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Tips for Handling Verbal Abuse?
janeymack
Posted: Wednesday, January 22, 2020 4:54 PM
Joined: 2/28/2017
Posts: 105


How do you handle angry accusations that you've done or said things that you haven't? Fiblets won't cut it because I'm not about to lie and say I did something awful, just to keep the peace, because there is no peace to keep! My husband accuses me of mistreating him, doing nothing for him (this accusation while I'm baking the cake he wanted and making dinner!), hiding his things in the garage, yelling at him, but I haven't. He told that if he treated me the way I treat him I would have left!

He's on 100 mg Zoloft "to keep the monster at bay" (my term), but administers his own pills because "there nothing wrong with me". So, every few days, I count his remaining pills and do the math. Yesterday, I counted his pills. Hours later he asked me if I'd been handling his pills because the container was moved about 1/2 inch from where he'd put it! What the what? 

This is mostly a rant, but he's been impossible the past two days with no end in sight.


Ed1937
Posted: Wednesday, January 22, 2020 5:11 PM
Joined: 4/2/2018
Posts: 2223


Janeymack, you've had your hands full lately. I'm sorry. If you check his pill box again, I suggest that you mark the spot so you can put it back in the exact place. If it's bad enough, get in touch with the doc. He might adjust the meds.
janeymack
Posted: Wednesday, January 22, 2020 5:19 PM
Joined: 2/28/2017
Posts: 105


Thanks, Ed. He is on his last 40/90 of the RX and doc requires a visit to renew. Not sure what they prescribe if Zoloft isn't doing the trick. He's pretty active, but short term memory is fading fast. It seems like the disease is progressing rapidly these last two months.


SuzD
Posted: Wednesday, January 22, 2020 5:23 PM
Joined: 3/26/2018
Posts: 29


My Dh has gone thru periods  of verbal abuse and accusations, at one time he was accusing me of having an affair with the neighbor.  Of course it’s not true ,  to bad, I could use the diversion.. I don’t agree and adamantly deny. He seems off that topic for now.  

He is not reliable with his meds, so I actually have to put them in his mouth and watch him take them. This is getting to be more of a challenge each day, for now I do tell them they are his vitamins..

Welcome to the club none of us wanted to be a part of. We are here for you, when you need us. 


dayn2nite2
Posted: Wednesday, January 22, 2020 5:33 PM
Joined: 6/20/2016
Posts: 2108


janeymack wrote:

Thanks, Ed. He is on his last 40/90 of the RX and doc requires a visit to renew. Not sure what they prescribe if Zoloft isn't doing the trick. He's pretty active, but short term memory is fading fast. It seems like the disease is progressing rapidly these last two months.

 

Zoloft is a VERY mild antidepressant and really will not change his behavior.  Contact the doctor and ask for something else.

jfkoc
Posted: Wednesday, January 22, 2020 5:50 PM
Joined: 12/4/2011
Posts: 17815


This is something I found for you....take a look.

https://www.alzheimers.net/1-6-15-new-approaches-difficult-behaviors/

I understand your position on "lieing" although I do not agree. I am sort of anything for peace and lets move forward. You are now operating with differing realities. 

What if  you say something like "wow, I hear you are not happy with me/ are angry with me and I am sorry for that."

Anger very often had fear at its root and we are forced to read between the lines.

Try and be a calming as possible for your own sake as well as your husbands. Screaming in the shower is a great release....also singing or humming...and of course, we are always here to listen.


LadyTexan
Posted: Wednesday, January 22, 2020 6:18 PM
Joined: 12/21/2018
Posts: 330


Janeymack I am so sorry you are dealing with this. 

On this dementia journey, when my DH is blaming me and yelling at me, I save myself future grief and heart ache by apologizing and/or keeping a calm tone and/or validating his feelings, for example, 

gee honey I can understand that's upsetting. I'm sorry about xyz. Thank you for telling me that. I'll try to do better.

Of course, I have to practice that response. It does not come natural to me. And it is not always applicable for the situation. Sometimes, I have to remove myself from the situation. I'll go into another room or go outside or put on my head phones.
I'm sending you a cyber hug. I know how it feels to deal with the verbal abuse. It hurts.

