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My mother has been diagnosed with dementia. She is angry and abusive to my father. I know this is a symptom of the disease, as she was never like this before. My father is still active but feels he can’t leave her alone for long, and when he does, she verbally abused him when he gets home. She will also call my sister and I hysterical, calling my dad names and saying she feels abandoned and is going crazy in her house “all alone” whenever my dad leaves. We want to hire a caregiver to come take her out and do whatever she wants to do a few times a week, especially when my dad wants to get out of the house, but she refuses to entertain the idea and my dad is just leaving it up to her to decide if she wants a caregiver. I don’t think it should be entirely up to her. We are all affected by her disease and need help as well. Should we be leaving it up to mom to decide if she wants a caregiver or should we insist. I’m not sure which is the correct way to respond to her refusal. Any advice?

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Get a caregiver & say she’s there to help you..not her. Meanwhile, caregiver can give her shower & wash her hair, help around house w laundry or whatever. Dad needs a break. I feel bad for you & Dad. Hugs 🤗
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sending lots of hugs your way! i hope things have improved since you posted, some days ago!
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eat-pray-love Nov 2022
I'd move your Dad out ....
Then Plan B re: your Mom....
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Your situation is exactly like how ours was with my dad. He has advanced dementia. It started being verbal towards my mom then it started getting physical. He refused any in-home daily aid. My mom was a prisoner in the house because he couldn't really be left home alone for a long time because he was scared. She would go in short spurts to pay the bills and do the grocery shopping. But in April, it got so bad, we had to have him removed from the house and placed in a nursing home, otherwise, we feared my mom's safety was in jeopardy as was his. I'm a long way away from them but I was able to get a social worker involved, which made all the difference for us. You will probably need to help guide your dad to make a decision for her. I feel for you both. It's so hard to watch a loved one go through this and know there is nothing you can do to make them well again. I would encourage you to find someone to come in and relieve your dad so he can enjoy life. I'm sorry you are dealing with this but know you are amazing for trying to help where possible.
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Your dad needs the break or this will take a toll on his health.

Seek out the evaluation of a geriatric psychiatrist for your mom. She may need a little helping bridging to a new loss of independence.

She hopefully can get enough help that she can be civil to any and all caregivers she needs help from, including you and your dad.

Carve out some special time to spend alone with him. Even if he is putting on a brave face, he is going through a lot.
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Tell her “the doctor” says she has to have someone a few days a week, might be worth a try? This is so hard, also if she’s taking a statin consider not continuing ( which many people are ) that can make dementia worse, it cuts off the cholesterol to the brain as well as body
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Sounds like you lovingly need to push the envelope and hire a caregiver whether she wants it or not. There are ways to try to be sneaky about it. Hire someone that is a caregiver but tell them to act like a housekeeper and just do some housekeeping and be there for her talk to her, listen to her, offered to help in an easy care free way and let it grow from there. Your father he knows his wife and this is a quite an adjustment for him to do too and he wants to be there even though she’s abusing him. He loves her. It’s time for the extra mile love. She is dealing with an internal battle besides the disease and you just got a love love love love love.

You know it’s like a child who doesn’t wanna listen and as a parent you just gotta take control in a loving way sometimes; it’s just reversed now. Start reading up, go to a support group, start researching and be firmly grounded in loving support no matter what comes. God bless you and your dad and mom.
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I did a double take. Thought I wrote this.
Just returned home from 5 hrs with my Mom. 2 hrs up & back..
Same except my Dad passed in January. And my Mom has been mentally ill for decades.
We pulled my Dad out for last few mos of his life w/24-7 Caregivers. Better for him to pass in peace surrounded by loved ones.
I am debating the same re: my Mom. She can afford & I think more human interaction would be good for her.. Then again the NPD-Borderline (she tore into 2 Solicitors who phoned today) & Early Onset and horribly argumentative behaviors...coupled with some odd "love bombing" in places...hard to figure out what to do and when.
I think my Mom has to slip mentally more OR she will tear into an aide or assistant.
Your Dad does not deserve this. A change for him would be good. Can he live with one of you or he stays there.. & she goes somewhere else?
But she sounds like my Mom. Doubt she would leave and go elsewhere..right?
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Slschiller: An individual with dementia should not make any decisions as their brain is broken.
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She has dementia. Introduce her to the new caregiver as a friend, and enroll her in your Mom's life.

