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It seems like I NEVER see any of the other residents at Mom's Memory Care Home have anger or outbursts. She's been on and off raging, yelling, cursing now for a month and half, and we finally get to see the neurologist tomorrow. The Memory Care Home has been giving Mom Ativan as needed to help keep her rages to a dull roar, but I am hoping to have a better solution. The fine line is that we hope to manage the anger, but not dope her into a stupor. I don't want her to get kicked out. BUT if anger is so common, why don't I see the other residents (there are roughly 60 total) ever having an outburst. Are they all doped up? Grrr...frustrated.

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Sunnygirl, Mom has always been rather spunky and spoken her mind, while I'm the diplomat. It's been very hard to receive her short temper because it's never been aimed at me except for maybe a few times over the years. I remember when my daughter was born via C-section it took forever for the epidural to wear off, so they kept me in recovery close to 3 hours. She got angry that nobody was coming out to give her an update, and demanded to go home. My stepsister took her home, and the next day Mom called and tried to complain to me, and I cut her off (one of the few times I just stood my ground) and told her that I was busy recovering from surgery and had my hands full, was not able to make sure someone had given her an update.

So, yes, she's staying in character.
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Kimiad, that is a good question. Can you say you are going to lunch, at least to get her in the car? I can get my Mom to go out, but I'm starting to worry she will refuse to go back to her Memory Care Home one of these days.
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Agitation, as it is often referred to, is quite common and I would imagine that most dementia residents do exhibit that behavior at some point. However, I do suspect that if the patient has always had a short temper, quick to snap or curse, it might be some remnant of their true personality. My LO is an only child and she was always quick to snap when things did not go her way or to curse you out in a heartbeat if she wasn't happy. She remained that way with dementia, but, it is much better with her taking meds for anxiety like Cymbalta, supplemented with a couple of other meds on an as need basis.