Sharon from Texas
Posted: Wednesday, January 22, 2020 6:22 PM
Joined: 1/22/2020
Posts: 5


I've just joined today because I was needing help understanding what all is happening. I'm sorry for your difficulties!!! I'm the sole caregiver, 24/7 for my husband. He was diagnosed many years ago and has been is slow progression but what I'm finding happening more recently is the paranoia and anger!! I'm absolutely amazed at all he thinks and comes up with!! His accusations are unbelievable!! I've only tried to help him in every area and when he begins one of his tirades, it is so painful that I am in tears!! I'm reaching out to see if this paranoi and anger is part of Alzheimer's and how to deal with it. By reading your writing just now now has helped me tremendously, even though I'm sorry for your pain. I didn't realize this was a trait that we learn to deal with. But now I see it is and hopefully there are ways to deal with this. My husband is on meds for depression and anxiety and they do seem to help with mood swings. Is there something else that will help these outbursts?  As you are aware, I never know when he will explode or what seems to set him off. Any information will be appreciated.
Eric L
Posted: Wednesday, January 22, 2020 7:39 PM
Joined: 12/5/2014
Posts: 1250


I’m coming from a different perspective because I helped take care of my MIL and I know the relationship dynamic between husband and wife is very different. I’m also not in the middle of the battle anymore (MIL passed last September), so I’m in a very different place than most of the caregivers here. Most of the advice I am going to offer you is based on the mistakes we made.

If you have to count his pills to monitor if he is taking them or not, he’s probably well past the point of being responsible for taking them himself. We let MIL be responsible for her own pills much longer than we should have. When we finally ‘took over’, it was better for everyone involved. Before we took over, we’d check and try to monitor but since it wasn’t really part of our routine, there were quite a few missed doses. Once it actually became our responsibility, there were very few mixed doses.

As day2nite already said, zoloft is a pretty mild drug. I started taking it because of anxiety issues related to my caregiving duties with MIL. I can only speak for myself in saying that it took the edge off most days. My anxiety issues are relatively mild, though. MIL was on it a couple times and it actually made her behaviors worse. It wasn’t until she started seeing a geriatric psychiatrist and he made changes to her meds. Many of her more challenging behaviors (like what you are currently experiencing with DH) became much more manageable.

Obviously like one of the other posters said, don’t simply agree for the sake of agreeing. If you’re getting accused of having an affair, I don’t think ‘confessing’ is a good idea. At the same time, denying it isn’t going to help either.  That’s one of those times where it might be better to redirect. ‘Oh darling, I love you so much. Remember that time when our battery died at the Grand Canyon and we had to call AAA to jumpstart it? We drove all the way to Sam’s Club in Flagstaff and just hoped we wouldn’t have to stop and turn off the car for any reason’ (that actually happened to our family a couple years back). Try to get away from the negative stuff and refocus. I realize it’s easier said than done. I made my share of mistakes when MIL was being difficult.

On the other hand, when the issues are relatively minor (like ‘moving tools’), why not just ‘confess’? Take the wind out his sails. ‘Oh darlin, I must have moved them by accident yesterday. I’m sorry. Why don’t we go find them?’ Ed gave you great advice with marking the location. Even on that one you can always say ‘Oh, I must have moved them when I dusted. Can you show me where they are supposed to go?’.


Sharon from Texas
Posted: Thursday, January 23, 2020 7:11 AM
Joined: 1/22/2020
Posts: 5


Thank You Eric! All you said is great information. It will help me in the future!! Even though I'm new to these posts, the ideas are all wonderful and helpful.  I'm sooo sorry for the loss of your MIL. One of the most confusing attributes of these outbursts is the complete change in attitude from just a few minutes before, from fury red faced anger to Sweet as can be smile within just a short time!! I'm still shaking from the outbursts and in tears and he's in a happy mood. It's taking a lot of adjustments for me. Maybe I'm needing meds myself for the stress. Thank You again for your input.
janeymack
Posted: Thursday, January 23, 2020 9:34 AM
Joined: 2/28/2017
Posts: 105


Thank you, Eric, and everyone else who's posted. Sounds like revisiting meds is a logical idea. 

I wonder; what is the difference between a neurologist and a geriatric psychiatrist, in terms of prescribing meds? DH currently has an excellent neurologist, who has prescribed aricept and namendin (SP?), both of which DH is no longer taking, plus his primary care doc, who prescribes Zoloft. 

Should I ask one of his current docs for something else, or seek out a geriatric psych? Keep in mind, DH has announced he is never going back to the neuro, because she makes him feel like an idiot (DH does not think he has AD). Adding a new geriatric psych doc would be a new battle for me!

