Father started having more problems in July - memory, speech and emotional. Multiple calls from him and his ILF in late August. Took him to hospital for altered mental status, admitted. Diagnosis from hospital: progression of dementia. Went to skilled rehab for 3 weeks to improve physical condition, work on ADLs and speech/memory. Improved physical skills. Still difficulties with changing clothes and bathing regularly. Attending physician and team from skilled facility recommended memory care due to continued need for prompting, his wandering and memory issues.
Moved him to memory care for safety, continued evaluation and care. He has improved some, still has memory and language problems. His behavior is becoming a problem. He does not think “anything is wrong with him”. He is upset/angry because “I lost his drivers license” (it is not lost) and “ he can’t go out and do anything” and “he doesn’t have his car”.
He can’t remember my name, does not know his other daughter even though she was at hospital too. Sometimes can remember a few things, not able to learn new. Other times memory is really bad and speech is incoherent.
He is really not fit to drive a vehicle. It is very difficult to listen to his anger about this issue. Only trying to get him help he needs, evaluation of cognitive abilities and keep him safe.
Any suggestions on how to handle the nasty and angry, seething behavior. I try to visit every other day for a short time. It is a disheartening situation.
Thank you
Thank you
Distract dad & change the subject when he keeps asking the same questions. If he is angry & seething at you when you do visit, you may want to stop visiting him so often, or even entirely for a while, until he calms down a bit. And if he doesn't, definitely speak to his doctor about calming medication. Chronic insistence on driving is a sign of agitation and calming meds like Ativan should help; they did for my mother who insisted her mother was 'hiding' somewhere in the Memory Care ALF and she just couldn't find her. It became a nightmare until Ativan saved the day.
I suggest you read this 33 page booklet (a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.
The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2
Here is a list of useful tips from her e-book I found to be excellent:
The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently
Wishing you the best of luck with a difficult situation. I hate dementia with every ounce of my being :(
The information in the booklet is very insightful and helpful. I need to keep things in perspective, sometimes not the easiest…….
Thank you
Any sudden change in behavior and/or mental status should trigger suspicion of a UTI--they often cause psychiatric symptoms.
Second, it should trigger a call to the person (hopefully a geriatric psych) who is or should be managing meds for mood/anxiety/agitation and the like.
Is this conversation about driving happening just with you or with staff and others as well? If it's just you, consider that you may be a trigger and think about stepping back from visits for a bit.
It's so weird to me that my mom gets fixated about this lack of being able to drive as well. She makes snarky comments about is. OK, fine, be snarky but there is no way in hell you are getting behind the wheel!
You could always say vague things to your dad like "I'll have to talk to the doctor about that dad and see what he suggests".
He does not have access to his car, it is a good distance away and in locked storage…… for now. He can’t just get out to drive. I do not want to give him the DL, it is still valid and he has mentioned “I will just have to rent a car”. Luckily, he does not have his credit card…..
- cutting down the amount of visits.
- considering meds for anxiety and mood.
- telling him a therapeutic fib that the "doctor needs to give him any approval to safely drive again".
- redirect the conversation if he keeps after the driving topic.
Everything about dementia is hard. I wish you peace in your heart on this journey.
Taking a patrol officer over to speak with him may help him understand the laws a bit better.