My husband with FTD pounds violently on faces of people pictured in photos or on tv, and now, on own reflection in mirrors! How to deal??

If you do want to keep him in the home (and that may become impossible given his violent behavior), I would bite the bullet and remove all the photos, etc. and substitute something else, like a basketball with a photo of a politician taped over.  

I don't have any suggestions for electronic devices unless you can find unbreakable plastic shields.    I think there might be some for blue light protection, but I'm not certain on this issue.    Places like Best Buy might have them, if they exist.

For magazines, substitute photo magazines, with focus on relaxing natural areas, like forests, or lakes.  Perhaps find some with sharks, as he might find an outlet in pounding on them, and there's no way he can hurt a live creature by pounding on photos.

Another thing to consider, although it might inadvertently improve his punching skills, is a boxer's punching bag.   Figure out a way to tape photos over it, especially of politicians he doesn't like.   The unintended result though might be that he becomes skilled at boxing.

That's just a guess on what might work. 

I wonder though what led to this fixation on people.  Has he ever mentioned dislike of any of the family members?   I don't have that much experience with dementia so perhaps this isn't as unusual as it seems to be.

As to where did it come from:   Can you correlate it with political events?  Are in you living in an area where political friction has resulted in physical confrontations?   We're in times that are challenging everyone, especially this transition time.  

Sadly, I think you're facing some really difficult times, and a potential placement out of the home in a controlled environment.    A medical institution such as a psychiatric hospital might be better than memory care.   I don't know though whether or not they're accepting new patients, other than those brought in by police, which is something I thought of if his violence escalates.  It's an option  I would investigate.

I wish I could offer some suggestions from experience, as I think those would be more helpful.    I do hope you're finding a way to protect your family by keeping them away, and that you also take precautions to protect yourself.    If I were in that situation, I think I'd be taking judo lessons.   And I mean that seriously.

I'd be terrified that he may move on to attacking real people since all faces both known and unknown seem to trigger it, you would be wise to keep some kind of panic button with you at all times. And I think that Garden Artist's suggestion of a short stay at a psychiatric facility is a good one, they would be better able to observe his behavior and tweak his medications if they have eyes on him 24/7.

CWillie, a panic button is a great idea.  I'm thinking she might also want to discuss the situation with the local police and get some guidance from them.

It seems to me that your terrified reaction is amply justified, and I’m hoping that you have some alternatives if he turns his reactions in your direction.

He is suffering from a terrible illnesses, as you know, and his behavior can be resulting from any reason or from no reason at all, but the fact is WHY isn’t really what you need to know right now, but instead, how to protect yourself and keep yourself safe, and how he can be HELPED to reduce this troubling and dangerous behavior, which from your comments, seems to be escalating.

Does your husband’s neurologist know how active your husband’s behavior is? Sometimes when we attempt to describe really inappropriate behavior to professionals, we have a tendency to minimize what we’re seeing, out of respect and a sense of protection for someone whom we love dearly and remember as kind, gentle people before they got ill.

You are not in a position to deal with his current situation this way. Consider how distraught he would be if he were well, and knew that his behavior frightened and distressed you. Would it possible for you to make a video clip of what he’s doing, and leave or send the video to the doctor’s office?

I don’t think it will be possible for you to isolate or modify what triggers this, because it sounds as though it’s a symptom of his condition, but you can report the current situation to his doctor as soon as possible, speaking about your husband’s specific actions, what happens before the outbursts occur, and what happens as he becomes more calm and oriented to his surroundings.

For your own safety, you can make notes of what’s occurring around him before he becomes agitated, and plan what you can do to keep him and yourself safe if his behavior does escalate.

Your husband is fortunate to have you.

Contact the Assoc for FTD and join their forum. Ver good group with real world experience. And yes, remove the triggers like photos, for now. You have to adapt.

