We have been having difficulty with communication. What do I do when he gets angry at me because I can't understand what he wants?

I and my mom's doctor thought my father's vascular dementia care was getting to the point it was damaging my mother's health and becoming dangerous, but Mom still wanted to keep Dad at home. She was his wife and primary caregiver and I supported her decision (helping her daily) right up to the day he hit her.

Because one of my brothers wanted to exploit my parents financially, I had to go to court and gain guardianship of my father to place him in an MC. Mom agreed but didn't really like it initially but became accepting after she saw Dad's health improve almost immediately in MC. Dad lived in good MC less than 2 miles from my brother's home and 6 miles from mine for almost 3 years and was reasonably content. Mom and I visited him at least weekly and my older brother visited him almost every day.

We were able to afford it by selling Mom and Dad's home and splitting the money. We "drew down" against Dad's portion of the home funds the difference between his monthly pensions and the cost of the MC. Mom moved in with me for several years (our plan of many years after Dad died since Mom didn't want to live alone) and was able to live on her SS check. Even though I eventually spent some of Mom's money on respite care and things to make her more comfortable (like a walk-in tub) there was actually some money left to split with my brothers after they both had all their care needs met.

Dad's MC would not accept Medicaid patients for new residents, but after a patient was there for 2 years, they would accept Medicaid from then on. So he only "had" to have enough to fund 2 years of care there. I suggest you sit down with an attorney or social worker familiar with the Medicaid laws in your state and look at what a financial plan would look like for you and your husband. My parents' finances were aided by mom living with me for less than maintaining a separate residence would have cost, but it can work even if you want a separate residence. You may find, as my mother did, visiting your husband in MC where someone else persuades him to take his medications, clean up, dress appropriately, and so forth is much more rewarding to each of you than dealing with the daily stress of his hands-on care and risking injury. Please also consider that you are likely to need some care requiring you to stay overnight in a hospital or some time recovering from a surgery or injury where you will be unable to care for your husband for a time; MC solves that problem too.

could you make some picture flash cards of some things you have in house (paste on the pictures of things, like hat, cup, tray,etc) then use them to help. If that doesn't help.....then say okay i will move it....then pretend to move whatever he is pointing to. My dad sometimes would ask about getting something or putting something away........i would pretend........sometimes it worked, other times not so much. if it didn't work, i would say.........i will try to do it later. its tough..........wishing you luck.

lindashort: Imho, perhaps he needs to be seen by his geriatric psychiatrist, assuming that he has one. If not, perhaps you should obtain that specialist.

Your husband has Alzheimers and he is driving you nuts and you can't deal with him and he becomes abusive. You are burned out. Question: why on earth are you allowing this to happen. He is sick, he needs care - but you need peace and a life too and you will never have it with him like this. This man needs to be placed somewhere at once before it is too late for you. When the behaviors and actions of people greatly negatively impact those who care for them, that has to end and they must be removed and placed. You have no other choice.

Tell his doctor what is really happening, including the attempts to hit you. Your husband's illness has changed and needs to be evaluated by professional health care providers. This exceeds your training and ability. It is not your fault. You have done nothing wrong.

Whoever evaluates him will have social workers with many years of experience to help you both find appropriate care for him while also protecting your future.

You have done nothing wrong. More importantly, you are no longer safe around your husband's illness.

Diffuse - distract - re-channel - and walk away for a few minutes or longer if necessary and possible.

Also - a white board can be helpful for communication or just doodling for him when he is bored and tired of watching TV. Use washable white board markers. I used one to communicate with my mother when she was in rehab and we had to talk through a window. I drew a picture of a thumbs up and thumbs down and taught her to answer my written yes of no questions that way. I was able to teach her that through the window. She was 93 but she got it. I also told her things like when I would visit next.

Sadly, Alzheimers' usually gets worse over the years. Get connected with a social worker and caregiving networks in your area so that you know what your options are. They may also be able to recommend a counselor for you, to help you with your own feelings. Try to get help at least part time so that you can take breaks. You have to be very forgiving with people who have dementia. Their minds are just not working well for normal life. You can't reason with them, they are not able to learn new things, and you cannot expect them to follow instructions. Also forgive yourself, and learn as much as your can about caregiving for people with dementia and what to expect with different stages and manifestations of dementia. Discuss the fact that he struck at you with his doctor. There may be medications that will calm your husband's agitation. You have to monitor these medications carefully, as they can have undesirable side effects.

You might consider contacting the local Alzheimer Assn. and ask if there's a social worker on staff who could offer insights.

In addition, if they offer the Creating Confident Caregivers' course, in person or on DVD, it's definitely worth the expenditure of time.   At the time I took it, it was free.

I was going to suggest using photos of things your husband might want, but it seems as though his desires wouldn't necessarily correspond, and diverge beyond something as basic as food, toileting, etc.