And if he helps, some of that behavior may eventually phase out or maybe not. It's hard to say.
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Kimiad, call Visting Physcian Association, just this month I found it very difficult to get my aunt out of the house because of size and dementia. For weeks I was trying to get palliative care in here, when on Monday I contacted visiting physician association they were here by Friday. I had prescription pills for her Edema the next day and hospice will be started Monday. Had I known over two years ago when I moved her in here that I could’ve had all her medical needs met in my home, I would’ve contacted them the day she moved in. I’m unsure if they’re in all states but you can look on the Internet and it will direct you to their services.
It’s far as dementia goes I have worked with several clients over the years and have seen medicine work for some people and no amount of meds and changes work for others it is a short season, most the time it’s been in the very end ( 6mts to year)that I’ve seen the most violent behavior.
When people talk about their parents being dragged into stupor also keep in mind it’s quite possible the dementia has them in a stupor the last 18 months of my mother-in-law‘s life she had no drugs but was in a stupor, I’m well aware of what she took as she lived in my home until she passed .
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goodspirit
It takes time fir the negative memories to recede and the better ones to return. Don’t feed the negative thoughts. The time your dad spent in care was only a short part of his life. You did the best you could.
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I remember a widowed neighbor of my parents who was taking care of an elderly lady in her (the caretaker's) home for some extra money. While visiting this neighbor one day, I remarked how pleasant the lady always seemed. The neighbor said "Ooohhh, you have no idea what she's like when you aren't here!"
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In my dad's AL, it was the same. Eventually, without us realizing he got doped like the rest and eventually settled down. The doping made him deteriorate so fast, that he could not stand upright or help himself anymore, in a very short space of time. Hindsight being the wonderful thing that it is, we would not have subjected him to it, had we known better. He passed just over a year ago and I have regretted this ever since.
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About 3 weeks after my friends got into the memory care apartment I had found for them, the wife began resisting all personal care when she soiled herself. I was advised to take her to a geri-pscyh ward at a hospital to find an anti-psychotic drug that would calm her without doping her up. It took calls to 3 different hospitals before I found one with an opening. They knew just what to do to get her away from her husband and go upstairs to the ward. There, it took 3 1/2 weeks to find the right drug and dosage since the first drug didn't work well. After that, it was smooth sailing in terms of cooperation and mood, though her frontal temporal dementia was progressing rapidly as were her abilities to function. The geri-psych. doctor is the next best thing. I would think staff there would have a clue about whom to contact. This shouldn't be their 'first rodeo."
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My mom is still living at home with my dad, and goes from being totally normal to super angry and abusive without warning. She was always kind of strong willed, and that has now drifted into being completely focused on herself and how badly everyone around her has wrong her and what awful people we all are. Except the dog, whom she's going to run away with and live somewhere else. She thinks he can talk and narrates his dialogue for us constantly. The poor dog tries to hide from her as often as possible. (And no, she can't drive anymore, thank goodness!) Unfortunately her anger is becoming more and more aggressive over time. Tonight only a few minutes after conversing with her about dinner on the phone, I arrived at their house, but the moment I walked in she began screaming "why are you here? Why are you here?" She had no memory of the phone call, and proceeded to scream at me and my father for a good hour and a half. Many of her delusions are focused on money, and vague resentments of people she knew 50 and 60 years ago have blown up into gigantic delusions of how she was taken advantage of. She accuses me of having secret boyfriends who I spend all my money on (nope!) and that I bought teeth for some man in California (I can't figure that one out) and she used to make $500 an hour (nope) but none of the rest of us ever made a penny, and so on. She no longer remembers anything happy or fun or enjoyable from our lives; all those memories have vanished (I'm so thankful we have photos, or my daughter would think she was always like this!) and been replaced by anger and aggression and delusions. So it's impossible to get her to the doctor because we can't have a rational conversation with her, and can't physically carry her out to the car. I'd love to hear how some of you were able to get a parent in need of care actually into care!
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I use to work on an Alzheimer's wing at a nursing home. My guess is that you just haven't been there at the right time. Eventually as the disease progresses, there will be fear and angry outbursts. For many, it comes after the sky starts dimming towards nightfall. Others are that way because they also have other dementia issues, like vascular problems, or even glucose levels that are easy to fluctuate high and low. Some might get more aggressive and defensive as they find that they haven't seen loved ones in a while, and for some, one particular memory or realization that their memory is false is enough to do it. The thing with dementia is that it's not predictable as to when there's going to be a massive breakdown in mind to body communication, and nothing seems right.

As for doping up...unfortunately, if the doctor prescribes it for their safety and the safety of the other residents, then it does happen. However, they start low and slow for most issues. Also, in some places, not everyone there has dementia. They are there for other health reasons that mean they just can't care for themselves anymore and they somehow ended up there. But anti-anxiety meds are useful. I have seen some break through that med fog and attack other residents under the false view that the person was horribly insulting or about to hurt them. I've seen people who were considered to be very docile in nature cause real harm to others. No matter how many staff you have, the residents can suddenly act quickly and without warning. I doubt any staff member of a facility is one that has never been attacked themselves. I was attacked twice. Also, residents get hurt trying to do things under anger and upset. They fall forgetting they can't walk, and break things, which can lead to a major spiral towards death.

Speak to the faculty about the meds and ask them to always update you when she seems more aggressive than usual.
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JJ I’m still with ya in this. Went to visit my mother at the hospital nd she’s screaming at the top of her lungs and combative with the nurses! You can hear her down the hall! I’m the most awful person and callous and a bitch! A very unproductive visit. At one point she looked at me and asked if she could see her daughter! I feel hopeless right now but please know your mom is not the only one with angry outbursts, right now my mom is impossible! I hope the geriatric psych will do wonders otherwise I’m afraid the NH won’t take her back. I’m still in the middle of trying to get the Medicaid application done & spend down her money! Everything is just up in the air & I feel like I’m losing my own mind
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JJGood19, you may find that you will have to take your Mom’s phone away. There will be a limit to your sanity, people can’t call if she is tying up your line, and it is not healthy for her to get that worked up anyway. Deep breathes and best wishes!
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Oftentimes, something is not as it seems, e.g. these other residents could be acting out during times that you're not there or it could be that they're showtiming because they see you there.
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Thank you akdaughter, I appreciate you sharing your experience. I believe that the anger is like you say, a direct result of fear and frustration, and medicine can only help so much, and as her disease progresses, her ability to reason diminishes, and coping mechanisms go out the window. I can see it happening.