Thank God I have all of you! {{{}}}


Eric L
Posted: Thursday, January 23, 2020 10:43 AM
Joined: 12/5/2014
Posts: 1250


Janey - In our experience, the visits to the neurologist became superfluous as time went on. It seemed like his job was to say "yep, she's getting worse. Let me keep refilling the aricept and namenda and I'll see you in 6 months".  When MIL was still somewhat aware, the appointments did upset her quite a bit. It was like she was learning every 6 months that she had dementia. Before she put on hospice, we decided to stop seeing the neurologist all together. By that time, we had lined up the geri psych and he was comfortable with prescribing the aricept and namenda. Obviously, your husband isn't at the point of hospice, but it was helpful having one less doctor to see.

The neurologist wasn't very comfortable prescribing any meds to manage her behavioral issues. He referred us back to her GP for that kind of stuff and then to a geriatric psych.  Her GP was pretty good, but he just didn't have the expertise in prescribing those types of meds to dementia patients. That's where the geriatric psych comes in. His or her speciality is to prescribe meds and adjust them for folks with the various types of dementia (I assume they see other elderly patients with psych issues). In our case, the geri psych was much more available than the neurologist ever was. If new issues popped up, my wife or her brother was able to call or send an e-mail to him and he was able to get her in for an appt or prescribe something else without seeing her. MIL was very, very difficult the last couple of years of her life. Without the geri psych, there is no way we would have been able to manage her behaviors and keep her at home.

See if you can get him in with a geri psych. You can even agree with him that the neuro wasn't good and didn't treat him right. Tell him you found a new doctor. What I would do in your case is if you get in with a geri psych, write a memo outlining all of the behavioral issues that you encounter with him that you can either e-mail, fax (I swear, the medical industry is still hanging on to those fax machines), or drop off in person before the appointment. Don't sugarcoat anything. Be blunt and honest. One of best helpers on this site, Jo C. also recommends that you take a copy of the memo with you to the appointment that you can slip to the nurse in case they didn't read it the first time around. Heck, I even used my phone one day to record one of MILs outbursts during shower time (just recorded the sound) so the doctor knew exactly what we were dealing with. Even though she was very compromised by the time she started seeing the geri psych, she still had enough awareness that she could put on a show and act like her "normal" self for short stretches (like the length of a doctor's appt). Make sure that you let everyone at the office know that DH doesn't think he has dementia and any mention of it will shut him down and ensure that he won't trust them. 

Sharon - For the last couple of years of her battle, MIL was pretty sour most of the time. She didn't have many happy moments. We didn't get many of those turn on the dime type of attitude shifts. Still, I think the hardest part was knowing her personality and attitude before things really went sideways. She was a "gentlewoman" (I guess you could say lady, but she was the type that didn't use foul language in public and was pretty nice to everyone she met). She was quite fond of using the f-word during the last couple of years. Prior to that, I'm pretty sure I never heard her say it in the entire time I knew my wife. She just became a completely different person.
jfkoc
Posted: Thursday, January 23, 2020 12:34 PM
Joined: 12/4/2011
Posts: 17815


My husband's neurologist pulled in a neuropsychiatrist for meds.
jdmg1
Posted: Thursday, January 23, 2020 3:50 PM
Joined: 4/23/2019
Posts: 285


Oh, janeymack, I am so sorry.  Our family doc has done a good job so far, but has suggested that may may want to enlist the help of a neuropsychiatric doc to readdress DH's meds if what he is taking now isn't helping in the future.
renandstimpy
Posted: Thursday, January 23, 2020 5:51 PM
Joined: 1/23/2020
Posts: 2


Just joined but I have to say I could of written the very same thing. So tired of it all.
Jeff86
Posted: Thursday, January 23, 2020 7:20 PM
Joined: 10/24/2019
Posts: 85


My DW’s neuro is an AD specialist and is comfortable prescribing/managing behavioral/mood issues.  Switched from Zoloft to Lexapro, which seems to be working better.

There can be such a thing as better living through chemistry.  Weighing in with others that you might seek more professional assistance than you’re currently receiving.  Hope things improve soon.


