My wife has severe Alzheimer's and anosognosia and lives at home. This leads to many angry sessions from her. Any advice?

Johnny13: Your wife's ability to reason is gone. It's a futile effort on your or anyone's part to expect her to improve. What you can and should do is speak to her physician for a medication assessment.

I am just so sorry and I do not have any answers because my husband thinks he is the best he has ever been and lives on rage now. I believe it is very hard to change the way you relate to a mate who is really no longer a mate in any sense of the word. I suppose sympathy and not getting perturbed is the best course but this is just so difficult.

Johnny, my mother has truly not been happy since my dad died back in 2003. It's been a struggle to get a smile out of her since that time, and it's always fleeting. I'm just glad she's relatively quiet and not combative (on Depakote, Namenda, an antidepressant for years now) and can't walk anymore. When I visit her daily at dinner time, she's usually talking to herself in an unhappy accusatory way. I pretend she's like she used to be and talk over it and tell her what I did that day, what my sister and her kids are up to. I even make things up sometimes. I don't fool myself anymore that she actually knows who I am or what I'm talking about. If I'm lucky, she'll eat her dinner. The staff are all friendly with her and always try to get her to smile. I wheel her back to her room for awhile now that it's darker and colder (can't go outside in the garden now) and plug in her CD player, which may or may not calm her. She may sing along. She may talk loudly over it. She may nod off. I comb her hair or file her nails. Finally, I wheel her back to the big TV room where others like her are sitting. I make sure she's warm and comfortable and sneak off. I wonder how much longer this will go on.

First off, I have no idea what you're dealing with, so anything I type is only a suggestion.

Digging into my own past with my mother & father, he took over the cooking and cleaning and she took offense - to her it was a slap in the face as he continued to take away her responsibilities (how she looked at it).

Instead of doing all her 'chores' - would it help to instead ask to assist her in doing some of the things you took over? Like cooking? Don't tell her she can't - ask if you can help - you can say it looks to be fun! Things like, can I measure out the ingredients for you? I'm going to guess your wife can still "stir the pot" while you place ingredients into it. For cleaning - ask if it's ok for you to run the sweeper or dust around the house with her.

Especially with an older woman - if you take away all she brought to the marriage (her skills) - they do tend to get offended. In hindsight, my dad told me he wished he'd handled it differently. But he hid it all from us kids so we didn't even know there was a problem until the week mom passed away.

My DH is 96 and feeling useless - so I try to find things that he is still able to do - like hug me and kiss me. And offer advice. I am fighting to keep his brain and muscles active.

I can't even imagine what you're going through. My dad told me that my mother would get mad at him, saying he no longer liked her cooking and didn't trust her to wash the dishes anymore. There's nothing worse than feeling useless, worthless and unloved. I pray you find a solution soon.

Well, just a bit of follow up to those who might wonder. We have her on some standard dementia drugs for the past 6 years, memantine and galantamine. Then currently in addition to those, she is on a low dose of Seroquel three times a day, and Ativan when needed (which is normally too late. cant give a pill to someone in a rage). We had her on an antidepressant but took her off amonth ago, but may put her back on it in the near future.

You can't reason with someone with Alzheimer's. You need to find work arounds. If she wants to cook, let her help make a salad. During that stage it was so frustrating for my mom... She was so used to being busy and doing lots of things. I would make cookie dough, then have her help cut the cookies and decorate them. We took them to her neighbors. She loved it.
I also purchased Swiffer duster, and we would dust together.
We would do sit and be fit, it was available on TV and Netflix. She didn't really do much of it but she thought she was and enjoyed it ;-)
Read about validation by Naomi Feil.
Trying to "prove" that her memory is bad will just frustrate her.
I know how challenging but it can be. Just hang in there and love her.

Johnny13,

Our family is going through a similar stage with Mom, though she is more selective about who she blows up at; mostly my sister and I and not so much the rest of the family. She's mid-stage, lives in memory care and hates it there. Truth told she hates everything, complains about everything; has no idea how good she has it with her lovely private room, frequent outings (at least twice a week and often more) and gifts from family members. A ungrateful, miserable wretch. She's driven off much of the family who can no longer bear her constant bile and threats, so much that it's gotten to be a joke. I have reduced contact to the bare minimum. When I do see her and she tells me what a worthless excuse for a daughter I am, I say "Well, Mom, you raised me," or "All you can do is pray for me Mom," something neutral like that. When it gets to be too much (and it always does), I walk away, or if I have the misfortune of having her out with me, I take her back to the car and drive her back to memory care and let the experts deal with her. Amazingly, MC staff tell me how "sweet" my Mom is, which makes me gag. Hopefully the anger is just a phase andeventually she'll forget what she's mad about and mellow into total cluelessness. Maybe she won't. Her brain is broken. Her doctors refuse to medicate her. I think they're holding out for a positive diagnosis of dementia with Lewy bodies, which would guide them to an appropriate drug. We still don't know yet. My best suggestion is to dis-attach as much as you can. It dulls the pain.