As for the short visits causing you guilt, I feel guilt on a regular basis about pretty much all of it, and then I realize it's not productive and I try to reason with myself. Some days I'm better at it, some days not so much, but really, the guilt has no place. If I were doing something wrong, then yes, but I'm not and neither did you, you had your Mom's best interests at heart, and so do I.

She's safe, she gets to do the things she enjoys, I see her way more often now that we are in the same state, like 1000x more, she is surrounded by people who care.
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JJ, you are where I was about two years ago. I was knee deep in end of year bookwork for my husband's business when I got the repetitive phone calls. Mom alternately called my cell phone and my landline. I answered the first couple of calls and then let them go to voicemail. The messages were angry. I decided to check her phone log (her cellphone was on my plan) and found that she was making lots of calls, some to random numbers at all hours of the day. I talked to staff and it was decided that her phone needed to go. I told her that I had tried to call her (a therapeutic fib) and got an error message so I needed to take her phone in for repair. The staff kept reminding her when she said she couldn't find her phone. The following month she was moved to the memory care wing and I told her that phones weren't allowed there because other residents might take them (easy for her to believe because she thought people were stealing her things whenever she misplaced something). We told her that she could use the phone at the staff desk whenever she needed to make a call. For a while she would demand to call me. Sometimes the staff would let her call, but most of the time they would pretend to call me and when I didn't answer they pretended to leave a message. It was hard to take her phone away, but it was contributing to her angry outbursts so it had to be done.

Like you, I rarely saw angry outbursts from the other residents. Some residents' personalities were not as volatile as others', and some were just at a different place in the dementia journey. Much of my mother's anger was directed at me, so I learned to keep my visits short, and when I couldn't keep the conversation from veering off to something that would trigger her anger I made an excuse and left. Now that she is gone, I have some guilt that I didn't spend more time with her, but triggering an angry outburst was not in her best interest, either.

She was taking medications and was seen by a geriatric psychiatrist, but I was never able to determine how much they helped. As her confusion increased, her anger decreased, so I believe that fear and frustration with her diminishing abilities was the main cause of the anger This is not something that you can fix.
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My wife, who is in an assisted living/memory care facility, has anger outbursts and will not listen to reason on some days, while she is easy going and happy on other days. I was thinking exactly as you, in that I saw no other resident ever having an outburst. I had intended to ask the nurses about this, but your post let me know I'm not the only one.
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Tiffany, you have to make light, or rather, try to find the humor, it's either that or plummet into depression, and I would rather search for the humor. Thank you for that story...I haven't been accused of anything quite like that yet, but it's good to know it might be on the horizon. ha ha
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Thanks, Dianelisa, My mom is on Namenda aka memantine, however her anger started a long time before they added that med.
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I also would like to refer you back to this aging care discussion about namenda causing aggression if it applies to you...
https://www.agingcare.com/questions/namenda-causing-aggression-168721.htm
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Some of these comments remind me of a woman in my mother's nursing home. I've been told his woman, who is probably only about 50 y/o but is in a wheelchair, has some form of schizophrenia that makes her believe some person or monster is hiding under the furniture so she often yells "Die!" at random times, and makes strange and insulting comments, including racial slurs, to visitors, residents and staff. One day she said "You're ugly!" as I walked by, so I said "Thanks; that's the only compliment I've had all day!" A staff member told me this woman has a problem and I shouldn't be offended by her comments, so I answered that I've seen her there for 4 years so I know about her and don't take anything personally. She never attacks anyone physically, so all one can do is wait to hear how "creative" a comment she can come up with. I think most people simply ignore her.
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It is not unusual for people with dementia to have angry outbursts. I worked in memory care units for years ,both as a nurse ,and then as an activity coordinator. I think sometimes the dementia clients just get very frustrated, scared and confused by changes in themselves. Their dementia alters their perception of their environment and they often feel threatened by the strangeness of their world!
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I have heard and read that most outbursts are only in front of family.

