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My mother is what used to be called a hen pecker, she torments my brother who lives with her. We do have help coming in, but I wonder if he ever gets a full nights sleep. She is insanely constantly demanding. Now it seems she has broken her toe from kicking the door when he left the room to avoid boiling over.
She has an amazing amount of energy when agitated and has always been unmanageable at times, but now the dementia has removed whatever self checks she used to have. Unless one works to make her feel like a pampered queen, she becomes hostile. Her fear prevents her from being reasonable, but it is not always possible to feed her misperception of reality. She will not go to daycare. I am afraid NH would kick her out. She has advanced dementia, but is still in denial.

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Your brother sounds like me, and your mother sounds like mine. Time for a NH! I cared for my mom for over a decade. How I survived it, I don't know. It literally felt like being tortured on a daily basis dealing with her endless verbal, and sometimes physical, abuse and constant demands. She refused to give anyone POA so selling her assets to place her in a facility was impossible. I finally had to resort to abandoning her to the state. I was on my way to a stroke according to my doctor from all the damn stress. Tell your brother to walk, abandon her to the state if need be and they'll put your mom where she needs to be, in a facility with professionals. Nobody deserves to have to deal with such nasty customers except people that are paid to. And who cares if they drug her? Better that than your poor brother ending up contemplating homicide, or facing a stroke from stress. These types aren't worth the misery they cause to everyone who tries to do right by them and I don't care what they've got. And no, your brother shouldn't walk away, he should RUN.
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My sister didn't live my mother, but she went through much of the same treatment. My sister was disabled from rheumatoid arthritis. She dropped dead, one year ago tomorrow.

And what happened to Mother, who for years had been so needy and helpless? She lasted about one month at home, then broke some ribs in a fall and went from the hospital to the nursing home. I thought "Well, she will be very hard to take care of."

Fast forward 10 months, Mother is almost 94 and clean, dressed, eating in the dining room, having visitors, getting her hair done, and speaking on the phone. Who
knew?

Yes, your brother needs to get out, both for his health and your mother's. Good luck and best wishes.
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She has had geropsych evaluations, ongoing geriatric care, good bone density. I know she will not have good or true insight into the dementia, and dont care that she does, just don't know what to do with her worsening treatment of my brother. I am starting to think he should walk away. She is on sertraline, don't want to dose her into oblivion.
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Lots of nursing homes have patients in them that are half nuts and they keep them in the facility. But how they do this to medicate them with behavior drugs.
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They can do the ultrasound bone density that is very quick.
That's all I have to offer except sympathy for brother.
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Geropsych eval. Respite. Maybe check her bone density if she would hold still long enough. Nursing homes may or may not be able to handle mental illness and behavior on top of dementia, but they should be up front with you on this. You probably should not expect her to ever have insight about her dementia; she thinks everything is fine as long as she gets what she feels she needs immediately and has lost capacity to understand why that is not possible. Her loss of reasoning ability as well as her fear is making her unreasonable.
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She will end up in the hospital again, and then you work with the MD to get her proper medication and placement in a memory care facility. Ask the doctor for a complete neuro-psych examination. Since she has issues of aggression, daycare is not an option.
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