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Almost a year ago, my husband with younger onset frontotemporal dementia, started pounding wildly on faces of family members/friends he saw in photos around our home. This violent behavior has progressed to beating on the faces of people on TV and other electronic devices, along with screaming obscenities at the faces, and last week, he actually broke our flat screen tv with his pounding-the whole screen is now black when we turn it on. About a month ago, this disturbing behavior began to include pounding on bathroom mirrors when he sees his own reflection in them. I’m terrified whenever he does this, that the mirrors are going to shatter, and even though I know I shouldn’t react with anger, as it just fuels the bad behavior, I instinctively yell at him to stop it. But he just laughs maniacally, and begins pounding again. He’s much bigger and stronger than I am, and so I try to calm down and explain that I’m afraid the mirror will break and he’ll get hurt, and then try to redirect him to some other room. But I’m on edge constantly, not knowing when he’ll be pounding on some framed photo, device screen, mirror, and even pics of people’s faces in magazines, and the pounding is always accompanied by screaming or screeching swear words at the faces.
My husband’s neurologist has had me start him on a small dose of seraquel to see if that may calm him down, but my question is, where might this hostile behavior stem from? It doesn’t appear that my husband is having any unseen triggers such as pain, hunger, too cold, too warm, boredom, etc. Seeing the faces themselves, seem to be the trigger. He even raps with his knuckles on the photo faces of close family members on the fridge. When I asked him what he’s feeling when he does that, he said “I just don’t like them” and these are photos of our daughter, daughter-in-laws and nieces:-( I have no idea what to do-I can’t take down every photo in our home, not let him look at any magazines or electronic devices where he will see faces, or cover up all the bathroom mirrors! I’m so at my wits end with this nerve wracking behavior, and I can only hope that the seraquel helps to at least diminish it, or cuts down on the number of violent outbursts.

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Contact the Assoc for FTD and join their forum. Ver good group with real world experience. And yes, remove the triggers like photos, for now. You have to adapt.
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Reply to vegaslady
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I'd be terrified that he may move on to attacking real people since all faces both known and unknown seem to trigger it, you would be wise to keep some kind of panic button with you at all times. And I think that Garden Artist's suggestion of a short stay at a psychiatric facility is a good one, they would be better able to observe his behavior and tweak his medications if they have eyes on him 24/7.
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It seems your husband is out of control at this time. The faces may appear to be "people" who challenge him in some way. SO, he is trying to get them to "submit" to him. I feel you have only 2 choices until you get him sedated enough that her doesn't react with rage:

1 Take down all pictures and mirrors. Only listen to the news on the radio, Keep your magazines under lock and key for your personal use. Do this until you and his doctors work out the "unique cocktail" of medications he needs to calm his rage. Be aware that this could take a year or longer... and you may be at risk of him turning the violence on you.

2 Send him to an inpatient psychiatric unit for behavior modification. He will need to stay until his outbursts are either redirected through therapy or calmed down through medication (or both). It will be much shorter than trying to work on the solution at home... and you will be safe from him turning the violence on you.
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My mom had FTD and as the disease progressed I received help from a geriatric psychiatrist through a hospice organization. She was started on Lexapro and Seroquel was added next. A couple of other mood regulators and anti depressants were used along the way. In the end Haldol was very helpful - but this is not a solution that always works.
The point is - you need to get your husband a psychiatric evaluation ASAP. A doctor can help you understand what’s happening in your husband’s brain that causes these behaviors. My mother could become a whirling dervish lashing out - biting, kicking, punching, scratching, pinching, hair pulling. It was scary and dangerous.
There are also many things you’ll learn from professionals about creating a calm environment. Removing clutter is a start. Keeping things simple to avoid over stimulation is key. Rest and quiet during the day as well. I’d recommend starting to look for a memory care facility that has some knowledge or experience with FTD residents. Staff need special understanding of the triggers and how to respond. I was adjusting my mom’s care plan every couple of months to keep pace with the disease progression.
It is a challenging situation and I remember all too well the early days struggling to come to grips with it. But it can be better with the right help.
Stay on this forum. I learned a lot from others that was valuable for my own mental health. You will too.
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DRoseSB Nov 21, 2020
Madzeena, what a terrible thing for you to have to see your mom acting in such frightening ways😢
I have definitely been thinking that my husband needs to see a psychiatrist, and I believe his primary care Dr had suggested that a while back ago, but I hadn’t felt the need at that time. Now, though, I feel it’s necessary to see one! I will have to contact his doctor for a referral.

Did your mom live with you, and if so how long were you able to care for her before needing to place her in a facility?

