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He has been dealing with Parkinson's for over 10 years, and I believe he has Dementia with Parkinson's as well. He has an aide with him 12 hours a day. One of the aides is very good with him, but he has aggressive outbursts with her. He acts out and wants to do things that are dangerous for him, and when she tries to help him, he tries to hit her or yells at her. She is very experienced dealing with dementia patients, but this is not my dad. I don't know how to help him. He lives in an Assisted Living Facility, and they have specialized care to help, but he refuses it. He is angry because he can't walk around and wants to get a hip replacement, but he is not a candidate for it. He has been going through these invasive tests I don't feel are right for him. I am trying to keep him in a routine as calmly as possible, but he fights against me all the time.


How can I get him to calm down and not be so aggressive?

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Talk to his doctor about meds for his agitation, if he isn't already on some. If he is, he needs them to be adjusted or switched. It's great news that his aid is experienced in this, but she needs to be protected. Make sure she knows you're working on a solution. I'm so sorry you and your Dad are going through this. Bless you for helping him!
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He needs a hip replacement? Is he in pain and could this be a contributing factor in his behavior? Maybe he needs something to address this potential problem, not just something to calm him down.
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poodledoodle Jul 2022
Hi OP! I agree with Vegaslady.

By the way, are you sure he’s not a good candidate for hip replacement? You’re right, an operation is a big risk - but not being able to walk is terrible (depressing; can lead to a low quality of life).

A family friend had a hip replacement at age 94 (after a fall). Very luckily it went well. She can walk now.

It takes weeks (physio) to recover from the operation, but it can be done. Of course, there are risks, so indeed sometimes it’s better to avoid surgery.

There are different degrees of dementia. It sounds like your Dad’s still mentally competent, otherwise you wouldn’t say: you “think” he has dementia. If he’s competent, and if he wants a hip replacement…

Well, what do you think OP? Maybe investigate a bit more, about whether it’s possible? Whether it’s a good idea?

The aim is not to live as long as possible. But as happily as one can. If one is miserable because one can’t walk around: sometimes there are solutions…

But I understand, an operation is a risk…but maybe your Dad prefers to take the risk. It’s his body, his life; he’s the one who has to live unhappily right now, with not being able to walk.
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Your father may be past the level of care assisted living can provide. He might be better served in a nursing home or memory care facility.
Ask his doctor to put him on medication for the aggression and violent outburts. That might be all that he needs.
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I have a classmate who was diagnosed with Parkinson's may 25 yrs ago. His wife kept him home till last Summer when he became aggressive and she could no longer care for him.

You need to get Dad to his doctor and have tests taken. I would bet there is some Dementia because it goes hand in hand with Parkinson's which is a neurological problem. Like said he may need meds adjusted or a new one indroduced.

I too agree that he maybe passed what an AL can do for him, even MC. Neither are skilled nursing facilities. You Dad will need more care as Parkinsons continues to deteriorate him.
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Sorry to hear about your ordeal. It is not easy but, the only thing to do is let them have their out bursts. If you try to fight back it gets worst. I am sure they are fustrated too and really dont know why they are going through it all. All we as caregivers can do is let things happen and assure them that we are here to comfort and care as well as we can. My father in law was difficult too with his diemensia and it was hard cause he would take it out on his son and me alot. At first we didnt know what was going on cause we werent advised that he had diemensia. After reading up on it, we learn to tell ourselves its the illness and not us. We as care givers have to see things in a different way. Now we have our mom, mother inlaw who has ALzheimers and she thinks nothing is wrong with her, she turns on and off and its hard to know what she is in everyday. She says nothing is wrong with her but with us her son and me she keeps repeating things and forgets alot. With others she is just normal as can be. So, again we tell ourselves its the disease. It helps for a while so we gotta take time outs with her alot. Hang in there and know one day we will all be in their shoes..
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lealonnie1 Jul 2022
No, sorry, we won't 'all be in their shoes' one day. Dementia is not something we all wind up with in old age. Nor is violent outbursts something we should 'let happen' and ignore. Especially when living in Assisted Living and having caregivers being threatened all day long. Super bad advice.
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Your father needs a higher level of care, most likely, Memory Care AL sounds right. And medication from his doctor to calm him down. No caregivers should ever be hit or violently approached. You don't just 'let them be' in such a situation.......it may just be the dementia talking and acting out, but why should a caregiver be hit or yelled at and better yet, why should your FATHER be dealing with this level of agitation? It's not right and it's not good for HIM! My mother, when dealing with Sundowning and her advanced dementia, got great relief with .25 mgs of Ativan which calmed her down quite a bit. When hospice came on board, they increased her to .50 mgs as needed and as her agitation progressed. There is no need to witness our parents in such a state, not when medications are available to help calm them down!