I do feel for you. I recall when my LO was in that stage. She refused to let you agree with her. She would fly off the handle. Nothing was right. She imagined things that I did wrong, that weren't there. It was very trying. I agree that anti-anxiety meds may be something to explore. They helped my LO a great deal. She was still alert too. Just more content.

If some of the anxiety can be addressed, then, it's a matter of getting ahead of her complaints. So that if she started to say that she was not happy with the doctor, I'd say, "oh, yes, that doctor was so smart. Did you notice how she gave you so much attention and was so polite. I think you picked a good one." She didn't recall that I picked the doctor. And if she started to say that she was angry with a certain relative, I'd say, it's sad how they have been unable to visit due to illness, but, they sent their prayers and would come soon." I would try to appease her and let her think that things were her choice. But, sometimes that has its limits and you just have to do the best you can. It can be exasperating and sometimes, you just have to leave it with another caregiver for awhile. That's why respite time is so crucial.  At times, I would just apologize to her, even though I did nothing wrong and say that I was sorry that I was not as good of a cousin as I should be and that I would try harder, if she would pray for me.  That worked sometimes. 

I eventually learned that she could not process much information, so, I didn't try to convince her of anything except that she had some issues, but, they could be addressed with meds, nutrition, and therapy.  I kept comforting her that things would get better.  I mean, why tell her they would get worse? There's nothing she could do, but, freak out or deny it.  She couldn't accept it. So, I didn't try to get her to acknowledge her condition. 

I will say that eventually all that angst dissipated and she never complained or argued anymore. Now she can barely say a few words.

My mom was same and still is and she is now in memory care. It was painful; but I wasn't the spouse. The best thing I did when mom got in an "unpleasant loop" was to redirect. This meant, once her agitation edged up and hateful outbursts -- I"d suggest we go for a walk, a ride in the car; or have a snack together -- letting her get the crackers out, pour us drinks, simple tasks but still made her feel "in charge" and "with it". The same with cooking - let her cut carrots, peel potatoes, do the salad -- participate together with you on safe tasks, but you remain in command.

You are doing the right thing with placing her. Then you can go from being full time caregiver back to be a loving and caring husband while you still can with her. There will still be rocky and guilt-ridden times (she'll guilt you cause she can't help it) -- but be sure to participate in caregiver groups and you will learn alot and rest easier as you take this next journey together.

Agree with above, medicate if needed to mitigate anxiousness on her part. She is probably really scared. My mom sometimes looks at me so worried and asks "am I losing it" -- very sad. I try always to "meet her where she is" even if that is inaccurate recollections, her childhood, or the same questions 50 times. It's okay and since I've accepted it -- so much easier and I'm no longer frustrated or anxious. We actually have lovely time together again.

Johnny,

I am so sorry you're going through this. I know how difficult it is and there really is no solution other than medicating your wife.

You mentioned getting her meds adjusted. I'm assuming, since they need to be adjusted, that they are antidepressants? What are you supposed to do in the meantime? Have you considered asking her doctor for a medication that will help her immediately like xanax? Something you can give her while her meds are being adjusted? As unpleasant as this is for you and I know it is, it's also unpleasant for your wife. Even though she can't comprehend that she has Alzheimer's or refer to it as a reason for her behavior, her outbursts don't feel good to her. Regardless of the cause of her behavior the symptoms are miserable for her. I hope you can get her some medication quickly so she can have some peace. And you too.

Hi Johnny,
As you can see, there is no reasoning with a demented person. This is a difficult stage because they don't see that anything is wrong. Calm her anyway you can. Hang in there until you can place her.

Placate her, tell her that she has cooked for the last 30 years and you want to return the favor. Reassure her that she was and is a wonderful wife /mother. Bring up all the great things she did. Tell her you worry for her safety from the bad people out there and that's why you don't want her to be alone. You love her too much for anything to happen to her.

Please know that they think that we hate them (my mom says that ALL the time) and the other behaviors you mentioned are all part of the disease. This is NOT the woman you married. The disease has taken over. It is a brain disease that changes their personality. Hopefully, you can get her meds adjusted to help her be more calm.

Keep coming back for support. We've all been there.