Thank you so much for all your helpful suggestions. I do notice that since my husband broke our tv, and we sit in silence while we eat, he is calmer at that time. I know it’s often advised to use music as an aide to help with mood and behavior, but it seems to agitate my husband instead of calm him, and he often will turn it off himself.
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Contact the Assoc for FTD. They have a lot of support. FTD is a very different dementia from Alzheimer’s and other dementias. It affects personality and social norms and filters. It can be very alarming to see and hear what a person affected can do with this condition. The brain is deteriorating and changing in very real ways and hubby can’t help what is going on. It could become very unsafe very quickly. Placement to adjust meds may be helpful but sometimes the meds can make it worse. Long term placement may become necessary for both yours and his safety. You definitely have reason to be concerned and careful. FTD (sounds like possibly Pick’s disease) is an extreme form of the disease and can be difficult to handle.
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I'm bringing this back into the mainstream instead of answering directly to a post.

Cetude wrote:

" Every single person who has suffered a stroke should be put on an antidepressant if they are able to take it."

Why in the world would you feel an antidepressant should be mandatory for anyone who can take it?  That assumes that many aren't able to cope with a stroke and move on w/o an antidepressant.   And it also encourages reliance on medicine as opposed to more healthy remedies.  There's enough of a prescription medication reliance in the US already.  

My father had a stroke at 80 years old.  He didn't need an antidepressant and wouldn't even have considered it.   He worked in his work shed (which he also partially built by himself), he interacted with neighbors, church friends; we went to free summer concerts; he drove across the state to visit relatives.

He never showed any signs of depression; in fact he's always been a determined person and that was his attitude, that it wasn't going to stop him from living his life to the fullest.

I never ever considered an antidepressant after I had a stroke.  Why would I?   I have my garden, my needlework projects, family and friends.   Why would I need an antidepressant?

Cetude, I realize that you're trying to be helpful, but please think seriously about your recommendation.  People are much better off if they can find coping methods that don't involve voluntarily taking medicine that may not be necessary.  Why encourage someone to take meds if they're not needed?
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cherokeegrrl54 Nov 21, 2020
Thank you GA...
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Unfortunately, I believe that FTD dementia is the least understood form of dementia there is, and the hardest to treat. Also the most difficult of the dementias in terms of behavioral issues and not knowing WHAT the heck to expect.

We have a poster here named OldSailor who's wife Luz suffered from FTD dementia..........and he took extraordinary measures to accommodate her bizarre behaviors. I remember he'd put her to sleep naked because the Depends and other briefs bothered her. He'd then clean up after her in the morning; every day, for years. Here is his Page on Aging Care:

https://www.agingcare.com/members/oldsailor

You can look up the Answers he's given on his page, all 709 of them, and perhaps glean some tidbits of knowledge from him; he was an amazing caregiver to his wife. I hope that helps you in some small way.

That said, you are facing a difficult situation with your husband and his aggressive behavior. Have you discussed this with his doctor? You need to immediately if you haven't already. He can become aggressive towards YOU without intentionally wanting to, but having a brain disorder, it can happen. The doctor needs to be one who's FAMILIAR with FTD dementia because many are NOT, and they will not be helpful for you. Research neurologists who have experience with FTD dementia in your area. Go from there. This is, of course, assuming you need such guidance. There are medications than can be prescribed for behavioral issues; anti depressants and/or anti psychotics.

Here is a link to the Alzheimer's website for more info about FTD dementia:

https://www.alzheimers.net/signs-of-frontotemporal-dementia

And here is a link to a lot of different websites talking about it:
https://www.google.com/search?q=ftd+dementia&rlz=1C1CHBD_enUS896US896&oq=ftd+dementia&aqs=chrome..69i57j35i39j0l5j69i60.5536j0j4&sourceid=chrome&ie=UTF-8

As time goes on and your husband progresses with the dementia, you may want to consider placing him. Look into Memory Care Assisted Living residences and Skilled Nursing Facilities in your area as possible options for later on down the road, if things get unmanageable for you at home.

Last but not least, please do not hesitate to call 911 if you feel in danger at any time. DH can be taken to the ER by ambulance for a psych evaluation; there is nothing wrong with doing such a thing. Even though he is not 'intentionally' being aggressive, YOUR life is very important here too and so is your safety. Oftentimes, caregivers forget that............getting SO caught up in the care of their demented loved one that they believe he is the only important person. That's not true: you BOTH matter. Take care of YOU, too, ok?

