FAQ46 - Alzheimers and violence

[norbert1]

P wrote,
My father in law has moved in with us....he had Alzheimer's and is nocturnal and combative....unfortunately my husband does not seem to understand my difficulty with the situation. His father constantly threatens me with either his fists or his cane...I am afraid he will strike me. My husband says that if I can't out maneuver the old buzzard it is my problem...I am the primary caregiver and I don't have the skill set for this...am I allowed to defend myself? Or do I have to just dodge and hope for the best...
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You have a real potential of danger here.

I know with my mother, she would display kinds of behavior with my wife that she would not do in front of me. That may be similar to what is happening to you.

People with alzheimers anger easily, because they have lost their reasoning and coping skills. It becomes important that the way we interact and communicate with them is done in a way to not provoke anger. This is a skill that cargivers develop gradually as their LO changes. But you have been thrust into the role suddenly. People with alzheimers can be like unreasonable little children, except that they are not little and they do not limit behavior because they respect you as a parent or authority figure. In the upper left, do a search for FAQ25 which describes communication does and don’ts. Also take a look at FAQ23

You would also benefit greatly from taking the course on Alzheimers caregiving basics offered by your local alzheimers association.

There is a post here on caregiver basics. In the upper left, do a search for FAQ39

There is an article on Alzheimers Violence posted at the University of Iowa, center on Aging that you need to read.
Google - Coping with Violence: If Your Loved One Changes
Or go to
www.centeronaging.uiowa.edu/archive/pubs/Newest%20Versions%20-%20pdf%20format/Coping%20with%20Violence.pdf

Call the Alzheimer’s helpline and discuss this situation with a counselor at 1-800-272-3900

If your FIL is prone to anger and violence, he needs to be under the care of a doctor who is a dementia specialist. The local Alzheimer’s Association can give you the names of dementia experts in your area.

Sudden agitation--
People with alzheimers have little mental reserve. In the future, if you see a sudden worsening of behavior, you have to suspect that they have developed an infection or pain, or other physical condition that is taxing their ability to cope. UTI’s are a common cause of sudden agitation.

Regarding your original question on defending yourself--

I do not know for certain, but according to the book Elder Rage, hitting an elderly person under any circumstances is considered elder abuse. So you have to be defensive only in your actions. No hitting back, no pushing.

Dealing with violence ----
- If anger develops - leave the room. It takes two to have an argument
- Keep your distance.
- Do not turn your back on him.
- If he tries to hit you - protect your self by holding a chair between you, or use a cushion from a chair.
- Carry a portable or cell phone with you, always.
- Do not get cornered in a room. Keep a point to escape behind you always.
- Lock up all knives.
- Remove all items that can be used as weapons (fireplace pokers, etc.)
- Have locks on your bedroom door.
- Make arrangements with the doctor on what to do if there is violence. Usually, he will tell you to call 911 and have the violent PWD to a hospital for treatment. Find out in advance, what hospital is the best for treating dementia violence. Not all know what to do or have an appropriate med adjustment program.
- Untreated violence tends to get worse over time. Delaying treatment will require bigger doses of meds to control the situation when finally treated.

Norbert

[alice]

Dear Friend..

There is a few things I would like to add to Norbert's very informative post. Your husband referred to your FIL as "the old buzzard" and you should be able to handle him. Even though someone is old and has dementia when there is anger they can become very strong and aggressive. My husband became very violent because of a new med that was introduced. He went from being slow and sort of bent over and having to have my help to walk, sit down and getting up to in a split second standing very strong and tall..pushing a table aside and coming after me swinging a dish towel making it tighter and tighter...his face full of rage. The only thing around for him to grab was the dish towel..thank the Lord. I was able to get into the bed room and lock the door and call my son. Later I learned from the neurologist this was not a safe thing to have done as he could of easily of kicked the door down because of his enormous strength. It took a few days to get the med out of his body and I practiced all of the safety procedure s that Norbert shared with you. I shared the above to not scare you but to prepare you that these things can happen even with some one who is weak, old and has dementia.

One other thing I can't stress enough no matter what the behavior problem is remain calm and back away and access the behavior..is it something I can help with or will giving him time and space help. The loved one picks up on your body language and will react accordingly..say if you show fear or your anxious. I maybe learned this more easily as my husband could not speak verbally so I had to read his body language, facial expressions and sounds he made. He remained active until he became bed bound in the 12 months of the last stage but this helped me care for him and his needs. Even though he was bed bound the need became greater to be able to read his expressions for pain , etc. In the beginning I noticed he also was watching my body language even though he could hear me so I became very aware of my needing to remain calm at all times. ..to not show despair or I have had enough attitude. To watch what I was saying, my facial expressions, etc. It not only helps your loved one to remain more calm but also to control some of their behaviors and it keeps you in a safer environment and helps you to be a good care giver..

To me I feel if you can notice what a loved one is doing (their actions..noises being made, etc) when they become upset and their body language at the time you will know what to look for before he becomes angry or aggressive again and prepare your self to change the subject..turn off the TV...move to a different room..suggest a dish of ice cream..take a walk and/or a ride, etc.. .that worked for me as a care giver. Also if you see he seems to become angry doing certain things or in a certain environment you then can work to avoid those type of situations from occurring again.

Do take care of your self and may God bless you as you care for your FIL..that takes unconditional love for sure. Work to get a support group that includes your husband..become educated about the disease that will be a huge help to you. Read all of Norbert's threads..a wealth of info there for you and you can know Norbert is very knowledgeable about AD, all forms of dementia, behaviors, meds and most anything pertaining to this terrible disease. He has been such a help to so many over the years..I know he helped me tremendously and I will always be grateful to him. Because of his help for my husband and I he will always hold a special place in my heart.
alice