Sharon from Texas
Posted: Thursday, January 23, 2020 8:45 PM
Joined: 1/22/2020
Posts: 5


Thank You so much for sharing with me Ed!  It helps sooo much to have someone help with questions and situations. I agree, at this stage he can turn on the charm for awhile. Because of this and because of my confused thoughts of what was going , I started writing down his episodes, dates and times of when he would explode. I thought there may be times I will need this info even though it's difficult to write. Yes, with his PC doctor he is just fine and this doctor is wondering why he's on anxiety meds and depression meds. He's even asked "Who is this doctor prescribing these meds?!"  I've tried to explain my husband's mood swings in front of my husband and I can tell the doctor is really confused. I may need to make a copy of his episodes as you suggested!  Great advice!  Yes, as your MIL was a lady all her life, so was my husband a perfect gentleman!! On good days he's adamant of his love for me and he wouldn't know what to do without me. On bad days he's a different creature!  And I am the monster he thinks!! Sooo sad. Thank You for sharing about your MIL personality before and after!  This really helps me!! Also, I had not received any info from the Alzheimer's groups. Only knew about memory loss but was unaware of the personality changes, depression, anxiety and fear, and anger. Meeting y'all in these online groups is already giving me hope of how to cope. Because he also denies having dementia, the thought of him or me going to a support group would send him to the moon. That's out of the question for right now but maybe later in I can start going. Thank You again for all your advice!! I really appreciate you!! I'm sorry for all you and your wife have gone through!! But those of us in the beginning stages are appreciative of your help!!
Sharon from Texas
Posted: Thursday, January 23, 2020 8:51 PM
Joined: 1/22/2020
Posts: 5


I'm sorry, I meant to say Thank You to Eric not Ed!  I guess I'm really worn out!
Sharon from Texas
Posted: Thursday, January 23, 2020 9:03 PM
Joined: 1/22/2020
Posts: 5


I too just joined and in reading the story's of others is troubling but helps me to know I'm not "the one going nuts or imagining these things!"  Yes, I'm worn out with no end in sight but I'm thankful for these people and help groups. Keep up your chin and me as well!! Each day is rough but with help from others we can navigate the troubled waters!!
Eric L
Posted: Friday, January 24, 2020 3:10 PM
Joined: 12/5/2014
Posts: 1250


Sharon - The really sad thing with dementia (aside from the dementia itself) is that the population at large just doesn't seem to understand that it isn't silly "Oh, Grandma put her undies in the fridge again" memory loss. There are so many changes that they go through. Physical, emotional, and cognitive and the only thing that really ever seems to get discussed is the cognitive issues. Even then, they don't seem to really discuss the devastating losses that the PWD goes though. It's more "they forget stuff" that seems to stick with everyone.

Thankfully, sites like this exist and the people that post around here seem to do a good job filling in the gaps. Even then, hands on experience seems to be how people learn. I stick around here because I hope I can help those with LOs in the earlier stages avoid some of the mistakes that we made. We were so ignorant early in the process that we just didn't know any better.
harshedbuzz
Posted: Friday, January 24, 2020 3:55 PM
Joined: 3/6/2017
Posts: 1982


janeymack wrote:

I wonder; what is the difference between a neurologist and a geriatric psychiatrist, in terms of prescribing meds? DH currently has an excellent neurologist, who has prescribed aricept and namendin (SP?), both of which DH is no longer taking, plus his primary care doc, who prescribes Zoloft. 

A geriatric psychiatrist is the specialist for prescribing psychoactive medications for the elderly including those with dementia. While any doc can write these meds, a geripsych is likely to be the best option.

Should I ask one of his current docs for something else, or seek out a geriatric psych? Keep in mind, DH has announced he is never going back to the neuro, because she makes him feel like an idiot (DH does not think he has AD). Adding a new geriatric psych doc would be a new battle for me!

The geripsych was the most valuable member of dad's care team aside from my mom. Dad hated his neurologist; he didn't believe there was anything wrong with him and saw no reason why he couldn't drive, manage his investments, live alone 1200 miles away or drink a couple of bottles of Chardonnay nightly as per his neuro's orders. 

He did like his geripsych which sort of surprised me as he thought mental health issues were a form of weakness. I sold the visit as a "second opinion to make sure the neuro was right and to make sure we were doing everything we could for him. He went for it. The geripsych was warm and engaging and dad looked forward to the visits. 