Sending you a big hug and a bunch of prayers. I'm so sorry that you are going through this difficult situation.
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Hi DeRose
As I read your post, my heart identifies with you and breaks for you as well. I am in my 6th year since diagnosis of caring for my hubby with FTD. Without a doubt the hardest part for us has been that my husband at 60 when diagnosed, has never LOOKED as sick as his brain actually is. When Drs and others earlier on looked at him and still even now, they have so many times underestimated the danger in our situation. I’ve had to be beyond diligent to make them understand that he absolutely has to be as sedated as much as possible or bad things are gonna happen. I’m not telling you to do this, but I got a flashlight with a stun on it to protect myself if all else fails. Not a taser, but a stun. It’s not strong, but will get him off of me in a crisis. In 6 years I have faced every threat you can imagine. Truth be told he should be in Memory Care, however we fall into that category of folks that worked hard enough to avoid being at or below poverty level in our retirement years in our state, but not making enough to pay the average of $5000 a month for a facility. No way to qualify for Medicaid so no way to pay for MC. So I’d love to have him in a home, but absolutely no options for paying for it. Anyway please take care of yourself. My hubby is on many meds and they are strategically given at specific times so to keep him directable. Adhering to medication times is paramount once you have them in place. There are those who might say “but he’s so out of it”.......well when you have to live in this 24/7 with fear and trembling, “out of it” sounds like a pretty good option. I have been where you are and it is a lonely road. Seemingly no one can believe what you go thru on a continuous basis.
I pray you find medical professionals that can help you. They are out there, you just have to find them. Stay strong!!
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lealonnie1 Nov 21, 2020
What a terrible situation! Have you spoken with an Elder Care attorney in your state to see what options you have? Sometimes Medicaid for long term care IS an option and we don't realize it, or how to go about qualifying for it. Plus, an EC attorney can give you other financial options such as VA Aid & Attendance benefits, just in case your hubby was in the service for ANY length of time. Go see one if you haven't already.......it's a free consultation most times. Good luck and all the best.
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Thank you all so much for your responses. You have validated that I do indeed have reason to feel scared and hyper vigilant most of the time! This morning was particularly disturbing, as he was pacing and seemed more agitated than usual, and began screeching and striking the bathroom mirror with a comb, and pushed my arm off as I tried to physically stop him from hitting the mirror. I had just started him on the seraquel last night at a small dose, and so many articles I’ve read advise that antipsychotic meds can often times worsen undesirable behaviors in dementia patients😱 I gave him his second pill at bedtime tonight, so I’ll see what he’s like in the morning.

Annreid, you know, I don’t really think my husband’s neurologist understands just how wild my husband’s behavior actually is, and I’m partly to blame, as I guess I don’t explain that I truly feel frightened by his actions, and that I need urgent advise on what I should do, or who I should call, if my husband becomes violent towards me! I believe most people just don’t take me seriously when I tell them how insane my husband acts-many people actually laugh because they find it so strange. And yes, Cwillie, I AM terrified that he’s going to move on to real people, with mine being the first face he smashes! My daughter suggested having a cloth collage made of all our faces and attaching it to a punching bag, but I’m afraid that would only encourage the hostile behavior! Although, he does like to beat the faces of certain politicians. So I could use one of their faces. I actually have placed a toy drum near his chair by the tv, and told him if he feels the need to beat on something, he can use that. He will drum out a beat on it several times during the day, but unfortunately it doesn’t replace the pummeling of photo faces:-( I have actually removed a wonderful old framed photo of my grandfather, as that seemed to be a favored picture on which my husband would take out his aggression, even though he respected and admired the man, and spent lots of time enjoying his company many years ago. Thought I’d better take it down before he cracked the lovely frame right in half!

GardenArtist, I have wondered about a geriatric psyche ward for at least temporary placement, perhaps while we are waiting to see if the med will help. I don’t know what started him on the fixation of people, but one of the first distressing incidents occurred when we had come back from a Yosemite trip about a year and a half ago, and he was carrying my suitcase into the house, and suddenly he threw it down yelling “ I can’t stand looking at this picture, I just want to rip it up every time I see it! I hate her!” He’d been looking at my luggage tag, which was a silly photo of my niece and her husband that they gave out as wedding favors! I got so angry with him asking why he would hate our niece. He said because she was full of herself and was a sickening person. Yet my niece had never been anything but kind to us. I think his loss of love and good feelings towards people are just a part of this horrible dementia. He has nothing nice to say about any women now, and refers to most he sees on tv or in magazines as
f-ing bs. And yet all he can think about is having sex. I’m so disgusted by the man he’s become, even though I know it’s not through any fault of his own, and it’s so sad that this is how I’ll remember him once he’s gone, because the man I knew and loved fades more from existence with each passing week. And never would I have imagined there’d be a time when I became afraid for my safety around him, as he was always my rock and the man who kept me on firm footing. And now I need a panic button to keep myself safe. It’s very sad, but also a very good suggestion. Thanks again for all your supportive replies.
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If you can use your phone to record some of his episodes you can show it to the doctor so they can see for themselves how frightening they have become.
And you might need to obscure your mirrors too, rub a bar of soap over them or cover with a cloth.
(I hope the seroquel works for you)
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