My wife is starting to show aggressive behavior. Staff at the memory care unit has asked me to come in twice to calm her down, comments?

This is a normal part of the dementia process for many people. Definitely check for UTI's and B12 deficiency. Also check that she is not depressed (common). Avoid antipyschotics or minimize them if at all posssible. Doping her into submission provides her no quality of life and believe it or not, she can still experience that.

My Mom went through 2 horrific rehab experiences at nursing homes because the aides and staff aren't sufficiently trained. Even if they were, they have no time to give the proper attention to a patient with dementia. Everything has to slow down. And be quieter. And simpler. And respectful in tone of voice. Gentle touch, saying please, thank you, I'm sorry, and coaxing are all impertive.

Your wife is confused and scared. Behavior is a reponse to something. If you can figure out the something, you can make it better. It can be noise, tone of voice, touch, light, etc. Also, please know that this is a phase and she will eventual become calmer. But it's rough one.

I wish I'd known more about how to interact with Mom when she was going through this. We would have done better. An endless well of patience and empathy coupled with respect will help her and her care givers get through it . She cannot help her responses - but she can be reached and soothed and have a better experience.

First of all, it is not your job to manage your wife’s aggressive behavior. This is a medical problem and you should meet with her doctor, nurse practitioner, psychiatrist or whoever manages and prescribes her meds. My Mom has gone through this. Her aggressiveness towards me recently increased and I worried she might also lash out against caregivers or fellow residents. I talked with her nurse practitioner and she suggested increasing her Seroquel. She had maintained on the minimum dosage for many years, had a spike in aggressive behavior and had her dosage increased. Then she settled down and it was decreased. Now we are back to the aggressive behavior. Her dosage of Seroquel was increased and the behavior stopped immediately. Yes, there are side effects; she sleeps more. But as she became more aggressiveI I could not take her out if the building anymore and her placement in assisted living was threatened. There are pros and cons to be weighed and you must consult with a professional on this issue

I totally agree with gingerjo99. You have to imagine how frightening and confusing it must be for people with dementia. Can you imagine not knowing where you are and having strangers around you. I’m not sure how much memory my mom can retain in any part of the hour. She’ll look away while I’m with her all day and in that few seconds she’ll look back at me and look startled or ask me where I’ve been. I just have to smile and give her a hug if she seems receptive. It’s frustrating but just imagine being in their shoes. It breaks my heart but I’m happy when I can see that my mom knows I’m someone who cares for her. She rarely remembers I’m her daughter but she knows I’m someone that cares for her. I try to always be touching her while I’m with her by holding her hand or massaging her back. It really seems to calm her. I think caring human touch is so important.

My mother grabbed my shirt and squeezed it around my throat this morning to choke me...& it’s the Aide’s day off ...I’m alone...she kept hitting me & screaming to get away from her & I shouldn’t dare touch her....so I said I have to wash her, change her diaper & get her in wheelchair & then she’ll have her breakfast...she says she doesn’t wear diapers & already took a shower....(she hasn’t had a shower in 1 Year 1/2 since I discharged her from nursing home) they used rolling shower chair w opening in bottom....but we just give her bed sponge baths in bed....You would think that I was committing murder the way she was carrying on this morning. The Seroquel just didn’t seem to work... Well, I didn’t listen to staff of SNF when they warned me it would get worse.....

youtube.com is free . You can watch Teepa Snow videos there and learn low stress/no stress work with those who can no longer comprehend life correctly . Please don't let yourself down and not watch . You will love the result you cannot get without learning from her .

Just a side note ...my father is still in ECF and my mother just passed away Sept 2 this year. She died from UTI and they said she had behavioral problems too ....she had dementia.

Have you checked on the meds shebis receiving? I would go over the list of meds to see if there are any Interactions. The ECF would say my mom having behavioral problems but it always seemed to be when she had a UTI also

Oh, she's back! And it's going better than I had thought. We're seeing some holdover on the memory care behavior, for instance she made this teeth baring face, and morphed her gnarled hands into claws, and growled at me when getting her in the shower. But it was so surprising, and slightly comical, that I just ended up chuckling her on into the shower anyway.