Dad is likely still in the denial stage.
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Does ur mom just treat family members with her anger or is it everyone?
? When we were looking at Al for dad... He was able to stay at home alone cause as sepsis resolved his cognition got better.
Al tour guide told us at times she was embarrassed that the lo treated her so well but treated family members like dirt. Can u test that out with a stranger to see how she would act after action is taken?
And the human service profession learn that as anger is just an
Emotion. They don't need to fear it's just an emotion they r more likely to observe it to and speculate what is causing it..
Hope u and ur father can get less infected by her anger or so she can't control u.


.
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Your mother has dementia. She cannot be in charge anymore and is no longer calling the shots.
She doesn't want someone coming in to help so your father can go out?
Too bad. Paid help will be coming in.
The correct way to respond to her refusal of help is to just proceed with bringing the paid help in. The first few times they are at the house you or your father should stay for their shift. This way your mother can get familiar with the person. Then your father can start going out. He should wait until the caregiver arrives before leaving though. Tell the caregiver not to tolerate any mouthy or belligerent behavior from your mother. If she acts up and lashes out at the caregiver, they need to tell her that they are there because her doctor and family sent them to help her out. Your father should not tolerate her lashing out at him either.
If you have adult daycare in the area, your father should have her going a few days a week whether she wants to or not. Most of them even provide transportation to and from home.
An adult with dementia has to be considered like a child. We do not allow children to be in charge. We make them eat their veggies, take a bath, change their clothes, go to school, and go to bed. You have to do the same with an adult that has dementia.
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Has mom always been mean? Only part of the answer, but has she been checked for a uti? My mom's a doll but when she has a uti she is Hell!
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My suggestion is that you hire someone. you don't discuss it with her, or leave anything up to her bc she is not competent to decide. but give a reason that she might be ok with like 'dad needs some help', or 'wouldn't it be nice to have someone do laundry?'
when you want her to decide something, give choices, like 'do you want this one or that one? not open-ended decisions. I don't ask my dad what he wants to wear, i say 'which of these two shirts?'
Then plan outings/activities that you know she enjoys and have the aide take her. i don't mean you should be dictatorial, but you have to take the lead. When my mom needed help in the house, i said it was for daddy. she was ok with that.
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- You need to get support / help for YOUR DAD. It is not right nor healthy for him to be the brunt of her changing brain chemistry / dementia.

- Support your dad to walk away or shift out of her visual site when she is screaming / activated. Encourage him NOT ARGUE and NOT 'stand there' and take it. He can only take so much - as all of you can in this situation.

POA status is essential and needs to be in place yesterday. Get an attorney to help you make this happen.

* Consider medication - is she taking anything for anxiety ? depression ?

* You need to get someone in there. Period. End of discussion - although the beginning of this discussion.

- Try to find someone who is confident; won't take the abuse personally and will set limits.

- I would ease someone in, i.e., not have her / him do 'much' [the first 1-2 days or so]. Just be there. Let your mom warm up / get used to this person around - more so on her terms (she is frightened/fearful / bitchy / screaming / angry - this is to be expected].

ANY PESON EVERY PERSON DOESN'T HAVE TO STAND THERE AND TAKE IT. Say once "If you continue to scream or xxx, I will walk away. And then do it. She'll get it in her brain (somewhere) that her strategy isn't working. And, if she doesn't so be it.

Do not allow yourselves to be PUNCHING BAGS. This requires tough love.

Care provider could clean up the kitchen so she'd know they are there - and not bother(ing) with her.
SHE IS FRIGHTENED and acting out old (workable) behaviors to meet her needs. This is to be expected.

