTI. UTIs can cause this type behavior.

You could call your local Area Agency on Aging to see if you could get GM assessed to see what level of care they recommend. This would also put her on their radar and establish that she is acting out.

I assume your mom is not your GMs Power of Attorney?

Be sure to let the doctor know about these episodes.

Perhaps an adjustment in her medication would be appropriate if there is no UTI.

Keep a log of her actions and be ready the next time she sees her doctor or has to go to the ER. If you have dates and times and behavior it might help to get her diagnosed.

It does sound like she has dementia.
Dementia will not get better but there are medications that can help you manage GMs behavior.

This site has a great deal of information to help. Tell mom to check it out too.
It’s better to vent here than to become too upset with GM. Remember if she has dementia her brain is broken.

A visit with an elder attorney might be a good idea for mom so she can learn what resources are available to help GM and protect mom’s future as well.

Go on YouTube and look at Teepa Snow videos. They may help you learn techniques for redirecting GMs anger.

Be sure to get her checked for the UTI. It takes an antibiotic to clear up a UTI. They can be fatal and are very common with the elderly.
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Will do. I didn't have my phone with me this time and it happened... very fast, but if this happens again (which I think it might - she's the type to escalate like this) I absolutely will.
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"Is there anything we can do to ensure this doesn't turn into she said/she said?"

Yes. You can record the abuse on your phone.
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Just curious - what would calling 911 do? Police will come and then what? Can they remove the abusive grandmother from the house? To hospital? Or maybe just take a report so that later on the mom and granddaughter can protect themselves from accusation of elder abuse?
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I want to, but my grandmother is one of the types that can act sweet and like the victim around other people/not family, and the last thing I want is my mother to suddenly get accused of elder abuse because my grandmother will insist that she's the one being hurt instead of vice versa. Is there anything we can do to ensure this doesn't turn into she said/she said?
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Do what Barb said. 
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Call 911. Now
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