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My FIL is in a care center. His "filter" for appropriate behavior seems to have deteriorated. He makes lewd comments, talks about sex all the time, and is angry and swears at everyone. It is enough to almost make you want to die from embarrassment. I feel for the staff. They get the brunt of his anger. He falls, get hurt, refuses to call for help and self transfers (not supposed to), uses the F word, sets off his alarms just because, refuses to eat, and is just being a royal pain for everyone. Does anyone have suggestions on what to do. He is already on an antidepressant but seems to just be miserable and wants to make everyone else miserable too. I am at my wits end.

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Remind him that his behavior is inappropriate and tell him how you feel. Also make sure you compliment him when he is good.
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There is a filter that I learned about in school, that two people have mentioned and two others have not heard of. Normally people filter their thoughts and don't express those that would shock or offend. This is the filter being spoken of. Alcohol or neurological imbalances are two things that can affect this.
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My dad did not do this but he did say awful things about other people.He had no control over his mouth.My dad was not like that.The staff should not be bothered by that,I hear it is very common.One man at my mother in laws facility used to sneak out and steal peoples shoes,then show them his penis.Definitely an adventure:(((
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Since this behavior isn't unusual for patients with Alzheimer's/Dementia, the staff shouldn't find this too shocking. It is embarrassing for you but don't confuse that with how the staff are feeling. As long as none of the staff at the residence are complaining or saying that can't manage these behaviors, I would try not to worry about it.
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Thank you all for your support and guidance. This has been so difficult for my husband and myself. We keep trying to think logically and I am learning that this is not going to fix anything. My father in law does not think logically anymore so we cannot make sense of it. And maybe we are not supposed to make sense of it. You all have been so helpful. Thank you so much.
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All - sexuality and anger seem to be the last things to go in a dementia patient. please don't stress out, be embarrassed or I feel bad for the staff. If they have been adequately trained for memory care work, they know this and they know how to handle it. Actually, if they act embarrassed in your presence, it's probably because they are feeling embarrassed FOR you.

A neuro-psychiatrist I was meeting with told me that dementia causes the ego curtain to lift. This, he explained, is what keeps all of us "in line" with not working out socially unacceptable things. It and its inhibitory effect either erode or dissipate with dementia. So we have people saying things and doing things that they never would have dreamed of before. I believe this is the "filtering" of which you speak.

You cope by listening everything you can about his kind of dementia and realizing that he can't do anything about his behavior, it's commonplace and it's probably going to get worse before it gets better. Just someone being crude in and of itself is probably not enough to warrant medication adjustments. However if an anger becomes combative or sexuality becomes aggressive, that will be a different matter, and one that probably cannot be logically addressed behaviorally, but only by medication changes.

Just try to remember him as he was and think of who he is now as a completely different person because that is the reality of dementia.
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As a nurse, I have no idea what you mean by "filter". However, there are dozens of antidepressants he could try because it doesn't seem like he is on the correct one for him. His verbal behavior is controlled by the left side of his brain, and this area may be most affected in dementia. Have his doctor test for his testosterone level, and I am sure staff is charting his verbal behaviors so his doctor can read what has been going on, and lastly, do not visit as often. You seem to be in more distress and embarrassment than he is. Behaviors that are not usual for a person are most distressing for family members who once knew that person when they were well. This is no longer the case, nor is it going to change until either some different medication is tried or he stops on his own (which happens as dementia progresses). Be patient, be loving, and do not take any of his behaviors personally. Staff should not be embarrassed.
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For now I would have my husband visit and let it go, things change, this will too.
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You face significant challenges. I do not know if this information will be useful to you, but I think it might help you to understand what your father is experiencing. Please take a look at my Washington Post article on an approach to communication called the Validation Method, and from there, go to the VM website. You may find some insights that will help you--not to change your father's behavior, but to support you in responding.
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Do some research online. Be very careful, my mother went through this, with her dementia. Her doctor, at the time, actually over medicated her. She could hardly move, and was very confused most of the time. It was awful, finally got her another doctor. Research the medications he's on. They might be the problem.
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There is a patch with medicine in it that helped a friend through this. (It's not unusual with Alz/Dem.) Speak with the physician.
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