The more I read here the more and more I see posts relating to dysfunctional behaviors coming from the afflicted. I have not yet been able to do research on this, however in my home (my Father has not had the official diagnosis yet but all the baseline symptoms).

I have seen caregivers bullied, attacked, etc. In my home now it seems to be more of the passive-aggressive BS. So is the Dementia causing this or is it the old age? How do we respond to it all?

I have seen many post responses that recommend placement. I haven't' seen any real strategies to deal with the dysfunctional behaviors and I think there should be.

I have tried ignoring. That usually doesn't' work because he will find something else or he kicks it up a notch to create even more issues.
I am also wondering if Dementia is comorbid with Psychiatric Disorders. I am seeing a lot of symptoms of these in my home. I am also reading a lot about others who see behaviors that mimic Psychiatric Disorders.

I thought it would be a good idea if there were some strategies that we could pool together to help minimize the behaviors. I did it with my oppositional defiant teen and it worked. My Son has ASD and his behaviors are well under control.

It doesn't' feel right to me to just throw up my hands and say I am not dealing with this. I would rather try and solve it. At a minimum I would like to implement some behavioral strategies to reduce the level of dysfunction. I am thinking this could help many who are here.

I wonder sometimes as well if they seem to "enjoy" the dysfunction created. WIth my Dad I offer solutions to problems and he never implements them. I really want to get a handle on this, but sometimes it seems so crazy I have to wonder if it is EVEN POSSIBLE to get a handle on it.

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I may get fussed at for this but here goes. My credentials are that I am a retired nurse, dealt with a lot of head injuries,AD, psych patients. To me dementia is a head injury,but the kind that won't heal or get better only worse.As for your teenager, the brain is still developing,there is no degenerative changes. I have had patients in their 40's with AD,it isn't always age related. Also dementia can come from brain tumors,sometimes these are fatal ,sometimes they can be "fixed" with chemo or surgery. But real dementia, the AD kind, you can't fix.Maybe someday their will be a "cure" pill but right now there isn't.You can only deal with it. Behavior modification won't work with it, especially if they are having short term memory loss.It can be maddening, there is no logic,no consistency.You can " solve" it, only deal with it, thru medication and care. By care, I mean make sure they eat, they are clean, they are in a safe environment.Unfortunately, AD is forever until there is a cure,and I don't believe they "enjoy" it.What's really awful is someone who already has psych issues and then develops AD on top of it, what a perfect storm.There is no predictability of their behavior, someone who was once peaceful can become violent and vice versa.You can get a handle on this, but you aren't going to "fix" him or modify his behavior.That will only bring more frustration on your part.This can be a very emotional journey as you see someone you know turn into someone you don't recognize anymore, you lose them twice.Please get him screened for dementia by an MD that specializes in AD and other types of dementia so you can know what you are dealing with and then formulate a care plan.Sometimes families have no choice but to place their loved one in a facility because they aren't able to have shifts of people watch over them,yes, shifts of people. Sometimes an AD person can go days without sleep,wander, restless despite meds,no one person can watch someone like this 24/7 with keeling over with exhaustion.Also,yes, they can get very violent and I mean really violent,like send you to the ER violent.Sometimes families just don't have a choice, AD doesn't give them one.We like to think we have control over a situation but you know, sometimes life just doesn't work out that way and you will drive yourself nuts if you think there is some "solution" that if you just do A,B,C everything will be fine.Dealing with a person that has dementia needs flexibility on the part of the caregiver, everyday is something new.
Helpful Answer (20)

Dealing with someone with dementia isn't like dealing with a willful child although it can feel like that. The person with dementia has absolutely no control over their behavior and isn't even aware of it. They won't grow out of it, the dementia only gets worse. You can find coping strategies but dementia isn't a problem that can be solved. The brain of someone with dementia is damaged, there's nothing that can be done about it. If families could cope well with dementia and manage it so that there's little stress involved in dealing with the dementia websites like this wouldn't be necessary.

You'll find coping mechanisms to deal with your loved one but with dementia sometimes one strategy will work one day but not the next day. Dementia is fluid, it's ever changing.

Sometimes medication helps but this is where you have to work with your loved one's Dr. Sometimes medication is indicated when the person becomes agitated but again, this is something that has to be figured out with the Dr. based on your loved ones symptoms. Many times implementing medication is trading one problem for another.

If you read the articles and previous posts on this site you'll read about caregivers who come to the realization that they can't change the behavior of someone who has dementia. All they can change is how they deal with the behavior of their loved one. We can't tell our loved ones with dementia to straighten up and fly right. It's not a behavioral disorder. It's brain damage and little can be done to change it.

There are a few tips and tricks in dealing with someone with dementia. Redirection is one of them. When the person is obsessing or repeating the same thing or maybe on the way to becoming agitated we find something else for them to focus on in that moment. Sometimes this works, sometimes it doesn't. And while it may not sound like much, keeping someone with dementia redirected is emotionally, mentally, and physically draining.