* Boundary setting is critically important / needed. Even with forms of dementia, I experienced client(s) to shift their behavior when I shifted / changed mine, i.e., set limits / boundaries / said I would give them a time out - and did (5 minutes to the rest of the day).

A strategy I use with a narrarsistic personality (in memory care) is saying she is 'in charge' , compliment her all the time... and letting her know she is helping staff to do there job. Ask her to 'report' back to you her observations. Tell her the help is for her husband, not her. Help your mom feel she has a job to do that is important .. so it fits with how she feels about herself.

Yes- of course the entire support system is affected. This is why:

You need to do what she needs and not allow her to dictate the care she needs. And others' need her to get this care, too. Everyone is drained and emotionally spent - and this will only get more intense if you do not set limits.
- Tell her what you are doing. (i.e., Getting helper). Do not argue. If she responds as she will - harshly, say ONCE I hear you . . . and then move on.
- She needs to realize that you are in control and doing what you feel she needs. She may or may not get it. Do not wait for her to understand (she may never get it). The changing brain / chemistry requires YOU to take control and care for her as she (and her husband/you, your sister, and your dad (?) needs.

Gena
Touch Matters
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You and dad must repeat 1,000 time per day:
This is a profoundly mentally disabled person with permanent brain damage.
This is a profoundly mentally disabled person with permanent brain damage.
This is a profoundly mentally disabled person with permanent brain damage.
This is a profoundly mentally disabled person with permanent brain damage.
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TouchMatters Nov 2022
No he needs to leave the situation [temporarily and set limits - once he realizes he deserves to and can) and not be subjected to this. Arguing or trying to 'talk logic' is a waste of energy as it doesn't work with someone with dementia.
This loving soul (her husband) needs support - and a break.
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Time to get mom placed so that your dad may get a few extra years without the stress. Please get your family a group appointment with the Geriatric Psychiatrist and make the decision as to where mom should be placed: get her diagnosed, if she hasn't been already and talk to an Elder Law Attorney about financing mom's assisted living journey.

Talk with your dad about staying in the house or moving to a different facility that offers Independent living.
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TouchMatters Nov 2022
Yes. Excellent supportive advice. Thanks.
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You're being far too passive. If your mom has a verified diagnosis of dementia then it's time to get Power of Attorney (POA) because your father is not helping much here. And, like others said, she should not be left alone AT ALL.

Bottom line - you need to step up and take control. Stop letting your mom decide everything. She's mentally incapacitated so she should not be deciding the course of action here. Get legal power so you can navigate the medical road ahead with more leverage.
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My father does not have anger issues but he still has some pride and so when I recently brought in daytime caregivers, I didn’t call them that in his presence. I said that they were people who were going to help do a little house cleaning. From there a relationship can, and in his case, has developed. I think bringing someone in and expecting the loved one to immediately jump on board as this being someone that’s going to care for them can be too much all at once. So starting as a “housekeeper“ but with the housekeeper knowing that this is really a caretaking position and letting the relationship develop organically. Just my two cents and I know that every situation is different.
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I agree with Alvadeer. Have a family conference. It is time to bring in the professionals. Work with your mom’s primary care provider. There might be a service through the hospital that specializes in “keeping aging family in their home environment as long as possible”. They should be helpful in both getting your father some help at home to bridge the time until she can be placed in a secure living environment. It will seem incredibly painful, but unfortunately with dementia there just is no happy choice and your mom is NEVER going to want help. My dad was the same way. I kept thinking after a fall, or feeling lonely, or after my pleas to say I needed some help that he would see the light and accept care. With dementia, they just cannot be rational. You cannot reason with dementia. The sooner you get help for her and your father, the sooner you might be able to get to a point where your dad and family have at least a little bit of peace. Your mom probably won’t ever be kind or happy again, but maybe she will have brief periods where she is pleasant. I can tell by your words that you will support your father, but don’t be afraid to suggest counseling for him. Please be sure he comes to a deep understanding that it is not his perceived failings, but rather this heart wrenching disease that has taken your mom away.
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Beekee Nov 2022
Agree. I made mistakes along the way by refusing to accept the reality of dementia. I consciously thought I was accepting it, but deep down, I was still thinking of this profoundly disabled person as my mother of decades ago, still trying pretend she could safely lead some type of independent life, still keeping her empty house while she was in full-time memory care so the rest of the family could visit her from out-of-state and still feel a sense of home. I sure wish I had the money back from those 3 years of property taxes and utility bills. It's a bitter pill, but with every decision large and small, you must always think of your parent as a profoundly mentally disabled person, no longer the capable, smart, kind person they used to be.
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No, you should not be " leaving it up to her ( your mother) to decide". You say that she has been diagnosed with " dementia". A dementia diagnosis limits severely a person's ability to make safe, rational decisions ( about anything). While her anger and lashing out is unfortunately often associated with dementia, as you say, it further identifies that the patient ( your mother) is not able to control her actions. She may be unsafe to others ( verbal abuse is verbal abuse regardless of where it comes from) and, she may be unsafe to herself.