Lynn - we are accessing more respite care now, a wonderful inter-generational center Monday - Friday, and starting next weekend bringing in an in-home care giver for one weekend night.

For our situation, the stress of Mom being at home turned out to be less then the stress of Mom being some place that was ill-equipped to keep her engaged and content. It still ain't ideal, but we made the right move... for now!

cak2135, I hope you never get dementia. You are pathetic to post that - and good luck getting a lawyer to defend you. Best to follow ML444's advice.

I am experiencing the same thing with my brother. He seems to get agitated easily. He never did until about 2 weeks ago. It is more the tone of his voice and using sharp angry words. it's not all the time - seems to be when something annoys him. A for instance; I was wheeling, he's in a wheel chair, him from an appointment and there where 2 people standing on the sidewalk. They where not in the way, but he yelled at them, "Get the hell out of our way" Some times he swears at the aids. He did go through a medication change a few months ago and they are changing him again - on the psych meds. Such a horrid disease. I am so grateful for all the support available for us who love the patient - being a relative, spouse, or friend. I, also, have been called to the nursing home to calm him down - all I can do is hug him, rub his back and tell him everything is OK. That calms him. sigh

My sister had surgery some time ago and sucker punched a nurse. My sister was put in restraints and transferred to a different hospital. To top it off, my sister was a medical assistant at one time where data processing was my thing; I hated anything to do with the medical profession.

As for those who said I should not work as a health care aide, I want no part of it. I work as a freelance artist and photographer. I also was a data processing technician for many years, and I was mighty good at it

Tell those homes who do not encourage their residents to drink their water
to go out of business, even drop dead

I always ask if there has been a med change try to elimate the cause. Sadly to say anti depressants do not always work with people with dementia. I am going thru almost the same thing a member of the family with dementia. I told them to cut down on some of this medication it is only making matters worse.

As others have mentioned, have her doctor take a look at her meds.Take her off of EVERYTHING that isn't about helping with her anxiety and physical comfort. Drug interactions aren't always extreme. Often they just cause a generally less-than-well feeling. So, eliminating unnecessary ones can just make people feel better and behave better.
Also, I second the Teepa Snow video suggestion. If the Memory Care Community where your wife lives doesn't use her Positive Approach to Care, you can still learn it (for free online) and introduce key tactics to the aides simply as "ways that I know work with my wife." I've seen it work wonders with residents who were rejected from other communities for violent behavior and were totally agreeable when the Positive Approach was used.

Has she had a new medicine recently added or changed? There are meds that effect one's cognition, and or behavior. Most , but not all are psychotrophics meds. But Not all. This would be my first thought and or action. Some meds when added with a current medication can cause side effects that a person was not experiencing or displaying prior to new meds combined with an old med or more than one of older meds.

I agree with BarbBrooklyn. If I were to have that terrible disease, I would want to be "doped up" as much as possible. Why would I want to experience the fear and anxiety of knowing what is happening to me? If it meant I would live a few years less with this awful disease, so be it. Sad to say, but there is no cure, and Alzheimer's patients do not get better. It's horrible for their loved ones to watch, but I would think seeing them calm (even if doped up) would be a little easier than seeing them agitated and afraid.

Consider the people who work at these facilities. Would you work at a place where you might be assaulted at any time? Some of these patients could be bigger and stronger than the workers. It's difficult enough to get people to work in nursing homes, etc.

If the aggressive behavior is sudden, I would suspect a UTI. She needs a visit with the doctor to determine if that is the case. If not, Seroquel might help her.

To any of the residents smacking the aides - if I was an aide, I'd smack you right back and twice as hard. I don't care about being fired, the GD joint will hear from my lawyer

