What can I do for my Mom's aggressive and angry behavior?

Truffles, my mom is 91, has had a stroke brought on by intractable hypertension. She has vascular dementia, probably Alzheimer's, congestive heart failure. BP problems were worsened by anxiety and depression. I agree that less is more when it comes to medications for the elderly. But at this point, it's the bp meds that they are able to cut down on. That's what causes mom to be dizzy. Remeron and zoloft have given my mom peace of mind and soul.

Truffles, medications can be life sustaining, as well as dangerous, but remember that we are all going to die sooner or later, so do the best you can - it will never be perfect. But why shouldn't an demented elder know some peace if medications help? Even if there is some shortening of life, it sounds like a wise trade off - after all, there is no possibility of really preventing death. And if caregivers are driven to suicide/homicide as a result of a no drugs policy, then what good is that? Making life bearable for a caregiver is a perfectly legitimate goal.

Aggressive behaviour is a major side effect of psychotropic drugs like seroquel yet when old people have this reaction to the drug it is just attributed to their dementia . Another side effect to antipsychotics can be tardive dyskinesia which is an irreversable movement disorder similar to parkinsons . What Im saying is that these drugs need to be used with the utmost caution . When used long term they can cause problems worse than what they are being used to treat . When a person gets old they need a healthy diet and vitamins , also mental stimulation not a dumbing down of their senses with a chemical cosh . Its a cruel ending for a lot of old people and there needs to be changes in the way old people are treated Did you know that psychotropic drugs can cause incontinence too . I personally think it is cruel that many old people are being forced daily to take a cocktail of these type of drugs . Old age is not a mental illness It is a natural progressive part of life yet the drug companies are making millions from it . It is normal to become forgetful in old age We all need to be more understanding and put ourselves in their shoes !! Doctors do overprescribe drugs to the elderly and it is unfair especially if that person has no family to keep an eye on them . Many of them are just lonely . There is a drug and a label for every feeling and emotion these days . Its more about money than care ! I really would like to see a change

Truffles, you are not listening.

Reminds me of the time when I was a brand new doctor in a brand new town and this other doc, who shares your point of view convinced me I needed to take a young patient off all his meds, because everyone knows those meds cause dysphoria and he would be all better without them in the rehab facility. I did it on his advice and regret it to this day...Between the other doc's dogmatism and my naivety, we harmed that patient, which is the one thing you are not supposed to do. Within a day of being fully off meds he was psychotic, flapping his hands, and buzzing like a bee, unable to participate in the rehab, and then that rehab was not terribly interested in taking any of my patients again after that either.

All meds can have side effects. Those that do, have them for some people and not others. All meds on the market on on the market because they have been shown to be helpful significantly more than harmful to at least some group of people. Maybe I should let my current rehab patient with schizoaffective disorder just go back to screaming and trying to climb out of bed because they think we are making them drink blood instead of water, and try vitamins and a good diet (which will be thrown across the room for fear they are deadly poison)? Would that be kindness?? And because of this underlying disorder, the low dose SSRI we normally use for people who have PTSD made her worse instead of better, maybe I should never help anyone else with that class of drug again, instead of just stopping it in her case?? Might that not be cruel to people who need to get their serotonin levels back up to where they can feel OK and function again?

Drugs and side effects are a hot issue for me, both ways. I see people hurt by side effects being denied or ignored, and I also see people whose lives could be a lot better if they would try the medications that would help with their specific psychological or physical problem. I have a child who is in extreme pain from high stomach acid, making them arch their back and clench their teeth, and the parent does not want to give anything that is not "natural." I suppose we will try some aloe vera juice, and it might help a little, but we could have nearly complete relief within hours or days if we could use what we usually do.

Just saying that THOUGHTFUL, careful, intelligent use of medication can do a world of good and being against all meds all the time makes very very little sense and leads to needless suffering just as much as any of the side effects you mention.