HB



Tony484
Posted: Friday, January 24, 2020 7:49 PM
Joined: 11/24/2017
Posts: 28


Not to be Pollyanna, but there is always some chance that the verbal attacks/accusations will lessen or disappear over time.  My DW, who was the sweetest person ever, mophed into the poster child for what you are describing, Just as I was beginning to accept that I would always be the bad guy, and I was suffering terribly as you are, the level and frequency of DW's verbal accusations started to lessen, along with her gradually deteriorating short term memory. She would attack but then shortly thereafter forget that she had done so or what it had been about.  So I could simply bring up some other topic.  This change was all very gradual and the problem is now almost (but not entirely) nonexistent as she cannot remember for very long either that she was mad at me or what she got mad at me about.  And she's a lot happier to boot with her more limited memory, which I think may reflect what some of the other responders to your message have said about the high level of fear and anxiety that can be experienced when someone with AD has some understanding of their situation.

 I  suppose that over time I also got better at handling DW's anger, in the ways that have been suggested above and in other posts on this board, as well as by doing a lot of reading about Alzheimer's. At this point, I wouldn't confess if I were accused of having an affair, but I have otherwise become a very good fibber, and much more adjusted to taking the blame for just about anything, and those techniques almost always work for us. I don't mean to sound judgmental, especially because I was initially somewhat the same way, but I've become convinced that a moral code that demands always telling the truth is a moral code that is not in the best interests of someone with dementia.    


Army_Vet60
Posted: Saturday, January 25, 2020 10:13 AM
Joined: 6/21/2019
Posts: 517


Janeymack,

What worked for me until my wife reached stage 7 was this:

When she got angry or frustrated and took it out on me, I didn't argue with her. I'd tell her I agreed with her anger and I wished I could make her better. It sunk in enough that she's say "Yeah I just hate this." Then I'd hold my hand out to her and she'd take it. I'd hold her hand for as long she didn't let go.

At stage 7, Parkinson's and Lewy Bodies took over and she couldn't control the verbal outbursts anymore.  It got to the point I'd walk away. I'd go out on the back balcony and commune with Nature for 5-10 minutes. She'd come to the door and look at me. If she said, "Can I come out?" I'd bring her on the balcony and hold her hand.

Near the very end, her outbursts were so toxic I had to put her in a Nursing Home for five days because I needed a Respite break.

She came home, was happy to be home, and died next to me about ten days later.

I suppose medicine could help subdue the outbursts to a degree, but it's so important not to lose your LO's trust. Arguing back won't help. Responding with verbal abuse of your own definitely won't help. 

What worked for me was empathizing with Sandy when the outbursts came, not reacting defensively or attacking her. When it got to the point that didn't work, walking out of the room did. When that didn't work, Hospice removing her from the home for five days was the last - necessary - resort.

You need to find a way to navigate through the verbal abuse. For me, it wound up being three different ways.

I hope this helps in some way.


Gwen&Rob
Posted: Saturday, January 25, 2020 12:03 PM
Joined: 11/8/2017
Posts: 13


My husband became very verbally abusive and it was turning into physical abuse.  His Neurologist put him on Zoloft twice a day and Seroquel at night.  These meds have completely changed him back to the nice person he was.
LadyTexan
Posted: Saturday, January 25, 2020 12:27 PM
Joined: 12/21/2018
Posts: 330


ArmyVet made a great point about how the best response to the verbal abuse changes as the LO's condition changes. I often remind myself that what works now, may not work next week. This disease is constantly changing my DH and me and our needs. I think that's another reason that caregiving is so exhausting. The conditions are ever changing, chaotic and unpredictable.
lvcatlvr
Posted: Saturday, January 25, 2020 12:35 PM
Joined: 5/7/2018
Posts: 347


Daynnight2 is correct. Zoloft is a very mild antidepressant that stops working after a while. Our younger daughter had serious depression when she hit puberty, so I know quite a bit about all the SSRI's. Also, we are fortunate to have a branch of the Cleveland Clinic here that only deals with brain health. My DH was put on Lexapro. I have seen that many on here also give Lexapro to their LO's. It seems to be the drug of choice for AD patients. However, he will have to be weaned off the Zoloft first, and I believe there is a waiting period before he could start a new one.

  As for letting him administer his own pills, my DH was doing that. Then he had his first major delusion that involved him thinking I was a stranger. He aggressively wanted me out of the house, and even pushed me down. I came to find out he had been skipping pills (I found them in various Dixie cups on his dresser), and sometimes doubling them!!! He had to be put in a psych hospital until he got on track, but things were never the same after that. He spiraled downhill from that point on. My reason for telling you this is because I don't want the same thing to happen to you. It's time for you to take over the administration of his pills.It won't be easy, but it will be better than him going off the rails.

By the way, I have been taking Lexapro myself for several years. I know it helped me be a caregiver and now is helping me cope with grief.