Thank you all so much for your responses. You have validated that I do indeed have reason to feel scared and hyper vigilant most of the time! This morning was particularly disturbing, as he was pacing and seemed more agitated than usual, and began screeching and striking the bathroom mirror with a comb, and pushed my arm off as I tried to physically stop him from hitting the mirror. I had just started him on the seraquel last night at a small dose, and so many articles I’ve read advise that antipsychotic meds can often times worsen undesirable behaviors in dementia patients😱 I gave him his second pill at bedtime tonight, so I’ll see what he’s like in the morning.

Annreid, you know, I don’t really think my husband’s neurologist understands just how wild my husband’s behavior actually is, and I’m partly to blame, as I guess I don’t explain that I truly feel frightened by his actions, and that I need urgent advise on what I should do, or who I should call, if my husband becomes violent towards me! I believe most people just don’t take me seriously when I tell them how insane my husband acts-many people actually laugh because they find it so strange. And yes, Cwillie, I AM terrified that he’s going to move on to real people, with mine being the first face he smashes! My daughter suggested having a cloth collage made of all our faces and attaching it to a punching bag, but I’m afraid that would only encourage the hostile behavior! Although, he does like to beat the faces of certain politicians. So I could use one of their faces. I actually have placed a toy drum near his chair by the tv, and told him if he feels the need to beat on something, he can use that. He will drum out a beat on it several times during the day, but unfortunately it doesn’t replace the pummeling of photo faces:-( I have actually removed a wonderful old framed photo of my grandfather, as that seemed to be a favored picture on which my husband would take out his aggression, even though he respected and admired the man, and spent lots of time enjoying his company many years ago. Thought I’d better take it down before he cracked the lovely frame right in half!

GardenArtist, I have wondered about a geriatric psyche ward for at least temporary placement, perhaps while we are waiting to see if the med will help. I don’t know what started him on the fixation of people, but one of the first distressing incidents occurred when we had come back from a Yosemite trip about a year and a half ago, and he was carrying my suitcase into the house, and suddenly he threw it down yelling “ I can’t stand looking at this picture, I just want to rip it up every time I see it! I hate her!” He’d been looking at my luggage tag, which was a silly photo of my niece and her husband that they gave out as wedding favors! I got so angry with him asking why he would hate our niece. He said because she was full of herself and was a sickening person. Yet my niece had never been anything but kind to us. I think his loss of love and good feelings towards people are just a part of this horrible dementia. He has nothing nice to say about any women now, and refers to most he sees on tv or in magazines as
f-ing bs. And yet all he can think about is having sex. I’m so disgusted by the man he’s become, even though I know it’s not through any fault of his own, and it’s so sad that this is how I’ll remember him once he’s gone, because the man I knew and loved fades more from existence with each passing week. And never would I have imagined there’d be a time when I became afraid for my safety around him, as he was always my rock and the man who kept me on firm footing. And now I need a panic button to keep myself safe. It’s very sad, but also a very good suggestion. Thanks again for all your supportive replies.

If you can use your phone to record some of his episodes you can show it to the doctor so they can see for themselves how frightening they have become.
And you might need to obscure your mirrors too, rub a bar of soap over them or cover with a cloth.
(I hope the seroquel works for you)

You are in a dangerous position with your dear husbands escalating violence....I would definitely call your local police or sheriff’s department and let them know about the situation and perhaps get their advice. Also you definitely should record video if you have a smartphone or other device that records, and show it to the police and especially his doctors. Certainly understandable that you are living in constant fear and that isn’t good for your health. I sure hope his doctor can have him admitted to a psychiatric facility so he can be given meds to help him.
Please remember if he turns on you, to get out of the house, away from him as quickly as possible. If you have neighbors that are close, I would let them know so they could be of help to you if needed. Prayers coming your way....Liz

How terrifying for you! I hope the meds work for him.

If he doesn’t respond to the meds, you are in an unsafe environment.

Do not hesitate to call 911 in an emergency.