So, you and your father/ family should definitely confer with her Physician for further referrals and assessment of your mother's needs for caregiving; and then make the decision best for All of you to get help with her. She will most likely be resistant regardless of who , when or where or how help us implemented so go ahead with whatever decision you and her POA decide is best after conferring with her Physician and/ or other specialists ( i.e . Geriatric etc).
Getting help " in the home" with her will require you being able to share with potential caregivers the pt behaviors etc and, for you to be able to select best; or perhaps it will be a " adult daycare" program that she could attend certain days of week outside the home to give your father and you all a break. " The ARK" Programs and others specialize in dementia care. Speak with Physician and Geriatric specialist in your area for help.

Practice good self care including not listening to her verbal abuse, ranting and raving...if you hang up the phone or redirect the conversation on phone or in person or walk away, she may be able still to associate her behaviors not being tolerated.

All that said, she is most likely also grieving the dramatic changes that she is experiencing and is both fearful and angry about these.

You, her husband and family are all also grieving these changes and the " loss" of the mother and wife you have all known.

Also enlist the support of your and her pastoral clergy support.

Practice good self care.....you will need all the care you can get from many different disciplines to help carry you all through the journey ahead.

Make decisions for your mother . She cannot make best decisions now.
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We had the exact same scenario except that my father had a serious progressive neurological disease. He cared for her as best he could. We could see that it was killing him. Against her will, we got someone to come in to help and got Mother heavy duty medication for those nights when she wanted to kill Pa. Mother is/was a very outgoing person which saved us. She was accepting of having more company. After Pa could no longer care for her(we decided) we had to place her in a memory home and I took Pa to live with me. Luckily, I enjoyed having him with me.
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No. It should NOT be up to Mom. Mom has dementia. That means she can't be held responsible to make good decisions. That is on her family now, sadly. And when you go through the process of that decision making, give simple and gentle explanations, and recognize that reactions may be quite volatile. There is not a good and easy answer; not everything can be fixed. Sometimes the only solutions are hard ones, full of rage and tears. But there is little choice and I know you recognize that. I sure am sorry and I surely do wish you the best.
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You can not leave it up to mom about a caregiver.
Mom should also not be left alone.
Bring in the caregiver as a "friend" of yours. Your "friend" on day 1 can help dad with cleaning, doing laundry and just chatting with mom.
On day 2 dad can offer some lunch to your "friend" (Sue) and realize he is out of bread. "Sue" can stay and chat with mom while dad runs to the store for a loaf of bread. Dad can be gone for 30 minutes or so.
On day 3 dad has to get a haircut and will be gone for an hour or so.
Mom will get used to "Sue" and be more accepting of the help.
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No, it is sounding as though your Mom cannot be left alone, and shouldn't be left alone, perhaps even briefly. I don't know her so I am hardly the last word here, but I think your Mom may now need a sitter in much the way a young child does.
If your Mom's personality is incredibly changed, if, that is, she is not the woman your Dad married and lived with all this time, it may be time for the family to conference about LTC placement for her. It isn't right that your Father is expected in his elder years to have to try to maintain care for her that he may not be physically or mentally able to do.
I would conference with the family (Dad included) and perhaps seek eval of either licensed social worker or neurologist to assess what is either here or may be coming for you as a family.
I am so sorry. You have described what is certainly the case for so many. You aren't alone. I know that doesn't help because some things just don't have good answers.
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Drugs. Something like Prozac
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dkiely33 Nov 2022
Are you for real?
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Good Morning,

Have you paid a visit to a Geriatric Neuro Psychologist? Perhaps, a little bit of medication for anxiety or whatever the doctor recommends.

