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Mom lives next door, is in ok health for her age, some dementia, takes antidepressent Prozac, hard of hearing but refuses to try a hearing aid, has isolated herself socially in spite of our efforts to keep her in touch with friends beyond letters and the phone, doesn't drive. Becomes enraged easily, often unexpectedly, and her pressure soars. Like her newspaper is late, my kids are too loud, there's nothing good on tv, someone wronged her 50 years ago, misplaced something, politicans, news, weather, etc. Dr is afraid med will lower her too much as it's normal when not angry. (increasing risk of falls) If I take her to the ER when it spikes, I'll be there every day. She doesn't believe she has a problem. Anger management is for other people with anger issues, not her. After all, if I just do everything to keep her happy all the time, problem solved. Um... I am mom to 3, and her caregiver. (my husband is patient and helpful - keeps me sane) I try to calm and redirect her but I am stressed, fearing for her health, plus her anger and negativity upsets me terribly. Yes, I take it personally, no matter how illogical. I hate that I cringe whenever she walks in my door (daily), wondering if she'll be friendly or clenching her fists, shaking, furious at some perceived slight. I watch her like a hawk for signs of a stroke, etc.

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Would her PCP prescribe an antipsychotic medication? Often elderly people lash out for no reason due to cognitive disorders associated with dementia. My mother did. She too got very angry at the drop of a hat. Fortunately not too many anger outbursts but enough episodes where I had to attempt to calm her down.
Another solution, and I hope you won’t take this the wrong way, is to stop taking her blood pressure but once a day if that. The woman is 94 yrs old.
How and why do you even take her blood pressure during these episodes? If no one is going to treat it, think about whether it’s necessary at that age. Her doctor is being cautious in not prescribing a antihypertensive med as then she will drop her pressure and can quite possibly fall.
Anger can cause high blood pressure in all of us. It’s a normal physiologic response.
I would think about pursuing an antipsychotic medication to attempt to balance her mood swings as these appear to be causing the episodes of high blood pressure.
Good luck!
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Has she always had a quick temper? Or, if you've noticed a marked change in her personality, roughly how long ago would you say it became obvious?

Also - how are you monitoring her blood pressure? I'm just trying to picture it: are you using an app on an iWatch or something?

Can you think of any other changes recently - medications, falls, trigger events, anything like that? You say she's in reasonably good health for her age, but at 94 that leaves quite a lot of scope - are there any known conditions?

It's a matter of figuring out whether something has happened that needs attention and, if possible, repair; or whether you need to look for new strategies to help you build your boundaries while letting her be.
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Try pineapple juice from your local grocery store. They come small cans of six. Dont buy the big can because her pressure may spike randomly. Let her drink a can or two, this will lower her pressure but it might take 30 minutes to work depending on her size and metabolism. Check with doctor because pineapple juice is very sweet and it may affect her if she is diabetic or allergic to it. As for mood swings, let her talk it out. Agree with her that it was wrong that person to take advantage when she has been nothing but wonderful to them. (Right or wrong, doesnt make a difference you just want her to calm down. And dont give your opinion because unless it will change the outcome for the better). It is a lot of work but try to be patience.
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Wow, this would be so frustrating, and scary for you. With her flying off the handle, walking on eggshells is not a good way to live your life. So I think I would concentrate more on the anger issue than on the bp. She doesn’t think she has anger issues, so that’s where I’d start. Can you stop her in her tracks during or after one of the fist clenching fits and show her that’s not a normal reaction to whatever triggered it? Assure her everybody gets mad sometimes, but that a normal reaction to A is B, not Z. That her jumping to Z is causing her health problems? That there are coping ways to calm herself down and stay healthier? There are many ideas on-line if you search for “dealing with an angry person” that you could try. If you can get her to recognize her responses are out of the norm, hurting herself and making you sad, maybe you can help the bp issue.

Just fyi I agree with the poster who questioned the need for the bp meds. Mom was on 2 low dose bp meds prior to the NH. They gradually removed both with no ill affects and now has a nice 130 pretty constantly. As their age, weight, metabolism and eating habits change meds sometimes need to be adjusted as well.
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I'm documenting her BP (taken with an Omron 3 cuff) after she reported leg weakness and some confusion. Got her to the Dr, checked BP and urine culture. Prescribed antibiotics for a UTI and now waiting on labs to confirm if it's cleared. No other changes in meds, situation... some Seasonal Affective Disorder likely compounding the issue. No BP nor heart meds for her. A statin, levothyroxine and antidepressant are her only regular prescriptions.

She's been somewhat quick to anger, critical and negative all my life. While I've explained that BP should be taken when quiet, calm, no eating, etc, she will storm in and demand it be taken NOW. We comply, figuring it'll help to illustrate her need to calm herself, hoping she'll see her reactiveness is dangerous to herself. Then, when she's calm, show her how it's back to normal. It's difficult to discuss her moods with her as she thinks she's fine and if only the rest of the world would stop making her angry...

Shane1124, I'll speak privately with her PCP about the readings and the possibility of an antipsychotic. I've hinted to him that agitation clearly plays a role in her numbers, but tap danced to avoid angering her. If he feels it's appropriate, I'll let HIM introduce the subject.
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Ana, has any qualified medical practitioner observed a raised bp in a clinical setting?

How often is she demanding to have her bp checked? Just to make sure I've got it straight: she comes to your house in a temper and says "I'm absolutely seething, those b@st@rds have left the gate open AGAIN, take my blood pressure at once!" Why does she want this done? To prove what, for what purpose?

How long has she been on the statins?
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Yes, high BP observed in a clinical setting. Dr calmed her and watched it drop.
On statins for 20+ years. We're to take her pressure daily, suggested by Dr after spiking re: UTI. We agreed around 4pm daily. Life happens, phones ring, things spill, dogs barf... we're late... she'll storm in. Never "Excuse me, but it's time to take my BP. Is now OK?" Some people always assume the worst.
And, Countrymouse, yes, if those b@st@rds left the gate open and her pressure soars and she has a stroke, then she'll know exactly who to blame. And that's important to her.
You know, I might be getting what *I* need here. Perspective. When it's always been like this it becomes your normal. Like if she comes in and I'm not home or I'm in the shower, I may find a snarky note on my kitchen table, complaining about how she needed to talk and I wasn't available. Meanwhile, I'm balancing my own needs and my family's just enough to keep my household running and her from blowing. I'm trying but burnout is around the corner.
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