Please try CBD oil. 1000 mg flavored under his tongue. No side effects. Works wonders in about an hours time.

Contact the Assoc for FTD. They have a lot of support. FTD is a very different dementia from Alzheimer’s and other dementias. It affects personality and social norms and filters. It can be very alarming to see and hear what a person affected can do with this condition. The brain is deteriorating and changing in very real ways and hubby can’t help what is going on. It could become very unsafe very quickly. Placement to adjust meds may be helpful but sometimes the meds can make it worse. Long term placement may become necessary for both yours and his safety. You definitely have reason to be concerned and careful. FTD (sounds like possibly Pick’s disease) is an extreme form of the disease and can be difficult to handle.

I would remove all photos within his reach and remove the Mirrors and let him continue having the magazines and the next TV you get have it mounted up high on the wall where he can't reach it.

At least while you see if the meds will work, he won't end up cutting himself with glass or mirror.

If you feel unsafe for any reason at any time, call 911, if he is acting out and violent they will take him to psychiatric ER for evaluation. Sounds like a combo of mental illness and dementia that needs serious intervention. He may not be coming back after evaluation, often you need some kind of trigger event to get a higher level of care. Sounds like you are there now. Please take care of yourself and let us know how you are doing. Also check out friends and family support groups at NAMI.

It seems your husband is out of control at this time. The faces may appear to be "people" who challenge him in some way. SO, he is trying to get them to "submit" to him. I feel you have only 2 choices until you get him sedated enough that her doesn't react with rage:

1 Take down all pictures and mirrors. Only listen to the news on the radio, Keep your magazines under lock and key for your personal use. Do this until you and his doctors work out the "unique cocktail" of medications he needs to calm his rage. Be aware that this could take a year or longer... and you may be at risk of him turning the violence on you.

2 Send him to an inpatient psychiatric unit for behavior modification. He will need to stay until his outbursts are either redirected through therapy or calmed down through medication (or both). It will be much shorter than trying to work on the solution at home... and you will be safe from him turning the violence on you.

All the advice given are good! Instead of taking down the mirror, cover it up. You too need a mirror. My husband sometimes talks to his reflection in the mirror and does not pay attention to what I want him to do (e.g. lifting his leg for me to put on his Depend). I covered up the mirror and it is helping.

due to his brain injury it has affected his behavior, OR it may due to depression and inability to cope; the only solution is psychiatric evaluation and treatment if necessary. Every single person who has suffered a stroke should be put on an antidepressant if they are able to take it.

My mom had FTD and as the disease progressed I received help from a geriatric psychiatrist through a hospice organization. She was started on Lexapro and Seroquel was added next. A couple of other mood regulators and anti depressants were used along the way. In the end Haldol was very helpful - but this is not a solution that always works.
The point is - you need to get your husband a psychiatric evaluation ASAP. A doctor can help you understand what’s happening in your husband’s brain that causes these behaviors. My mother could become a whirling dervish lashing out - biting, kicking, punching, scratching, pinching, hair pulling. It was scary and dangerous.
There are also many things you’ll learn from professionals about creating a calm environment. Removing clutter is a start. Keeping things simple to avoid over stimulation is key. Rest and quiet during the day as well. I’d recommend starting to look for a memory care facility that has some knowledge or experience with FTD residents. Staff need special understanding of the triggers and how to respond. I was adjusting my mom’s care plan every couple of months to keep pace with the disease progression.
It is a challenging situation and I remember all too well the early days struggling to come to grips with it. But it can be better with the right help.
Stay on this forum. I learned a lot from others that was valuable for my own mental health. You will too.

I don’t have an answer for this. I just wanted to offer my empathy and long-distance hugs because this must be so frightening for you. I am sorry about this whole situation and this terrible affliction. My heart goes out to you and I hope you find a solution soon.