Trying to reason with someone with dementia is futile because they don't have the ability to reason anymore. Your son retained his ability to reason when he was having behavioral problem but people with dementia can't be reasoned with and trying to get them to make sense will drive you crazy. If they insist that the sky is red trying to explain to them that it's really blue will take up your entire day because they can't understand. It's just easier on us if we say, "Oh yes, what a lovely shade of red" and then try to move on. Arguing with someone with dementia is useless and maddening.

You don't have to throw up your hands and refuse to deal with it but understand that you won't solve it either. You'll find coping mechanisms that help with your loved one and some days they'll work and other days they won't. And if you find coping mechanisms that work for you then you must come here and tell us about them!
Helpful Answer (18)

I have heard the negative comments " all you want to do is drug the elderly" and this usually comes from people that have never had to deal with a human being that has dementia.I am all for better living thru chemistry. On the right medication regimen,and this can be trial and error because one drug does not fit all,but they can at least have some quality of life even if it is just to not be terrified all the time.,even if they never recognize their family again if they are just at peace. I know that the former Supreme Court Justice Sarah Day O'Connor 's husband has AD, he no longer recognizes her or remembers their long marriage, in fact the facility he is at he now has a girlfriend who is also a resident at the facility and Ms. O'Connor will visit and have lunch with them both. I know this has to hurt her but he is calm and happy and has quality of life and I am sure on several drugs.I believe that without the drugs this would be a miserable man and a miseable situation.
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I can't add anything to Tex's and Irish's comments -- they sum it all up.
Regarding your comment about wondering if they "enjoy" the dysfunction: Yes, I absolutely think that happens. Sometimes it's the original personality coming out, even more magnified. And sometimes it's the only time they get to feel that, in that one moment at least, they have your attention and they're controlling things. Even if the situation is actually getting out of control, they know, in a very "toddler-ish" way, that your reaction is due to their behavior, and I can see how that might be satisfying to them. Absolutely maddening when it gets in the way of their care, though.
Helpful Answer (8)

The only way that I know of to ameliorate the behavioral and personality changes that come with dementia involve medication. Not "drugging the patient into submission) but using anti anxiety agents, antidepressants and other psychoactive meds to ease agitation, paranoia and overwhelming dread. My mom's brain looks like swiss cheese on a CAT scan. Without meds, she's in abject terror of the IRS and something else so frightening she can't tell us what it is. Just cries, "I'm a bad person". I won't let her be like that.
Helpful Answer (8)

Yes, dementia can exist with psychiatric disorders. My mother is bi-polar, has Cluster B personality disorders, depression, high anxiety, paranoid delusions, and Alzheimers. She was also exhibiting signs of OCD when in her home. This combination is well beyond the capability of your average GP, but mom would never seek help for her psychiatric problems - ever. It was taboo.

The dementia emphasizes, exaggerates, and amplifies the psychiatric behaviors. She lived with us for 3 1/2 weeks while her apartment was being readied in the residential facility. In less than a month, she had all 4 of us hiding from her, dreading her theatrics, her demands, her negative domineering talking, her tantrums. We couldn't even relax in our own house anymore. She refused to let me or anybody else assist with her medications. She had 19 different meds to take, and she had it so mixed up there was no way she had the right things at the right times which helped nothing!

Were her behaviors from her psychiatric disorders or her dementia? I struggled with that for a long time. I figured out that dementia had taken away her reasoning skills, so anything process related or that had more than one or two steps was gone. What little emotional regulation she ever had was gone. Her ability to process visual and auditory information correctly was gone.

Her angry and negative responses to everything was not dementia. Her attention seeking stunts were not dementia. Her hissy fits and tantrums were also not dementia. Her mean spirited way of talking to any of us was not dementia. Her trying to hit me in the head with her cane while we were driving down the highway was not dementia.

These things had always been there in mom, I'd lived through it as I grew up, but now, they were a lot closer to the surface because of dementia. She had very little control over it anymore. She used to behave in front of strangers, neighbors, and people in authority, so nobody outside the house really knew what was going on behind closed doors. She can't hold it together anymore, and that is dementia. She's not as clever and devious, which is dementia.

At some point though, it no longer matters what the cause is. The treatment approach is the same. Anti-psychotics and anti-anxiety meds. A secure memory care residential unit where people know what to expect and how to handle it.

You will need to plan ahead for your dad and your family's preservation. Someone will need power of attorney and probably guardianship. He will eventually need to live somewhere other than your house.
Helpful Answer (8)

Wow, there are some really good responses on this thread! texarkana, that is one of the best explanations of the difference between dementia and treatable disorders I have read!

Aphena, we tend to think of dementia as a memory problem, but it is certainly a behavioral problem, too. And a decision-making problem. And an executive-functioning problem. As far as I've read, dementia doesn't cause other psychiatric conditions, but can co-exist with them.

There are over 50 distinct types of dementia. With luck the Neuropsych testing will help to at least tentatively identify which kind Dad likely has. That will have guide your research and learn what to expect and to a lesser degree how to cope.