I am concerned by the escalation to physical response by your husband.  You may have, as others have suggested, consider a higher level of control through facility placement.

OMG I have been going thru this and yesterday was the worst. I completely lost it.
I wish I had words of wisdom but I do not. I am trying to keep my husband home as long as possible because I do not want him to feel all alone but I can see the time is coming for both of our sakes. I am so tired. I realize memory care will take most of our savings but sanity is important and even our dog is having issues now.
My husband can get around but hearing issues, vision problems and has not been able to write for 2 years and can barely read anything except his name.

Ok so my answer is totally out of the box. At those times when you can't understand him, can you tell your husband you're having hearing problems and have him write down what he wants? Maybe it will diffuse the situation.....

My dad has pancreatic cancer and while he hasn’t been diagnosed with dementia I can see that he is becoming more forgetful, irritable, depressed, demanding, unreasonable, and trouble communicating. It’s frustrating and quite heartbreaking as we often argue—through no intention, just that he has a tendency to demand something while I’m either in the bathroom or changing my clothes and then he gets mad that I don’t answer right away. It’s my first time dealing with this situation (my mom died in hospital and did not go through this stage of dementia, thank God) so I’m still learning, and it’s always one step forward three steps back but what I can advise is this—1) ignore the sarcasm and biting remarks 2) change the subject when you can 3) distract him if possible, by playing a favorite song 4) tske a deep breath and smile, ask him to repeat his request 5) do not take the bait. It’s tempting to react and retort but this just triggers more reactions 6) though it’s very hard try not to take things personally.

What I do with my father is he has a big note pad of paper and a big magic marker like a bold sharpie and anytime we have trouble getting correct words across he simply write sit down the best way he can. That seems to work for us for the time being… Stay safe and good luck Oh and also he does suffer from sundowners disease as well so communicating earlier in the day is much better then in the late afternoon or evening hours

Your husband may be experiencing Sundown Syndrome. This confusion happens in the evening when a person starts getting tired, lengthening shadows make things look "different," and the person with dementia may not be able to handle any frustrations,

A few things to try:
Turn on more lights in the late afternoon.

Keep your husband on a consistent schedule.

If he is getting up at night, he may benefit from a sleeping medication.

If you notice he is more agitated with violent outbursts, he would benefit from seeing a geriatric psychiatrist and maybe anti-anxiety medication.

I’m sorry you are going through this.

I would reach out to his neuro/primary and even ask for a nuero psych consult. They have better experience and understanding in medications that may help him.

This is so hard for you and you need to make sure you do not get hurt. Even if he qualified for the aides or care it would also endanger them. I do not have dementia experience but I have seen outbursts from infections and stroke and the neuro psych did help a lot. Maybe that will even allow you to get help as you won’t be worried when he is with others. Keeping you in my thoughts

Linda, my aunt was convinced that she and she alone could care for my uncle with dementia.

It was only when one of my cousins discovered that his poor mom was being beaten black and blue (my uncle wanted the key so he could go wander on the nearby highway) that my uncle was admitted to Memory Care where he lived quite happily for several years.

Sadly, my aunt dropped dead of a massive heart attack shortly after he was placed: she continued to "take care of him" every day in memory care.

I assume that you've visited an eldercare attorney and ate telying on solid legal and financial advice and not simply "what you've heard".

Medicaid will NOT leave you impoverished.

Ask his doctor to prescribe him medication for the aggression and keep him in a more relaxed state. It will help.
I've worked with many elderly people with Alzheimer's/dementia who often became very aggressive and even violent at times for many reasons. Sometimes it was out of frustration because they couldn't express themselves and other times it was for whatever reason, God only knows what.
One thing must always be so. You can never let a situation with an Alzheimer's/dementia sufferer ever escalate for any reason. Tell them everything is fine and then temporarily ignore them. Completely ignore them. Don't talk, don't look at them, don't anything for a bit. If you're alone in the home with him and there is no one else with you, this is the only action you can take to try and stop the situation from becoming dangerous.
If your husband is getting physical like you've said, then your situation has become dangerous already.
In truth you really don't have a whole lot of options. You can put your husband in a care facility which is where he belongs at this point. Or he will have to be medicated to where he is unable to physically strike at you. Bring in some outside caregivers to help you with him. Hire privately because you can negotiate the wages that way. You can't when it's agency help.
Of course you want to do right by your husband and don't want to put him in a care facility if it will cause you financial hardship.
Your safety has to be the top priority though. If you're in danger, call 911. Don't have any shame about it because if something happens to you, your husband will get put in a nursing home. The police and an ambulance will come and take him to the hospital. The hospital staff will send a social worker to speak with you and they will even help get him on medications to keep him calmed. Please don't neglect your safety and wellbeing.
Someone on this forum, I can't remember who made a great statement about caregivers in situations like yours.

"Don't light yourself on fire to keep someone warm".