I very much appreciate all your concern, support and advice. I wouldn’t hesitate to call 911 if I feel my safety is at immediate risk! So far, I have been able to redirect him most of the time, but it’s the truly demented look on his face during these outbursts that is so disturbing. It reminds me of Jack Nicholson’s face in that horror movie, The Shining. And it’s strange, but many times as he’s laughing his wild laugh, he’ll say he’s “as nutty as a fruitcake”, almost as though he knows he’s out of control but can’t stop it, or even worse seeming to enjoy it.
All of your suggestions are very helpful. I’m thinking of having my son help me cover up the biggest mirrors with bubble wrap, and we actually do have a neighbor who’s a semi-retired police officer, living across the street, and he’s told me he’s there anytime I need him-and several times in the last month, I’ve almost run over to get him, but then was able to handle the situation myself.
Beeje, I have considered CBD and wondered if it might help. Would I need a prescription for it? Could he take it with the Seraquel? I always get concerned about interactions of being on meds with herbals and other alternative treatments. Personally, I hate drugs and would always prefer to go the more natural route, but in this case, it seemed the drug was necessary. As you said, Jennifer, FTD is NOT like Alzheimers-it starts right off the bat with personality changes and social inappropriateness, and the behaviors can be quite challenging. It’s terrible to witness the drastic, scary changes in your spouse whom you’ve known and loved for over forty years.
I’m now hiding the laptop and magazines and placing many photos in envelopes out of his sight, but we have so many framed photos on our walls, it will be a real chore to take them all down, and the saddest thing is, my husband took many of them, as he majored in photography in college, and was a very talented photographer, and even made it a part time business, in addition to his full time job with the office of education. Behavioral variant FTD has taken ALL of who he was, away😢

I'm bringing this back into the mainstream instead of answering directly to a post.

Cetude wrote:

" Every single person who has suffered a stroke should be put on an antidepressant if they are able to take it."

Why in the world would you feel an antidepressant should be mandatory for anyone who can take it?  That assumes that many aren't able to cope with a stroke and move on w/o an antidepressant.   And it also encourages reliance on medicine as opposed to more healthy remedies.  There's enough of a prescription medication reliance in the US already.  

My father had a stroke at 80 years old.  He didn't need an antidepressant and wouldn't even have considered it.   He worked in his work shed (which he also partially built by himself), he interacted with neighbors, church friends; we went to free summer concerts; he drove across the state to visit relatives.

He never showed any signs of depression; in fact he's always been a determined person and that was his attitude, that it wasn't going to stop him from living his life to the fullest.

I never ever considered an antidepressant after I had a stroke.  Why would I?   I have my garden, my needlework projects, family and friends.   Why would I need an antidepressant?

Cetude, I realize that you're trying to be helpful, but please think seriously about your recommendation.  People are much better off if they can find coping methods that don't involve voluntarily taking medicine that may not be necessary.  Why encourage someone to take meds if they're not needed?

I am so sorry you’re going through this. Dementia symptoms vary depending on the parts of the brain involved. With FTD is very possible that the prefrontal cortex is involved, this is one of the areas associated with anger. Within the specific area of the brain (affected by dementia) there is an interruption in communication. So your husband may see the pictures but the brain may not be able to comprehend who or even what the picture is. Or the brain may even be misinterpreting the visual information and perceiving it as a threat. In other words, if the communication line that would remind him that the picture is a family member, is broken, the feeling he may be getting might be intense fear as his brain interprets it as a threat.
I’m worried about your safety. If you don’t feel safe, even for a moment, please reach out to someone who can help you.

I know how crazy behavior can trigger anger. Is your husband by any chance taking the seizure medication Kepra? Your neurologist will know.
Take the photos and put them where he doesn't see them. The TV may be overstimulating. Especially certain stations like CNN.

Unfortunately, I believe that FTD dementia is the least understood form of dementia there is, and the hardest to treat. Also the most difficult of the dementias in terms of behavioral issues and not knowing WHAT the heck to expect.

