My mother with dementia is angry all the time and verbally abusive toward my dad. We want to hire help, but Mom is refusing. Not sure how to proceed, suggestions?

Would you let a toddler make the decision as to whether a babysitter comes in to stay with them? Of course not.

Crass as it sounds, a person with dementia is regressing to a place where they can't make the decisions, much like a young child. A child gets to choose between the red shirt or the blue one, but they don't get a say in whether someone comes to stay with them or where they live.

It's time for the adults to take charge. It's overwhelming for your dad, so perhaps you and your sister can take some of the pressure off by deciding this for both of them.

My aunt - who lives alone - also adamantly refused my arranging an aide to come in a few times a week for her. So, I changed the name, and instead of referring to the person as a "caregiver" or "aide", I told her that I was arranging a "health and wellness coordinator" or an "exercise trainer" (for balance and mobility) - and for that, she became very receptive - it was all in the way it was worded to her.

Perhaps you can try to reword the term "aide" into something more desirable - and maybe she'll become more receptive.

Wishing you all the best !

"Dad is just leaving it up to her to decide if she wants a care giver".

Dad will need to adjust his thinking. Try this..
He needs to take the wheel on this one as Mom cannot drive safely.

"I don’t think it should be entirely up to her".

Correct. The help is for BOTH of them. To enable HIM to leave the house with peace of mind. To increase HER safety.

If Mom cannot reason that, has become selfish as they do, explain the help is for HIM.

I keep telling my LO this. Everytime the other cancels the support, attempts to cancel, fusses, tantrums etc.

It seems in my case, a long standing habit prevents the sensible one overruling - he really dislikes seeing her upset.

So. To be blunt... I say he has to toughen up.

The options are;

Option 1
Arrange the Aide.
Mom gets upset.
Dad feels a bit bad.. but Mom is left at home much SAFER.

Option 2.
No Aide.
A tantrum is avoided.
Dad feels slightly better, but then Mom is left home alone, distraught & panicked + left UNsafe. Dad feels bad about that.

Mom gets upset EITHER WAY.
Dad feels bad either way too (well until he understands..) But option 2 is SAFER.

Put those options to your Dad.

PS +1 speak to the Dr about meds for mood

Everyone defers to mom, but she isn’t in her right mind. Time to make it clear that you’re in charge and realize you have to be. That will be best for everyone. She may never understand but she’s incapable of understanding a lot of things now. That’s how this disease is. Sorry you have this problem.

Slschiller, you might want to have Mom checked for an Urinary Tract Infection. Such an infection can cause all types of behavioral problems on an older adult. Your Mom's primary doctor or urgent care can run a simple test.

Depending on how far gone she is, is whether she should be making any decisions. A demented mind should not have any authority.

I would find a companion, introduce her to mom and let them develop a friendship. Then she can visit with mom, regularly and if possible, take her out. Mom doesn't need to know she is a paid companion.

Your dad matters too and you do not want him to become a statistic because he can't get away and take care of himself. 40% of caregivers die before the person they are taking care of.

I would tell my dad that this needs to happen and it needs to be at least once, if not twice weekly.

That's my opinion on the matter.

Edit: he should also have her seen by a geriatric psychiatrist to get her on some meds to calm her down. It's not good for her to be upset all the time.

Discuss this with her doctor. There are meds that can help with this problem. Good luck.

I agree with Alvadeer. Have a family conference. It is time to bring in the professionals. Work with your mom’s primary care provider. There might be a service through the hospital that specializes in “keeping aging family in their home environment as long as possible”. They should be helpful in both getting your father some help at home to bridge the time until she can be placed in a secure living environment. It will seem incredibly painful, but unfortunately with dementia there just is no happy choice and your mom is NEVER going to want help. My dad was the same way. I kept thinking after a fall, or feeling lonely, or after my pleas to say I needed some help that he would see the light and accept care. With dementia, they just cannot be rational. You cannot reason with dementia. The sooner you get help for her and your father, the sooner you might be able to get to a point where your dad and family have at least a little bit of peace. Your mom probably won’t ever be kind or happy again, but maybe she will have brief periods where she is pleasant. I can tell by your words that you will support your father, but don’t be afraid to suggest counseling for him. Please be sure he comes to a deep understanding that it is not his perceived failings, but rather this heart wrenching disease that has taken your mom away.

My father does not have anger issues but he still has some pride and so when I recently brought in daytime caregivers, I didn’t call them that in his presence. I said that they were people who were going to help do a little house cleaning. From there a relationship can, and in his case, has developed. I think bringing someone in and expecting the loved one to immediately jump on board as this being someone that’s going to care for them can be too much all at once. So starting as a “housekeeper“ but with the housekeeper knowing that this is really a caretaking position and letting the relationship develop organically. Just my two cents and I know that every situation is different.

You and dad must repeat 1,000 time per day:
This is a profoundly mentally disabled person with permanent brain damage.
This is a profoundly mentally disabled person with permanent brain damage.
This is a profoundly mentally disabled person with permanent brain damage.
This is a profoundly mentally disabled person with permanent brain damage.