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I've had a wonderful, warm, close friendly relationship with both my only sister and her husband for over 40 years. Eight years ago when he was 59, he had a stroke which ended his career as a physician, and they decided to permanently move to their extremely nice vacation home in Vermont.



Then, two years ago, he was diagnosed with Parkinson's. She, a former nurse, has always been strong, healthy, and capable until earlier this year when she developed rheumatoid arthritis (under control now w/meds) and began expressing caregiver burnout complaints to me. Her beloved dog is currently in a serious decline with kidney disease which necessitates her awakening several times every night to let him out, so she's seriously sleep deprived. Her husband is no help at all in this matter because he, probably as a result of his many meds, is usually asleep in the living room and is FAR FROM being on top of their dog's needs.



I'm two states away and visit them 2 or 3 times a year. We've always had a very pleasant, fun time together .... until now. She and I had planned a "sentimental journey" this past weekend to our home town in the neighboring state, but that had to be cancelled because of her dog's decline and her husband's concerning behavior (like, recently she discovered him staring blankly at the refrigerator's contents while the sink faucet hose was spraying water all over the cherry cabinets and the hardwood floor.) She begged me to still come up and stay with her because she's so strung out and of course I did.



Turns out my BIL has simply NOT been taking his meds as he should ("Ahhh, I'm gonna flush 'em all down the toilet!!" he yelled at one point) and she is totally sick & tired of being the med police with him. As we found out this weekend, one very important thing he should have been
religiously taking was 325 mg. aspirin, the omission of which landed him in the ER on Saturday when he had a TIA.



Fortunately, he was OK, and when she brought him back home, she read him the riot act about how neglecting his meds was so detrimental to him, and causing extreme anguish for HER and her health, and she snapped. It was bad - she was screaming and crying hysterically, during which he looked stunned but then starting laughing (nervous defense mechanism) and scoffing, "Oh, come on! I don't believe this! You two need to calm down! heh heh heh" You can imagine how we reacted to THAT. It got even worse.



She wanted me there to support her and defend her, and I did. Frankly, she is more important to me than he is, plus our mother (who was in a similarly stressed position caring for my bitter depressed dad with cancer plus his 90 yo father who lived with them) dropped dead of a sudden heart attack in 1991. I'm haunted by this sort of thing happening again.



Anyway, next day, after he spent the night skulking elsewhere in their big house, she & I went out for lunch (appetites having been shot to hell the day before.) When we got back and pulled into the garage, before I could open my passenger-side door, THERE HE WAS, pulling open the door himself.



"YOU GET THE HELL OUT OF HERE!!! GET OUT OF MY HOUSE!! [btw, the house is in both their names] I WANT YOU OUT OF HERE, YOU B***H!!! YOU STARTED ALL THIS!!! I PACKED YOUR STUFF AND THREW IT IN YOUR CAR!!! [no, my car was locked] YOU GET THE HELL OUT OF HERE AND NEVER COME BACK!!!" He was right up in my face, blocking my way. I was scared because I am a survivor of domestic physical abuse and had my hand on my cell phone, about to call 911 if he got physical (he didn't.) But I would have pressed charges, no doubt about it. I have zero tolerance for this; I don't care what the circumstances are.



My sister (psychiatric nurse training) calmly repeated, "No. She's not going anywhere," over and over again, "This is my house too." We were in the garage, where I saw my bags and laptop case tossed in the entry - he had really gone into my guest bedroom and cleaned out all my stuff. (more to come)

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He’s very sick, as both you and your sister know. His threatening behavior won’t go away, and he needs to be in assisted living or perhaps memory care. Please do everything you can to persuade your sister to get him out of the house and away from her. He should be considered dangerous now.
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I wonder if his outburst was due from Parkinson, as he was diagnosed only 2 years ago and PD is characterized by slow progression in general. Neurologist will need to do careful, lengthy assessment.
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I would hope he has been going to a Neurologist since he has Parkinsons. I would say Dementia is now in the picture. Sister needs to get him back to the Neurologist.

