My elderly father with severe dementia is having behavioral changes and I don't know what to do. Any ideas?

To address another issue, you say he resists bathing and putting on clean clothes, but he must sleep in PJs since he hit you with them? Id just take the dirty clothes when he gets into his pjs. One problem solved. I know clean clothes on a dirty body is not optimal, but it will still smell better than week old both!

I concur with the post from dontask4handout. Before I knew that my mother had dementia; she would act out and try to hit me. It was too the point that I was scared to go over to her house, especially after my dad passed away. Safety comes first, before anything else. When they are acting out or raging; they can do just about anything. In my situation my mother went into the hospital in January of 2017, and was not released until March 2017, however, since she resided alone, the hospital would not release her to go home. She went into Skilled Nursing Facility and then Memory Care. It is not easy and there was a lot of guilt about this situation, however, it is out of my hands, and as the months go by I realize that she is safe, and I am safe. Your dad needs to see a doctor for possible UTI, and possibly the doctor can help you get him admitted to a facility. I had endured years of verbal abuse from my mother, and it did not get better with dementia. This is a situation that will not get better.

First my hubby 9 yr alz sleeps long hrs. The doc said what's the matter w sleeping. So he may wake at 10:30 eat & back to bed. I just let him sleep sometimes 3:30 get him up. He sleeps at nite getting up to pee except maybe 1 nite out of 14. I now give him Tylenal PM if he's still awake 12am. Pills...the doc said just give them to him at nite. No problem. One thing alz persons don't like to be told what to do like being a child. Learn new wording. Read Alz Reading Room. Many good ideas. Also Teepa Snow on internet. I know you work but if you could & your mom go to support group you will feel much better. Many good ideas given. I find my hubby gets upset when I get impatient. So I must stay calm & realize if he doesn't do something the world won't come to an end. Many caregivers get sick & even die if they don't take care of themselves first. I'm glad you have help coming in. Ask yourself what would make me feel more relaxed. Then do it. By the way when my hubby is awake he must be kept busy or he rearranges counters, opens envelopes, rinses dishes soooo I found he loves 100 pc puzzles & dot to dot by numbers & spends hrs at them. I take dot to dot bk when we go someplace so he is occupied. We know this desease has no cure & affects not only them but the family. Hubby asks me many times what's my name. I keep it short w name only not that I've been his wife for 63 yrs. He doesn't know our 4 grown kids . I don't think he really knows what a wife or sons & daughters are. Our kids just say I'm so & so your son & 1 min later he'll ask agIn. It's all part of the disease. Remember we are in 2 diff worlds. In our world we can change but in there world they cannot & there's only goes downhill. There may be short moments you feel they are better then it goes back. Many of us are caregivers all w persons different. I have time of my own when he goes to adult day care 4 hrs 3 times a wk. This is only possible as we took out Long Term Care years ago never thinking it would be for this disease. We didn't take out enough but works for now. May God be with you & bless you & your mom for your care.

As a childhood abuse survivor, I never would've stuck it out as long as you have because it sounds like you must of been trying to care for your dad for quite a while. Violence is a sure sign of more than just dementia, there must also be end stage Alzheimer's. I would hurry and get him into a facility and make sure he has a guardian. When they get violent or even start yelling, that's it. At least for me that would be it, I have no tolerance for any type of abuse whatsoever. The first time someone like you're describing raises a hand to me, either I'm out the door or they are depending on who's name the home is in. I would definitely wash my hands of this situation if I were you before he has a chance to really hurt you because he's at a stage where he is now dangerous and you don't know when he may actually pick up something more than just pajama bottoms. The next thing he picks up may actually be a knife, tool or even a gun! You better get out of there before he has a chance to really do some serious harm because he's definitely not in his right mind. Hopefully after reading this you'll pick up the phone and call the squad and have him taken to the ER. Don't bring him home when he's discharged, talk to social services immediately and tell them you're not bringing him home and he's not coming around you no more because he's dangerous

It may be that you are dealing hostility brought on by dementia, but you do need to rule out a urinary tract infection.

My mom would never hit me, then one day I was tying her shoe lace and she began hitting me on my back with all her might. Clearly her intent was to hurt me. Then the next day when I was removing her soiled pull-ups as she sat on the commode, she began hitting me in the side of my head with her fists. We had her tested and she came up positive for a UTI. We got that cleared up and she never raised a hand to me again.

There r meds that can help but you may need to think an alternative. Your father can hurt you. They still can be very strong. He may need care that u can no longer give.

Shame it is tough. They do change with dementia. My dad turned into someone we did not know. He hated some nursing care and others he liked. If he didn't like the person, he became aggressive in that he would not let them touch him. But he never hurt anyone. One doesn't know what goes on in the mind and it is very hard seeing them like that. My dad passed away quietly after a stroke which damaged his vocal chords and he was very passive in the last few weeks. Hindsight is wonderful and I often wonder if I could have done more.