I have been my mother's caregiver for ten years and barring any ill treatment from NH staff, can tell you that she went through a very aggressive stage here at home. She has Vascular Dementia. She is so strong and violent that she twice sprained my wrist while I was changing her brief. This behavior, like many others, comes and goes in waves. In her case, I believe it's brought on by stress, anger and frustration at being 'forced' to do things or have things done to her. She sees it as a violation of her person and responds in kind. Her mind no longer understands that being fed, kept clean and safe are behaviors we perform for her benefit. She simply thinks we are trying to bully or harm her. It's the dementia exacerbating these thoughts and behaviors. But since your wife is being cared for in SN, you might seriously want to consider a low dose med when she is on an upswing toward anxious and aggressive behavior. Normally most behavior can be charted and dealt with before it gets to the point of violence. Her carers at SN should alert you when they see anxiety rising and offer you the option of a preventative mood med to nip it in the bud. It's bad for her to be aggressive with staff, but imagine what it's like inside her mind. Confusion, fear, anger and frustration running rampant in a way her mind can no longer control or make proper sense of. Talk to her doc about a low dose med, make certain she is not being baited or abused by staff and most importantly, offer constant reassurance that she is safe and you will protect her no matter what. Good luck to you.

It could be a progression of her dementia.

It could also be that she is being mistreated in some way.

Can you install a nanny cam, without sound, to record how she is treated, when you are not there.

My grandfather was becoming aggressive with several aides.

On a nanny cam I learned that one was rifling through his draw and taking items.

The other was refusing to give him water, when he asked because they said it would cause him to urinate.

It is not healthy to withhold water from someone, particularly the elderly who are already prone to dehydration for various reasons.

Some of the people that work in these facilities have good hearts, but too many do not and really only work in these facilities because it's the only job they can get.

Check for a UTI - anger is often an indicator.
If not, consider a calmative. There are natural alternatives at a health food store that may work or talk to her Wellness doctor to prescribe a low dose of something to take the edge off, for her.
I use both on my dad.
Allowing ppl with dementia or alzheimer's to suffer makes me really sad.
Some families refuse to allow anything to be given.
It's the person that suffers because the aides start to try to avoid taking care of them. I've watched it oh-so many times and breaks my heart.
All the best to you!!

I am sorry this is happening. I know it must be horrible for your wife and upsetting to you.
You might want start showing up at different times. It might help you pinpoint what is going on.

Is the facility calling you at around the same time? It might be some activity or a particular person that is causing your wife to get agitated. Especially if it happens out of the blue.

My dad was never a problem at the home. Then he started to get clearly upset when I would visit.
Found out one CNA was doing things she shouldn't. She shouldnt have been a CNA. She was very young and had no empathy for her residents.

She came in the room right in front of me. I had never seen her before. Went straight over to my dad's bed. Grabbed his hamburger off his plate, and shoved it in his face, yelling EAT! Then turned to me and said he doesn't eat enough, with an annoyed look on her face. Then threw the hamburger back on his plate. He got very mad and upset. I was so shocked, I couldn't even talk! She didn't wash her hands, was very abrupt, and shoved just food in my dad's face! Then she walked out of the room!

My dad was also getting big scrape marks on his face from pushing the razor blade into his skin as he was getting shaved. I got a few ph calls warning me he had big bloody scrape marks on his face. That had never happened before. The CNA was being very rough with him. I think she was abrupt and he was reacting. He had been in the home a couple yrs before he started having problems. He hated her. So the problems were real. He tried to tell me things were happening. I thought it's not that bad. Yes it was!
Another time the CNA pulled his blankets/bedding off the bed and threw them on the floor. The air from that went in my face along with the dirt from the floor. I was sitting in a,chair visiting.

Nothing is allowed on the floor. Not even trash bags with soiled briefs. It goes from bed to special trash can. The nursing home can get cited big $$$ for that. So she was doing things she wasn't allowed to.

So my dad had a legitimate problem. He never complained before that. I went to management over that.

Your wife might be objecting around an activity, like bathing. She might feel bullied to bathe. The staff insist residents get clean. Residents can say no, but at a certain point they need a shower. It also helps check for sores/skin etc. Is it happening around bed time? Changing clothes to get ready for bed. It can be very traumatizing having someone remove your clothes when you don't want to. Cna's can be abrupt to get them into bed. They have 12 residents to look after. They are on a tight schedule.

I would definatly see if there is a legitimate reason she is getting agitated before requesting anxiety drugs. It could be 1 CNA or an activity/s she is objecting to. Or it could be another resident coming into her room, taking things.

That was another problem with my dad. Residents were walking in, taking things out of his closet and drawers. Luckily his room mate was able to yell for the nurses and they would redirect the wandering resident. They were both very upset by that.