You cannot prevent "it" from happening again. Your husband's brain is broken. You have no control of where this disease takes him and what "it" may be next. You only have control over how you react.

That said, it's time to, at the very least, ask his physician for medications to help keep him calm. For example, risperidone and olanzapine reduce aggression and are typically tolerated well. That may enable you to keep him home longer.

Equally important to your safety and financial wellbeing is bringing in help at home so that you can take regular breaks including, perhaps, putting him into respite care for a week or two once or twice a year. But that only will work if he is calm.

His needs are only going to increase. And you are already burned out. Your needs are equally as important as his. Things need to change if you are going to keep him home and be safe with him around. He is not capable of participating in making big decisions anymore. Only you can decide how they will change.

It is obvious from your described situation that you still see your husband as he was, and you also see as he is now. Unfortunately the “was” has more weight with you. He is no longer who he was. If you get angry you are only going to hurt yourself, and may cause him to hurt you. You need to adjust your roles and how you interact with your husband. Start looking at your husband as a helpless person/child who needs your help and will do things you do not understand. At the very least, if a situation might become violent, you need to walk away from it, but do not walk away mad. Make off like you forgot something, make a phone call, go to washroom, and cool off. Come back later and do not bring the disagreement up. He will probably have forgotten it as well. You need to work smart around his new undesirable behaviors. He is no longer your peer.

Is your husband immobile?
Realize that your role as a caregiver is to keep him independent as long as possible.

Understand that it is your right to walk away from any disagreements before they start. Step outside. Or say you will be back after going to the bathroom.

It is not your role as a wife or caregiver to be ordered around. Avoid being ordered around, and allow him to go without his every need being met.
Not to punish him and not to neglect him, but to allow for his independence.

You can be protected financially. Medicaid allows assets to be split. Your husband split being spent down and then Medicaid applied for. You become the Community Spouse remaining in the home and having a car. You will get enough to live on. That could be part or all of you monthly combined income of SS and any pensions. Depends on how much u need to live on. You will need a lawyer for this so have a consult with one well versed in Medicaid.

If your husband hits you, call the police. He may need to be placed for a Psychic eval. They will give him or adjust his meds.

I'm sorry for your stressful situation with your LO, but I'm concerned that one day he won't miss when he swings. Have you thought through this scenario and what you would do if it happened, and then began happening regularly? You can read the posts of others with ALZ/violent husbands and the advice given to them. Perhaps this is a discussion to be had with his physician to see if he/she recommends any medications.

I learned a lot from Teepa Snow videos on YouTube about how to communicate with cognitively impaired people (or at least as good as it can be). She also explains why their communication changes, which is interesting and helpful.

I wish you much wisdom and peace in your heart as you work through this with your DH.

My mother would become so frustrated as she increasingly couldn’t control her mind. It wasn’t anything to take personal when she lashed out because she couldn’t come up with the words. I learned to “reset” her. I would change my tone from hers to happy & carefree with a sentence like Oh look outside, it’s a beautiful day! Would you like an ice cream cone or let’s go sit on the porch! As soon as my tone changed, she would hesitate, forget her previous mood & change along with me. When I hired aides to stay with her & they didn’t do this, my mother developed habits of escalating frustration with hitting. I had to change her aides when I discovered it because it was taking her down a negative road. Also too many words are confusing. I found upbeat, to the point words were easier for her & kept her in a lighter mood. If you have a good hospice team in your area they can stop by to help on a schedule. My mother can’t communicate much anymore & is mostly bedridden but she’s as content as she can be & doted on. It does take a lot of adjusting to get meds right & behavior management working but it’s possible to have a peaceful environment where their needs are met even before they ask & they feel secure. Good luck ❤️

You are admitting that you're burned out, that he's now getting violent, yet because of financial reasons you don't want to place him in a memory care unit, where he belongs. Things that make you go hmmm.....
Do you at least have some hired outside help coming in, to give you a break once in a while, as taking care of yourself is just as important as taking care of your husband? You can't do it all yourself, as you are finding out.
My husband lost his ability to speak after having a massive stroke at the age of 48. He did eventually regain a few words and some short sentences, but having a conversation with him was difficult, as I couldn't always figure out what it was he was trying to tell me. If after a good bit I couldn't figure it out, I would tell him so, and that for now we just needed to drop it, before we both got upset over it. Sometimes that would work, and sometimes I just had to walk away from the situation before I got upset with him, as it wasn't his fault, and he would get mad at me because I couldn't figure it out. I had to tell him many times that I was not a mind reader. It's hard. I know. But it's not worth getting in a fight over. Especially if he's getting physical. My husband never did that, for which I'm grateful.
And as my husband got older his comprehension of the spoken word got worse as well, which made things interesting to say the least.
You must now do what is not only in the best interest of your husband, but also what is in the best interest of yourself as well. I wish you the very best.