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New to group: Dad with rage Alzheimer's
cathlaf
Posted: Tuesday, January 21, 2020 8:00 AM
Joined: 1/21/2020
Posts: 2


Hi folks,

My 77  year old father has been dealing with memory issues/dementia for several years, but was only recently diagnosed with Alzheimer's.  He lives at home with my mom, and my kids and I (48 yo daughter) live in the same neighborhood.

His doctor suggests the ALZ is in the moderate stage (not sure if that's the correct terminology -- not beginning, but not completely advanced).

Dad can still care for himself, although he has virtually no short-term memory.  He only drives with Mom's supervision, although she generally does the driving.

The issue we are struggling with is his rage and anger.  Most of his anger/rage (all verbal, nothing physical) has been directed at my mom.  He gets angry about the past (his own and my mom's), angrily asking about boyfriends she had as a TEENAGER.  They've been married over 50 years and faithfully so.  But he expresses anger at how he thinks she may have acted while dating before they even met.  His filter is off, and he makes insensitive and sexually and/or racially charged comments and "jokes."  

To make matters worse, my younger sister and her family have an opportunity to move out of state for a dream job, and they are planning to move this summer.  My dad is so angry!!  (We'll all miss her, but we're excited for their future.)  He has been cold to her, even refusing a goodbye kiss when she was last over.

Mom has discussed this with their doctor (general physician).  He is on Seroquel, but has only been taking meds for a month.

Mom continues to read and research ALZ, but has yet to reach out for any help as far as a support group, locally or online.  Despite her openness to research, she still seems surprised when Dad doesn't remember things or gets upset.  A bit of deep-rooted denial??  I wouldn't blame her.  This isn't how they imagined their retirement playing out.    

I'm not sure what else I can tell you to give you a fuller picture.

Seeking ideas, suggestions, reassurance, anything!

Thanks in advance

Cat

 


Rescue mom
Posted: Tuesday, January 21, 2020 12:39 PM
Joined: 10/12/2018
Posts: 1332


Sorry you have to be here. Hopefully you will get more response, sometimes it takes a couple days on these boards. Others may be like me, I’m sorry not to have any better advice or tips for you. 

But, I can tell you that caregivers have to grow thick skins, and lose a lot of expectations. People with dementia DO lose their filters, and often say mean, hurtful and inappropriate things.

 People can say “it’s not him, it’s the disease.” And that’s true, the disease causes it. But its still him saying it, and it still hurts. You just have to....move on. It’s not unusual for them to act that way. And yes, they forget. And yes, they lose concern for others (as with your sister). Logic and being rational (as with accusations of cheating) are no longer operative with them. It’s all part of this ugly, awful disease.

Support groups do help, both for your mom and for other family who deal with him.

PCPs are often surprisingly unprepared/fall short deal with the problems of Alzheimer’s and dementias. A geriatric psychiatrist is usually more helpful, and can do Rx, if you can get him to one.

If he starts acting out physically, that’s different, and your mom must be protected from that. That, and wandering, are common reasons for placement. I’m kind of surprised the Seroquel does not calm him more. Maybe talk to the doc about dosage and/or different drugs?


caregiving daughter
Posted: Tuesday, January 21, 2020 4:36 PM
Joined: 11/27/2012
Posts: 2123


Keep the relationship up with the doctor that prescribed and provide active updates. It's wonderful for sis on the move but no one in the family should expect dad to understand and be supportive. His judgement is impaired. He may or may not understand the move part. He may sense something big is happening but can't logically think through so his reaction may seem like rage. I would recommend all stop talking about the move. Sister should say good-bye with a wonderful warm hug like she is off to the grocery store. Don't make a big deal of. Don't argue with dad and don't try to get him to be cooperative. Routine, physical activity, soothing words are critical. It worked for my mom for me to kneel on the floor when I talked to her. I listened and I stopped trying to communicate events to her. Don't get me wrong--I went for months trying to teach her how to fill the pill box and read her calendar. It took months but I learned how to be softer and gentler. Ensure everyone is in a physically safe position during these times of rage. Call the 1-800 if a concern exists. Books help but they are NOTHING like hearing others' experience live. This site works or encourage your mom to become part of a support group. Relationships with someone with dementia is not intuitive. You truly have to learn from others' experiences (Teepa Snow--this board).
LicketyGlitz
Posted: Tuesday, January 21, 2020 8:49 PM
Joined: 2/3/2018
Posts: 600


Hey cath, we have had really good results with Seroquel for our mom. She hit the rage stage last January and we were overwhelmed with her anger and aggression. We worked closely with her geri psych doctor for a couple of months getting the right dosage taken at the right time before Mom (and us) starting getting some relief.