We have a poster here named OldSailor who's wife Luz suffered from FTD dementia..........and he took extraordinary measures to accommodate her bizarre behaviors. I remember he'd put her to sleep naked because the Depends and other briefs bothered her. He'd then clean up after her in the morning; every day, for years. Here is his Page on Aging Care:

https://www.agingcare.com/members/oldsailor

You can look up the Answers he's given on his page, all 709 of them, and perhaps glean some tidbits of knowledge from him; he was an amazing caregiver to his wife. I hope that helps you in some small way.

That said, you are facing a difficult situation with your husband and his aggressive behavior. Have you discussed this with his doctor? You need to immediately if you haven't already. He can become aggressive towards YOU without intentionally wanting to, but having a brain disorder, it can happen. The doctor needs to be one who's FAMILIAR with FTD dementia because many are NOT, and they will not be helpful for you. Research neurologists who have experience with FTD dementia in your area. Go from there. This is, of course, assuming you need such guidance. There are medications than can be prescribed for behavioral issues; anti depressants and/or anti psychotics.

Here is a link to the Alzheimer's website for more info about FTD dementia:

https://www.alzheimers.net/signs-of-frontotemporal-dementia

And here is a link to a lot of different websites talking about it:
https://www.google.com/search?q=ftd+dementia&rlz=1C1CHBD_enUS896US896&oq=ftd+dementia&aqs=chrome..69i57j35i39j0l5j69i60.5536j0j4&sourceid=chrome&ie=UTF-8

As time goes on and your husband progresses with the dementia, you may want to consider placing him. Look into Memory Care Assisted Living residences and Skilled Nursing Facilities in your area as possible options for later on down the road, if things get unmanageable for you at home.

Last but not least, please do not hesitate to call 911 if you feel in danger at any time. DH can be taken to the ER by ambulance for a psych evaluation; there is nothing wrong with doing such a thing. Even though he is not 'intentionally' being aggressive, YOUR life is very important here too and so is your safety. Oftentimes, caregivers forget that............getting SO caught up in the care of their demented loved one that they believe he is the only important person. That's not true: you BOTH matter. Take care of YOU, too, ok?

Sending you a big hug and a bunch of prayers. I'm so sorry that you are going through this difficult situation.

He may need medications to calm his dementia, which is manifesting violently. Keep speaking with his doctor about it until you get the right medication and dosage. Don't expect a logical explanation for why this is happening. Dementia is weird. People with dementia do illogical things and don't make good judgements. We had to dementia-proof my mother's living space when she got advanced dementia. She was a wanderer, so it meant that she had to go to a locked memory care facility. When she moved there, they removed all sharp objects (scissors, knives, etc.) from her room, and in your case you may have to temporarily put away pictures with faces in them and try to keep images away from him that disturb him. Would it work to cover the mirrors? If he is too violent and you can't control it and are afraid, you may have to consider a memory care assisted living facility for him.

I hate to say it but this man is insane and very DANGEROUS. I cannot begin to imagine why you have him at home with you. You must place him somewhere at once. This simply cannot be tolerated no matter what the circumstances are. I might even consider calling the police to make it a matter that is on record. They might put him into the hospital and then the transition to a facility might be easier. DO NOT ALLOW THIS TO CONTINUE - HE COULD KILL YOU.

I DON'T THINK YOU UNDERSTAND WHAT DANGER YOU ARE IN!

You need to separate yourself immediately from him.

When people mention you taking photos on the walls down, you respond with it would be a big job. Get them down now. I bet you are thinking about packing them neatly and storing boxes. Grab some garbage bags, throw them in the bags and put them in the attic or somewhere out of sight. Those photos are not worth your life.

If he ever hits you you won't have time to call for help, from anyone. People who are mentally disturbed have super-strength. If you touch him he could in reflex hit you and knock you against a wall or make you helpless with one hit with his fist. At that moment in time, you are not his wife, you are the enemy.