My mother is aggressive and angry without the help of any drugs and has been like that all her life. Now she is also delusional and paranoid, again without any drugs. Drugs are only hope she has for some peace from her fears and some ability to stay in relationship with others. Her delusions drive people away. her anger has driven people, including family members, away. She has had a healthy lifestyle, eats properly and so on, but age has caught up with her and she now has vascular dementia. She and I and other family members are not inclined to take any more drugs than are absolutely necessary. Without medication she will be relegated to basically a mental hospital type setting and will continue to suffer psychotic episodes, and will be medicated when these occur. With regular medication she can be placed in a more pleasant setting and have some kind of a more normal social life. I am her advocate for medical issues and am advocating for meds as they ease her symptoms. They do not cure anything, as there is no cure for what she has, but they improve her equality of life. Do I like it? No. Are there side effects? Yes. I would far rather that meds were not necessary. Some times none of the options are great. She is in psychological pain, she is has isolated herself from others due to her illness, She is depressed. Meds are the only treatment available. I wish it was otherwise, but it isn't.

The other thing to say is that we are not talking about "drugging" normal, healthy seniors or trying to find a cure for normal aging. A little less mental sharpness or poorer memory that means you have to get better at writing memory lists may be normal aging. Not running the mile in 5-6 minutes anymore is normal aging. Dementia, depression and psychosis are pathology, not normal aging.

I just think it is very sad that some old people have irreversable tardive dyskinesia and other brain damaging side effects brought about by the over prescribing of psychotropic drugs It is unnacceptable . We need big change in our care system and . many other people feel this way too ! Journalist and author Robert Whitaker has hit the nail on the head with his amazing book "Mad in America"
Anyone with an aging parent should read it !

Had JK reposted since the initial inquiry? Troll?

Although I have yet to find an answer for my own mom and her ability to be so hateful, as I was reminiscing I remember a wonderful friend who would always calm down and relax when you would read the bible to her. Worked better than any medication on the market. God's word .... It's amazing. Hope this helps someone

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Also want to say thank you to Vstefans for taking the time to explain. I agree that ppl do better with meds and then there are some who do not. Just seems to me that for everyone that has a bad effect it's like 75. And for the ones you never hear about because they are doing so much better they seem to count as a lesser population because you don't have any complaints. It's always the squeaky wheel that gets the grease and always the Most attention whether good or bad. Medication is and can be a wonderful thing both for the patient and caregiver. I for one would rather be comfortable in my old age rather than having uncontrollable rages Just saying. It's not all bad for all elderly who are on meds.

Thank you for your responses. Some have been very helpfully! My mom has been in the faculty now almost 3 months and things are still about the same. The serequel seems to work be helping sort of. She doesn't yell loudly at me she now starts to cry and then goes into telling me how much she hates me and the place. I think the hardest part is that I just can't get her to calm down! I just feel so helpless! I keep wondering if it will ever get easier not only for me but especially for my mom!

I believe quality of life is more important than just number of days lived. My aunt is 92 and beginning to suffer (note use of word SUFFER) agitation. Paces the floor, can't sleep, follows us around thinking someone is going to take her little dog or abandon her. If we can find a medication that will calm her down and give her a little peace I will be more than happy to give them to her.

My mom is now blind due to macular degeneration & just moved into an assisted living facility because my brother cannot be with her 24/7. I live out of town & call frequently & have made monthly trips home the past 4 months because of her health. She is extremely mean to my brother who has always been available to her for dr. appointments, grocery shopping, companionship etc. including her in his family's activities. She hates the facility; won't try to do anything for herself like she did at home; and complains to me about my brother. He is a warm, loving, caring man and it hurts me to hear her trash him. How can I make her see that she's being mean and whatever solution you give her for her problems, she says "no".

Quite frankly, none of us are there and can see through your eyes. You know your mom best. Work closely with the doctor. Educate yourself on the stages of Alzheimers and the behaviors you will see because of the disease. What you *will* see will be alarming, scary, and it's not for softies. Sometimes meds help, sometimes not. I can't sit idly by and do nothing for my mom though.

I will not bash nursing facilities, docs, or meds. Modern medication has done amazing things for many people I know, including myself and my mother. All meds are not bad, so I am leery of anybody who says to pitch it all out the window.
That may do more harm than good.