Sometimes just a small dose of something can make a good impact.

It's difficult when you have one elderly parent caring for the other elderly parent.

Oftentimes, the person who is ill cannot see that help is needed. They sense something is not right but I believe in calling on the troops. All hands on deck.

You need to build a team. The longer this goes on, your loved one ages and basically you are going up against old age. Usually, by the time they hit 80 there is more than one health problem to deal with.

The fact that you mentioned your mother was not a combative person at all prior to her diagnosis makes me think that how can you mother make decisions for herself. Her mind is aging. The brain is aging and she may think her husband is leaving her and going out without her and having a good time.

One morning a week respite program is not a bad idea either. Something in the neighborhood that provides breakfast and a hot lunch. There are some wonderful facilities with hard working people.

I can only imagine what it's like for your father to bathe your mother or shower her. Hopefully the bathroom is handicapped accessible with a shower chair, nozzle, etc.

You can have Mom' PCP do an assessment and write the scrip. That way if dad is ever on his back you have a slot for Mom in a pinch.

I hope that I was of some help to you. You want to do right by both of your parents and you sound like you are level-headed and a good daughter.
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Medication is needed for the anger/anxiety issues. Once this is taken care of then other decisions will fall into place. Just know that not all meds are the same and work the same on all patients it may take a few different flavors to get it right but start now.
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dkiely33 Nov 2022
Medication can help but it won't cure the dementia.
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I feel sorry for you all with such abuse hire a caregiver to give all of you a break
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Do not leave the decisions up to her. Hire someone who understands the situation and is expereinced. Over the years, the situation will get worse. She will need diapers and will need to be cleaned up daily. Eventually, she will need to be fed. Be string.
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My mother doesn't have dementia but "only" depression and anxiety and due to the serious surgery awaiting her drives my father mad by refusing to let him go anywhere for more than three hours, guilt tripping him all the time: "You're supposed to take care of me". I see the toll it takes on him as for the first time in decades he is unable to sleep through the night. She doesn't need any help right now BTW, she just likes to blackmail us all with her problems. She cannot enjoy life and neither should we.
Please think about your dad's mental and physical health as well as the rest of the family. Your mother will sadly never improve, but your father might get worse. There have been cases of caretakers dying not long after their wards because their bodies couldn't take the strain anymore. The caregiver is a must, otherwise, it's the nursing home. In the end, you are the adult in charge, not your mom. I don't know how advanced her condition is, but my grandmother who was in the early stages would have understood that it's better to have an assistant than to be forced to move to a home.
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BurntCaregiver Nov 2022
@AnneGreen


Your father needs to cut her down straight away with some tough love. He needs to stop letting her control his life. He can go out anytime he wants and for as long as he wants. The "You're supposed to take care of me" does not mean your father has to become a slave to her abusive neediness. Yes, a person can use being needy as a form of abuse and manipulation. This is my mother to the letter.
She needs to be made to undertand in plain language that she can either get help for her depression and anxiety or lose her family. Your father should bring up the possibility of divorce. Then see how fast she starts curbing her behavior. She will learn to keep her abusive neediness in check if your father and her family stops humoring her and starts giving her the tough love she needs.
My mother doesn't have dementia but has depression and anxiety. She also refused to ever seek out mental health treatment for it. That's not my fault. It's not your father's fault or yours either. Your mother has no right to ruin your life or anyone else's because of her choice not to seek mental health treatment.
Tough love, my friend. Then even go Grey Rock if you have to. Good luck.
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