You probably should not have joined into their fight. You can be supportive of sister without getting involved. Even if he has no Dementia, he had a right to ask you to leave IMO. My DH would not have appreciated your input.
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In addition to after effects of stoke, Parkinsons can also cause anger issues and outbursts, definitely causes personality changes. My dad has PD and went thru a phase of being very angry and yelling at everyone, all the time. That has now devolved into dementia and delusions. He def needs to be seen by neuro to assess cognitive changes with both the stroke and PD (my dad also had a stroke right after being diagnosed with PD). Support your sister, help her get in home help for him as she is very burned out, understaably so. He needs to be seen ASAP because there may be med adjustments needed but as others have said, be careful as this could escalate. Maybe take your sister home with you and hire caregivers for him for a respite stay while you help her get things figured out. I am sorry, this sounds terrible. Parkinson's is a terrible disease and add in the strokes too, it's not good. My dad also stopped taking meds and it caused a very bad fall that landed him in the hospital and now a nursing home. PD can progress quickly, so def get him assessed for all of this. You are a good sister.
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As a former nurse, your sister should realize that her husband, having had a stroke, is likely suffering from dementia now as a result. Which is probably why he was found staring blankly at the refrigerator's contents while the sink faucet hose was spraying water all over the cherry cabinets and the hardwood floor. And probably why he flew off the handle and over-reacted about wanting you out of his house. When dementia is present, all bets are off as the elder can be impossible to deal with and get through to. Logic is gone and replaced with all sorts of ugly new behaviors, unfortunately. Further, he's been diagnosed with Parkinson's on TOP of having had a stroke, which doubles his likelihood of having some form of dementia.

Your sister acting hysterical by screaming & crying in reaction to his TIA and not taking his aspirin is a sign that she's reached the end of her caregiving limitations now. He likely felt ganged up on when she was screaming at him and the two of you were acting so upset; so he felt like it was your fault and you 'started the whole downhill slide.' When a person with dementia gets something in their head, you can't chop it out of there with an axe!

Your sister is not capable of caring for her husband any longer, it sounds like, and the stress of having a sick dog AND a sick husband is too much for her. She's right at the end of her rope now and in need of respite. Either she hires in home caregivers to give her that respite, or perhaps her hubby needs placement in Assisted Living now. Has he had a cognitive evaluation by a Neurologist?

And as sp mentioned, your BIL could indeed become a danger to your sister as his dementia advances and his temper tantrums worsen. The doctor needs to know about all this and a course of treatment/action needs to be undertaken. It may mean he gets placed. It may mean your sister calls 911 if and when he throws a fit and scares her or threatens her in any way. He can be transported to the hospital for a psych evaluation which may be just the answer that's needed here.

I think you both have to look at this as your BIL is a very sick man and your sister is a very burned out and frightened wife right now. I think her best bet is to call 911 when he has another outburst & get him evaluated by a psychiatrist to see what's going on here.

I suggest that you support your sister but that you do nothing to provoke her husband in any way; don't agitate him b/c really, who knows what he is capable of doing if he gets angry enough? THAT is the worrisome part of this equation, in my opinion. Try to keep her calm, yourself calm, and the crying & yelling OUT of the picture entirely. The goal with a dementia patient is ALWAYS to keep them calm, no matter what. Your sister should alert his doctor to what's happening so perhaps a calming medication can be prescribed for him. My mother had good luck with Ativan.

It's a terrible situation that's going on, for sure, and I'm sorry for all of you. Sending you a hug and a prayer that some sort of answer can be found that will help your sister find peace in her life once more. Disease such as this can surely wreak havoc; I know. My mother had advanced dementia and it was shocking the things she said & did, especially while in an agitated state of mind.
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Maybe your sister (and her dog) need to come live with you for awhile.
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I am so sorry. You sound like a good sister and are trying to help.
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My first reaction is that him surviving that stroke was not a good thing.

My second reaction is that said stroke may have caused his weird emotional outburst.

My third reaction is he will become a danger to your sister as his disease progresses.

My fourth reaction is I hope to God she is willing to place him in a facility when it comes to this.

And finally what a terrible disease and way to slowly destroy their relationship and lives. Hugs to them and you.
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