Since you already have nurses and aides come in they can get him up and get him dressed...do you have a sitter there as well? Do you live with them or just check in on them daily? Is he currently taking any medicine for anxiety..they may help with the outbursts....?
If his health continues to decline and he is uncontrollable...you may want to think about placing him in a long term facility...this would be your last resort.  if you need to apply for medicaid this can take several months and they have stringent financial guidelines in which they look back 5 years on their finances.   It takes a lot of patience to take care of two elderly parents.... As the mind declines..the rest of the cognitive skills are a minute behind...

I hope you find some help and assistance...I can only offer words of encouragement because I know how difficult it is.

Cathy.

To satisfy mom and help out dad, perhaps you could provide his meds and breakfast in bed, then let the hired hands see to getting him up and about later?

Definitely a change in routine can precipitate emotional response in someone who does not understand it all... If the suggestion I made doesn't work, then you may have to try getting intervention and/or medication to alleviate his problems. You cannot reason and/or argue with dementia, so there is no point in trying. You either find ways around the issue or get additional help.

Whoa, that is a scary situation!

I tend to agree with cetude. Has your Dad been tested for a urinary tract infection? Those reek havoc on the elderly. My usually mild-mannered albeit mouthy mother became combative and delusional when she had one. They actually had to tie her to the bed at the hospital. My hubby has a visiting nurse once a week. She does heart and blood pressure checks, asks him the same questions every week and then leaves. She has been of some help, agreed, but in the long run, not much. Since she is our " Case Manager", I plan to be very frank with her when she visits this week, on the advice of the good people here, and see what "real" help she might be able to provide. You seem to be spinning a whole lot of plates on sticks and that's darn near impossible. I worry for you that Dad is becoming combative. I worry that if he gets his hands on a knife or scissors, things could turn serious.

People say "let the nurses handle it" -- well, the patient can refuse help and the nurses can't do anything about it. Nurses cannot force care without violating some code of ethics. In my opinion you probably have to get medical help such as psych medications to get his behavior under control..and if you go the nursing home route and he acts out (starts hitting staff), they WILL put him in the hospital and may even refuse to take him back because he could be a danger to both staff and other patients. IF he is refusing care and medications you could end up calling EMS or the police to get him in the Emergency Room and have him Baker Acted which would force a medical evaluation. It's probably all you have left if he's refusing this and that and striking out. You can try reasoning with him which sometimes works..but in the case of severe Alzheimer's that's very difficult.  I know people will disagree with me but believe me home health nurses just won't "handle it" -- they simply will chart refused care and leave, and offer to come back at a later time. They would have no choice but to do that.  PS: You may have to give up your job. In my opinion they may need 24-hour supervision.   Just wait until he starts wandering around at night or going to the bathroom in his pants. Oh yes the "fun" has not even begun yet.

I think his eating and medication schedule should reflect his own daily cycle, and not the other way around. If he usually wants to sleep until 11:00, then his medication schedule shouldn't start at 8:00. And perhaps his in-home help could arrive later, depending on Mom's needs. Brunch is a perfectly good meal.

Would Mom take it better if the nurse explained the new schedule to her, and assured her they would handle the medications and make sure he got nutrition?

Your mother is a real fighter! That's both admirable and touching, but you will need gently to help her come to terms with changing realities - one of which is that your father's care is best left to professionals, and that allowing them more input is the best way to keep everything under control for longer. Reassure her that they know what they're doing, and that she mustn't feel worried about staying out of the way while they get him sorted.

It might be a good idea to look for a memory care unit for your father. Your mother will likely say no if you ask her, so don't ask her - you're just finding out, you're not planning to abduct him and lock him away. And then, if you find one you're happy with and they're really any good, they will be able to help you gain your mother's agreement to placing your father for the benefit of *both* of them.

Thank you for your response. I am inclined to let my father stay in bed if he wants to. My mother wants my father to get up so he can take his medications and eat so he does not get weak. She insisted that I go up and get him to come downstairs. I told her I am not going to do that again. I don't want to be yelled at and hit. The people who come to the house handle both of their needs. My father is not very cooperative with anyone who wants to bathe him or have him put on clean clothes.

These folks need 24/7 care either at home or in a facilty.

You have nurses and aides coming to the house. Ask them to get your father up and dressed, and don't worry that he isn't presentable when they arrive - that's part of their job. Also... if your father prefers to get up later, is there any special reason why he can't have his way?

Make sure your mother has everything she needs, then hand over and go to work. And good for you for keeping your full-time job!

Will the people you've got coming to the house be able to cope with your mother's ill health too?