It did not completely alleviate her anger, but it sure made it semi-manageable! If you get two months in and are still not seeing results get back to the doctor and ask for another solution. If you can, get a referral for a geriatric psych doctor as they are well versed in the medications that can help your dad, and your whole family, put a little distance between the rage and your day.

Good luck to you all!


harshedbuzz
Posted: Wednesday, January 22, 2020 4:46 AM
Joined: 3/6/2017
Posts: 1980


cathlaf-

My dad's presentation of mixed dementia came with a big side helping of aggressive nastiness and a fixation with all things sexual. I suspect my dad had some mental health issues his entire life, but I know people who report this kind of change as a complete 180. For my dad this seemed to have peaked in the middle stages of the disease; you might get a break from this as he becomes more impaired. 

Two things complicated this behavior. The first was a function of memory loss. He suffered with a lot of confabulated memories- when there are holes in a memory that are backfilled with incorrect information from another situation. This led to my mother and I being accused of all manner of ghastly behavior that might have been done by someone else or even that he saw on TV. Plus he had delusional thoughts where he believed things that just weren't true. Depending on the nature of the accusation, it was generally best to lean into it and validate how it made him feel by apologizing or promising to deal with whatever upset him. I can appreciate that it's hard to apologize for crimes one didn't commit, but it can really be the fastest way to extinguish the anger. My mom really struggled with this as it felt like one more indignity to apologize for something she didn't do like spend all the money or have sex with random men in the Rite Aid parking lot. 

The other piece was that dad sort of time traveled in his head. This sometimes meant he brought the social mores of a more conservative time to a situation or that long past slights were fresh in his mind although not necessarily recalled faithfully. He tried to ground me once for shacking up with that tall guy over there. I was 60 and married to him for 32 years at the time. 

I would encourage you and your mom to get him to a geriatric psychiatrist if possible. They really are the specialists best charged with managing psychoactive medications. Dad's neuro started him on Seroquel in the hospital; in part because we refused to take him home unless we dialed back the aggression. He wrote for a single 25mg dose at bedtime which was not quite enough to make him amenable to the validation strategies I described above. His geripsych added a morning dose of Seroquel and increased his Prozac to manage the depression/anxiety which presented as irritability. That helped a lot. Dad enjoyed his geripsych appointments and could showtime like it was his job which made convincing the man that we were struggling with behaviors at home a bit of a challenge. I made a couple short videos of dad dishing out his ire which I emailed to the doctor. 

It sounds a bit like your mom, like mine was, is a bit like that frog in the pot of warm water. I don't know that it's denial, per se, as how insidious the disease is in how it can present slowly and even with good days/bad days which make accepting the diagnosis harder. 

Another thing that helped was getting my mom a psychiatrist and therapist to help with her mood and an IRL ALZ support group. I could do all manner of explaining best practices around dad's behavior, but she needed to hear it from a peer who had been there. And I was not that person. This short essay helped her understand dementia from dad's perspective and helped her a lot. 

http://www.dementiacarestrategies.com/12_pt_Understanding_the_Dementia_Experience.pdf

HB


cathlaf
Posted: Thursday, January 23, 2020 5:44 PM
Joined: 1/21/2020
Posts: 2


Thank you so much!
RanchersWife
Posted: Friday, January 24, 2020 6:46 AM
Joined: 3/14/2018
Posts: 228


Dementia, rage and driving don’t mix. Mom needs to do all the driving. If he has a wreck and kills or injures someone your parents could loose everything when they are sued for allowing him to drive.