This could explain why you only see your Mom having outbursts. I'm guessing that others go through it when they visit their LO's too.

I'm sorry - it has to be hard on you. You make time to visit and probably get yelled at the entire visit.
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I'd like to share this resource:
alzheimersreadingroom.com
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JJ I HOPE I CAN DO THIS! I live in Canada while mom is in NJ and i am the only child and i can tell you right now I’m emotionally and mentally drained. I do understand the disowning because as soon as I don’t give my mom what she wants such as taking her home, I’m the most awful person and she should of never had kids, every name in the book & disowned to only get a call the next day with no recollection and the process starts again. I’m learning and reading up on how to deal with a person with dementia and that is to never tell them “they can’t or they are wrong” because I’m just asking for her to get nasty! My mom was always someone who got nasty when she didn’t get what she wanted and a very vocal person however with dementia it’s over the top! I hope they actually get her up to the Geri Psych if the hospital and things can get evened out
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There are as many manifestations of anger as there are personalities. Some people tend to have outbursts, just as they did before their illness; others hold back the outbursts thus becoming confused and bothered. My Mom is like that. She was always a quiet and very private person, never expressing anger outward. Always careful about social standing. Now, she gets angry within and expresses it by going into her shell and feeling bad about loosing her memory...she is in the mid-to-advanced stages.
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Not to make light of the situation, as I know how upsetting it is to see the decline with the awful outbursts. But I was accused of going # 2 in my mother's depends, while she was wearing them mind you, which happened before I even arrived that day. I was torn between a giggle and tears of sadness. Didn't show either expression though, that would have been like throwing gas into a fire.
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Starr, I just found out that our area is seriously lacking in quality psychiatric care for the elderly. The closest unit that the head nurse trusts is about 3 hours away by drive. She also says we don't really have a decent geriatric psychiatrist in the area, but I'm glad she recommended the other doctor who is really good with medicine and the elderly even if his title is MD. His background is pharmacology, so that gives him an edge.

Last night we had a new, and hopefully fleeting new development. My Mom, who by the way had a lovely day out with her caregiver and gym training session, started spam calling me for about an hour before dinner. I spoke to her at the beginning of the hour, sure that since she had had such a lovely day, it would be a nice call.

NOPE

And then she proceeded to call me 15 more times and leave 12 voicemails. I finally answered the phone an hour later just before dinner, and it was surreal, it was like she had no recollection that the last hour she had spent calling me and talking to my voice mail. She was even in a decent mood?!? (she had only disowned me on one voice mail)

After Dinner, there was a repeat, she spam called me 12 more times, but this time left no voice mails (probably because my voice mail was full) and stopped after about 30 minutes.

UGH. I hope this pattern doesn't stick.

EricaMagoo, we can do this!
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One of the pluses of having my mother in AL is I knew she would behave herself when people outside the family are around. She’s always set great store in behaving like a ‘lady’ and ladies don’t curse and hit.

And yet, before she went to Geri Psych and got proper medication that’s what she was doing at home. I’m so glad she’s calm now, she’s happier.
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Listening to your stories makes me feel not alone! My mom was just taken out of NH for swinging at the staff and cursing up a storm and taken to the geriatric psych unit. I do hope some type of medication will work for my mom as the NH she is in doesn’t seem to tolerate her well. Although another resident at her place as I walked by him told me “f you, drop dead” but I guess because my mom is continually doing it they aren’t able to handle her. I don’t want her kicked out! I hope everyone’s loved ones get calmed down!
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jj and staaar, these stories are humbling, amusing, and touching. jj, it’s interesting to note that these happen when the family person is there... so at least you know that.
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