Best wishes to you, and continue to share your journey with us!
Helpful Answer (7)

My husband suffered from Alzheimer's, or more accurately -- we all suffered from his illness. It's a difficult progressive illness mentally and physically. It's as though they regress gradually back to an infant stage where they can no longer care for themselves regarding hygiene, dressing, walking, eating, drinking, bowel & bladder control, etc. The mental aspect is definitely the most difficult part to deal with. I found these strategies to be helpful:

Distraction - when they're being argumentative, bring up another subject pertaining to something in their life that made them happy, proud, peaceful, etc.

Delaying -- for example, if they refuse their medications, bathing, eating, and the like. Say 'okay, that's fine' and try again in 15 minutes or so. Chances are they won't remember their little "fuss" a few minutes ago and may be more cooperative.

Tasks - Give them a simple task to do. For example - sorting buttons, tearing up junk mail, folding towels, sorting things by color, finding items in a catalog, looking through magazines or picture books, sorting old photographs, etc. This will make them feel useful and get their minds focused on other things.

Research: What was life like when they were a child? You can find out a lot on the internet. Ask them questions about it, such as what type of music did they like, who were the most popular movie stars, what kind of clothes did they wear, what were the popular books of the time, how many children were in their school, etc. This is a great way for grandchildren to get to know what their life was like, and usually the person really enjoys reminiscing!

Hygiene: Remember that when they were children, people probably bathed only once or twice a week. You can use no-rinse shampoos and pre-moistened towels especially for this purpose as they may be afraid of falling in the shower/tub or embarrassed about their inability. They probably didn't change clothes every day either when they were children, so they don't understand the need to do so now. Unless odors or health issues are a concern, cut them some slack as far as frequency in bathing, changing clothes, etc.

Protect yourself: If their behavior becomes aggressive, combative, or violent, back away. You don't have to subject yourself to injury! Walk away for a few minutes and if need be, ask a friend or neighbor for help.

Speak calmly: No matter how riled you may get, try to speak in a calm and even tone. Watch your posture -- are your fists clenched, are you leaning into their face, are you clenching your teeth, etc -- your care receiver will pick up on these cues and it will escalate their behavior. Go outside for a few minutes and calm yourself before continuing.

Medication: Yes, there is a time when medication is necessary. I was also reluctant to medicate my husband until my daughter pointed out that he would be mortified by his behavior if he had the capability to see himself as we did. This will help in some way to maintain their dignity as much as possible.

Communicate with Doctor: Keep the doctor informed of new symptoms as they develop, even if it's only through e-mail. When you're finding it difficult to maintain quality of care, let the doctor know that you need help.

Hallucinations: You won't be able to convince them otherwise, so it's best to just acknowledge what they're seeing or hearing, then distract.

Take care of yourself: This is so important -- eat healthful foods while sitting at the table (not on the run), get enough sleep, keep in touch with friends and family for support, drink plenty of water, take your own meds and keep up with vaccinations for flu, pneumonia, tetanus, etc, and make time each day to do something that you find enjoyable.

The more tricks/strategies you have up your sleeve, the better. When one doesn't work, you can try another. Don't try to go it alone -- enlist the help of others and keep the medical team in the loop.

I wish you the very best!!
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amy and tina (((((hugs)))) I know how hard it is. Mother was not diagnosed with BPD until she was 96. and even then it was not followed up so she got no meds at that time. Her regular doctors were no help, and she changed her dr every few years. It was only when she was hospitalized, age 100, for trying fly across country alone without proper id that she was seen by a geriatrician and a psychiatrist. They were not entirely useful, but did assign visits to her by a community mental health team, who monitored her. Even then she snowed the nurse, but the psychiatrist saw through it, as had her case manager (assigned to her the previous year as she had home health care.) Between them and me and the ALF Health and Wellness Coordinator keeping in touch and us letting them know what we saw and heard, finally the psychiatrist decided that she needed to be hospitalized whether she wanted to go or not, Fortunately she went willingly and has been evaluated and treated there. A shocker to me is that they still consider her competent, not that it makes a great deal of difference to my job. I keep my distance. She did not assign POA until she was about 96, and only then after much convincing by her financial advisor. She did not want to give up control. I told her I had zero interest in taking anything over for her as my life was busy enough, but if she had a stroke for example and needed help I would do it. At my age (77) I hardly need to be looking after someone else. Mother has been negative and controlling/manipulative all her life and still is, though a little modified by the meds.

I eventually figured out that she did not want solutions, she wanted problems and to complain about them and try to get people to do things for her, and when they did it was never enough or good enough, so she could complain about that. Last time ( a couple of months ago) she complained to me that "things" were not being handled well, I asked her if she wanted someone else to do it. She changed her tune.

They tend to put you in a lose lose situation - d*mned if you do and d*mned if you don't. Until they do something dangerous to themselves or others I don't think there is much you can do except look after and protect yourself from the criticism, negativity and demands. It has taken a long time to get to this point (((((((Hugs))))))
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How do you respond to a parent in a NH who's telling you they are going to kill her when you leave. The NH staff says she is not like that when I'm not there. There is some paranoia, but not that extreme. I don't know how to respond so I usually make it worse. She says she knows how to act with them so they wont hurt her and gets mad at me for not believing her. She has had mental issues for years and on major psyc drugs for 40 years. But now it is out of control. It tears me up every time I have to leave her when she is so scared.
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