Some people here will say 'oh sure, keep him DOPED UP' which is not the goal; the goal is to keep him CALM and relaxed, as we would want for ourselves in the same situation. Please speak to dad's doctor about what's going on and to get a prescription written for him. My mother was super angry about a wide variety of subjects when her dementia was advanced, being wheelchair bound was one. The Ativan took the edge off to the point where she was able to smile again and to interact with me and her caregivers in a pleasant and amicable way. THAT is the goal here. Being aggressive and angry is not a good state of mind for your dad to be in, let's face it.

Wishing you the best of luck with a difficult situation. It's very hard to see our parents like this, I know, and my heart goes out to you. I went through it for quite a while with my mother and it's heartbreaking.
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Beeshepard Jul 2022
I agree with you. There is no reason for a caregiver to be exposed to combative behavior which can be controlled by medication. Sun downing can really escalate into violent behavior if no medication is used on the patient. Its not drugging them up either! Its modifying their behavior to avoid the patient from getting violent or someone getting hurt.
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I would start with setting an appointment with a Geriatric Psychiatrist who can confirm your diagnosis and prescribe medications that can address his pain and violent tendencies, which may cause him to be placed in memory care (rather than Assisted Living). A proper placement may assuage the situation and protect you from having to be his caretaker.
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Kmi7688: Assisted Living is no LONGER the right fit for your father. He requires a higher level of care, e.g. perhaps Memory Care. His outbursts will have to be controlled via medication.
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He needs the specialized care in the facility. You, or whoever is his POA, must make these decisions. It is NOT up to him.
This is also dangerous to a caregiver - the lashing out.
Of course he will 'fight against' you. His brain cannot process or make the decisions necessary. He is frightened, angry.
You must make these decisions for him - for his safety and welfare.
Educate yourself (Teepa Snow website) re aggression. It is not something you can easily or necessarily 'fix' by trying to calm him down. He may need medication. You need to speak to medical professions. Immediately. Do not wait until somethng happens. Gena
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Please get him referrals to a neurologist (for the dementia and Parkinson's disease) and a psychiatrist (preferably one experienced with geriatric clients for his outbursts and agitation). Agitation and outbursts are common in latter stages of Parkinson's disease. A competent neurologist and/or psychiatrist should be able to prescribe medications to help him remain calmer when things don't make sense to him.
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Get meds for him prescribed by neurologist.
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I guess Cover999 would prefer to be hit, punched, scratched, verbally abused
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First, he needs medical attention to rule out treatable causes of his behavior. UTI, blood chemistry imbalance, and pain are all culprits in worsening behavior.
Parkinsons disease often includes dementia in many patients, with hallucinations that are often paranoid in content. Lewy body dementia is hard to treat with drugs, as many of them seem to make symptoms worse instead of better.
Your dad may have some recollection that he acted badly towards others, including his caregiver. There can be some shame around this. And even a great
aide can get burned out after a while. A neurology workup and a geriatric psychiatrist are needed to figure out what is going on...and get a plan.
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