So it could be a legitimate problem. Let us know if you find out what it is. Good luck~

Please review her meds. My mom's doctor upped her Aricept and within a week she was throwing things at me, hitting me, punching. We immediately went back down and after about a month the violence stopped.

Have you watched any of the Youtube videos by Teepa Snow? I strongly encourage you to do so. There are quite a few, but one in particular shows how she, a stranger, would approach someone who was being very aggressive. These are two that are excellent... Helping a Distressed Person with Dementia" with Teepa Snow - 10 ways to de-escalate a crisis with Teepa Snow. These are short and there is no reason the staff could not find time to watch them as well. I would insist on it! I'm watching everything I can find by this lady. She role plays the situations and makes it very clear how to approach and deal with those with dementia.

I feel your pain. The same is going on with my brother. What I am finding out is when one of the aids approaches him in the slightest aggressive manner - he gets nasty and in a rage. I have been called down a few times also. Talk to the director and director of nursing. You have valid concerns and need to ask why she is getting anxious. It is part of the disease, but appears to come on faster they get nervous, feeling backed into a corner or yelled at. Does she get sun down syndrome? Is there a specific time she gets agitated? If you see a pattern maybe they can play soothing music for her or engage her in an activity to get her mind refocused. Good luck and God Bless.

So appreciate your sharing
Vuongphi

I am a caregiver and I have experienced some of the behaviors you touched on. With proper training, those caring for your wife at the facility she is in, can better assist your wife. Understanding that empathy, loving and being calm goes a long way when these situation arises, and that it is not the resident fault (it is the disease that is acting our and speaking).
A set routine for residents with Alzheimer's can be very helpful, distraction and redirecting sometimes will do the trick. Knowing what their favorite music is and playing or singing to them had worked for me in the past.
However, there is another alternative, have you thought of In-Home care for your wife? There are some good home care companies out there with programs that are beneficial to those suffering from memory loss. The key is that you have a one to one approach, not one caregiver caring for 10-20 residence.

If it’s not UTI, I’m wondering if she’s taking Arocept or Namenda. Both together or seperatly can cause stomach irritation and other nasty side effects. Patients can’t always communicate what’s hurting so they become aggressive. That was our experience with MIL, anyway.

Because she believes she is in her home ( which she is but not the home she thinks ) , would it not be normal to react when people do things in her home she does not want ( or she thinks they do ) ?

On the other hand , there are schedules to keep and aides sometimes have to be a bit ( or even a lot ) pushy to get things done before the next shift comes on .
This is not a comfortable thing for one to feel in their own home but it is the way it has to be most often .

When your wife feels she must protect herself with aggression , is it after dinner , before lunch or at bed time ? This can be key on how to help but it is really important to know .

Remembering that a care center must always sound positive and leave no doubt they can " handle " things and they want you to believe they do " nothing " , which can be true , whatever behavior they do have may be a misconception in your wife's mind that is not correctly working .

Again , this is a hard call .

Having worked in Memory Care I am sure of where I speak .

Alprazolam is a medication that if you insist she is able to try then it most likely will be for the best since it brings complacency for most within 20 min. Then your loved one and the facility are at peace . I really believe in helping with this medication ( never Lorazepam since it has serious side effects like panic attacks which make a situation worse .

Think about it like this - Let's say you have a headache , a really terrible headache but someone wants you to do something like shower and get to breakfast . If you take an aspirin or whatever you may be able to do so within a few minutes . But they want you to function right away ! What kind of stress would you be feeling ? ( and in the meantime you cannot communicate to let them know what is wrong ) Your wife is in a situation where her mind cannot work correctly and she cannot tell anyone even if she feels sick . She cannot control her mind .

Getting her help you are sure will work is best for your peace and all concerned .

There is an answer and it can only be the right medication . The care center knows this already but apparently nobody is suggesting this type of help which can depend on the care center budget , I don't know .
A dr YOU can speak with in person to express how uncomfortable this is for your wife , you and the facility is crucial .
Yes they may try to convince you to have her try whatever is normal for their facility but please take down the 2 medication names I have given you and take them with you . Otherwise we get confused in a world we do not normally function with . God bless you friend & know I am really praying for your situation .