If he is in a rage and you call the cops, he could be shot to death. The news is always full of a family member calling the cops because they can't handle a mentally disturbed person who gets shot because they won't/can't obey commands. If he won't listen to your commands, he isn't going to listen to a cop. No one with a right mind is going to let themselves be seriously hurt or killed by a mad man. My Granddaughter's boyfriend is Bi-Polar. He had an "episode" and the neighbors called the cops. He fought them, headbutting one and hurting him. Tasers didn't work, they only work about 60 % to 80% of the time. They told my granddaughter that next time they were going shoot him. The next time he had an "Episode" he reacted different, so he just went into a mental hospital.

I agree with the advice to video his rages. Please, get him to a place where he can get help and you will be safe.

DRose: I did see your update of 8 hours ago. I was going to suggest removing pictures and covering up mirrors. Seroquel is a sedative. I am not a medical professional, but perhaps he needs a different medication. Prayers sent. I do fear for your safety as your husband is VERY ill. Please take care!!

I learned the hard way years ago that you have to be bluntly honest for doctors and provide as much information as you can. They don't see us for long and looks can be deceiving. Don't white wash anything. Mention the broken TV. Clearly there is a danger with his condition and they need to understand that YOU might be in danger. Hopefully you can get a consult and, even better, an admission ASAP. Sometimes they have to try different medications before the find the right one(s).

While waiting for assessment, as hard as it is, definitely remove or cover every picture and mirror. Even if the new med he is taking now starts to work, the effect could wear off and he could start again. Until it or something else works, not only could he create a mess, he could injure himself in the process. I should think taking the pictures down would be less work than cleaning up all the mess he could make, should he attack them. Bath and dresser mirrors would be hard to take down/remove, so use towels or sheets to cover them up. Hopefully you have shades or drapes that can be drawn over windows, as often one can see oneself in the reflections in the glass (usually at night.)

Start by contacting his doctor and tell them what he's doing and stress that he IS a danger to himself and that YOU don't feel safe! With the holidays coming up, you need to get this process started yesterday! PUSH hard when you talk to someone at the office.

Even if you wanted to place him in a facility, he would need the right medication(s) to keep him in control. Most places are not equipped to deal with someone who could be a danger to others.

Some good information above. I definitely agree that you need a doc experienced with FTD. It is different from other dementias because of the marked personality changes and it is common for the changes to involve sex in some way. Your comment that his aggression is more against women and his heightened interest in sex concerns me in particular. If possible getting a video would be hugely helpful, a picture is worth a thousand words and a video can say it all or much more than you could ever describe. And sadly I like the idea of having some sort of stunner or even a very loud noise like a rape alarm that you can wear on your belt for emergencies. It may never happen. But it might. And as much as you love your husband and he loved you all his normal life, things are not the same now. His normal self would likely be horrified at all this. But it is what it is and so you have to keep yourself safe. Big big hugs.

My wonderful husband had similar behaviors, awful. Be very very honest with the Dr. We tried to keep him off antipsychotics using xanax, gabapentin, and Zoloft for about a year. Eventually we had to add Risperdal. He was a hockey player and hockey coach most of his life. He was frightened when he acted like that and he could not control it though he tried. Took quite a bit of a combination of meds to get him stable. He was one of the most stable, wonderful people I have known. There is no true reason you can identify. We found a great geriatric psychiatrist and neurologist who worked closely with me to adjust meds until we got it right. He told me it is a broken brain. I spent many hours reading and talking to knowledgeable people. He quit walking shortly after adding the Risperdal and it has been tough to see, but he was so unsafe for himself and others. I have kept him home and am very happy about that, especially since COVID. He wouldn’t have been able to go anywhere else with that behavior. He has been on Hospice for over a year now and is much calmer and somewhat stable, but must have meds every 3 hours to keep him this way.