I am also leery about advice to just move mom every time she isn't happy. You might find that turns into a chase for the pot of gold at the end of the rainbow. It's just not there. Happy comes from perceptions and beliefs. When you have a degenerative brain disease your perception, beliefs, and ability to comprehend is severely impaired. Different dementias progress different ways. Nothing may ever get mom happy as compared to when she was younger and didn't have a dementia. That may not be a reasonable goal. This is something to discuss with the doctor and your social worker.

Are all elderly people overmedicated? I think that's an opinion, not a fact. When an elderly person goes into care, the doctors have to treat certain things with meds because the body can't do it independently any more. They have to pick their battles. It's not easy and I take my hat off to the people who treat the elderly.

Sometimes sedatives are completely in order. When a person's behavior is so violent they are a danger to themselves & their caregivers, it's either that or being strapped down. If I am like that, please drug my old butt up to the hilt! I don't want to spend my days raging and raving, screaming, clawing, scratching, spitting, & hitting. Is that shocking to see, experience, and deal with? Absolutely. But there are no magic answers with dementia. There is no one size fits all answer. There are no guarantees, no promises, no warranties. We just do the best we can.

have a word with the doctor and voice over youre concerns about this medication having no effect. I would also delve into this living facility as to why she names it ( a h*ll hole ). have you tried visiting during the day instead of night-time? I would certainly want to see if her behaviour differs between day & night. if the staff can handle it during the day, then why does the night-staff put her in her room before you even visit her at night? they should be helping her not shutting her in.it may help if you were to visit her alone, you were the one who cared for her before she went into this place. take it in turns it may be better on a 1 to 1 basis. personally to put my mind at rest I would turn up unexpected during the day to check out all of this out, this could even be true it may well be a ( h*ll-hole) and is finding it impossible, if so then that is why she has changed her behaviour so quickly, and hating you for putting her into this place. if so you can allways find another. check it out. good luck.

JKayjr - talk to your social worker at the NH and ask for a care conference. The place my mom is at does them quarterly, and they last about 20 minutes.

If you have concerns in between conferences, then there should be a contact you can talk to. If not the social worker, then someone who is the designated person for family to speak to. Use this person to help figure out what's going on.

Sometimes Sundowning makes people become extremely disturbed, and it can start early in the afternoon. Nobody knows what it is exactly, but it is AWFUL to see. This might be a cause of your mom's behaviors.

It could be related to meds.
It could be a urinary tract infection nobody has found.
It could be pain.
It could be the dementia making physical changes in her brain.
It could be a nice combo platter of all of the above.

The only thing you can do is work with her doctor and the people in charge of her care to understand how to find the cause and what to do about it.

Ask the people who work there what the protocol is for someone in your mom's shape who may become disruptive, loud, angry, etc. I would want to know why they put her in her room, and what else they may have tried before that.
I mean they can't have somebody out in the middle of the common area screaming and swearing and being agitated. It gets others agitated and then there is a great big problem. Putting her in her room might be one of the ways they try to get upset people to settle. Ask how often she's checked on when that happens. I would think they would have a protocol for the aid workers to follow.

It's like trying to figure out what works with an upset toddler. Maybe they need less stimulation to settle. Maybe they need a nap, a change, a snack, or to just work it out of their system. It's entirely trial & error with human beings who aren't machines that follow a strict cause & effect diagram. Especially when brain change is afoot.

ALso, look at what you exect for care levels. If she is in a group setting in a NH, they are likly not staffed for a lot of one on one time. If you want her to have more individualized attention, maybe you need to look for smaller scale congretate housing. There are lots of choices out there these days and it boils down to what she can afford.

Just keep in mind not all people respond well to every drug. Mention what are you seeing to her doctor and see if they won't be willing to try something different. My grandma was on anti-dementia medication. We had to take it away because it altered her mood, made her upset, worried, angry and just plain miserable. We decided back at 70 that we would rather enjoy the time we had with her rather than prevent the disease. She has functioned very well until the last year or so and she's 85. So I'm not saying to take her off but instead I'm saying see if there isn't another drug with lesser side effects that might respond better with her. It's tough to watch. Just make sure you do your homework with making sure she gets the best care she can and don't be afraid to advocate for something different if you think it will help.