Has anyone else noticed a lot of problematic behavior with dementia?

I may get fussed at for this but here goes. My credentials are that I am a retired nurse, dealt with a lot of head injuries,AD, psych patients. To me dementia is a head injury,but the kind that won't heal or get better only worse.As for your teenager, the brain is still developing,there is no degenerative changes. I have had patients in their 40's with AD,it isn't always age related. Also dementia can come from brain tumors,sometimes these are fatal ,sometimes they can be "fixed" with chemo or surgery. But real dementia, the AD kind, you can't fix.Maybe someday their will be a "cure" pill but right now there isn't.You can only deal with it. Behavior modification won't work with it, especially if they are having short term memory loss.It can be maddening, there is no logic,no consistency.You can " solve" it, only deal with it, thru medication and care. By care, I mean make sure they eat, they are clean, they are in a safe environment.Unfortunately, AD is forever until there is a cure,and I don't believe they "enjoy" it.What's really awful is someone who already has psych issues and then develops AD on top of it, what a perfect storm.There is no predictability of their behavior, someone who was once peaceful can become violent and vice versa.You can get a handle on this, but you aren't going to "fix" him or modify his behavior.That will only bring more frustration on your part.This can be a very emotional journey as you see someone you know turn into someone you don't recognize anymore, you lose them twice.Please get him screened for dementia by an MD that specializes in AD and other types of dementia so you can know what you are dealing with and then formulate a care plan.Sometimes families have no choice but to place their loved one in a facility because they aren't able to have shifts of people watch over them,yes, shifts of people. Sometimes an AD person can go days without sleep,wander, restless despite meds,no one person can watch someone like this 24/7 with keeling over with exhaustion.Also,yes, they can get very violent and I mean really violent,like send you to the ER violent.Sometimes families just don't have a choice, AD doesn't give them one.We like to think we have control over a situation but you know, sometimes life just doesn't work out that way and you will drive yourself nuts if you think there is some "solution" that if you just do A,B,C everything will be fine.Dealing with a person that has dementia needs flexibility on the part of the caregiver, everyday is something new.

Dealing with someone with dementia isn't like dealing with a willful child although it can feel like that. The person with dementia has absolutely no control over their behavior and isn't even aware of it. They won't grow out of it, the dementia only gets worse. You can find coping strategies but dementia isn't a problem that can be solved. The brain of someone with dementia is damaged, there's nothing that can be done about it. If families could cope well with dementia and manage it so that there's little stress involved in dealing with the dementia websites like this wouldn't be necessary.

You'll find coping mechanisms to deal with your loved one but with dementia sometimes one strategy will work one day but not the next day. Dementia is fluid, it's ever changing.

Sometimes medication helps but this is where you have to work with your loved one's Dr. Sometimes medication is indicated when the person becomes agitated but again, this is something that has to be figured out with the Dr. based on your loved ones symptoms. Many times implementing medication is trading one problem for another.

If you read the articles and previous posts on this site you'll read about caregivers who come to the realization that they can't change the behavior of someone who has dementia. All they can change is how they deal with the behavior of their loved one. We can't tell our loved ones with dementia to straighten up and fly right. It's not a behavioral disorder. It's brain damage and little can be done to change it.

There are a few tips and tricks in dealing with someone with dementia. Redirection is one of them. When the person is obsessing or repeating the same thing or maybe on the way to becoming agitated we find something else for them to focus on in that moment. Sometimes this works, sometimes it doesn't. And while it may not sound like much, keeping someone with dementia redirected is emotionally, mentally, and physically draining.

Trying to reason with someone with dementia is futile because they don't have the ability to reason anymore. Your son retained his ability to reason when he was having behavioral problem but people with dementia can't be reasoned with and trying to get them to make sense will drive you crazy. If they insist that the sky is red trying to explain to them that it's really blue will take up your entire day because they can't understand. It's just easier on us if we say, "Oh yes, what a lovely shade of red" and then try to move on. Arguing with someone with dementia is useless and maddening.

You don't have to throw up your hands and refuse to deal with it but understand that you won't solve it either. You'll find coping mechanisms that help with your loved one and some days they'll work and other days they won't. And if you find coping mechanisms that work for you then you must come here and tell us about them!

I can't add anything to Tex's and Irish's comments -- they sum it all up.
Regarding your comment about wondering if they "enjoy" the dysfunction: Yes, I absolutely think that happens. Sometimes it's the original personality coming out, even more magnified. And sometimes it's the only time they get to feel that, in that one moment at least, they have your attention and they're controlling things. Even if the situation is actually getting out of control, they know, in a very "toddler-ish" way, that your reaction is due to their behavior, and I can see how that might be satisfying to them. Absolutely maddening when it gets in the way of their care, though.

My lack of knowledge then led to my questions. I had dated a man for 10 years with TBI so I know disfunction. I Know understand the brain is damaged and there is no logic. THank you for that. I have made futile attempts at getting him to see logic and he simply does not. I have learned to navigate around the symptoms. It took my almost a year but his Neuropsych testing is coming up. Then I will know what I am dealing with exactly, I hope. He does have MDD so, it's quite the battle here dealing with it. He is aware something is wrong. Our only issue now is he wants me to take over everything he is responsible for and I feel this would only de-power him. I take control when needed on fiances because that is an utter mess. What he is becoming at times is mean and hateful. That is not the Dad I knew. He was the kindest, most honest, caring man on the planet. That demon for me has yet to be battled. At this point I am trying to learn how to navigate around the behaviors. On a positive note, dealing with the ASD and my Son kinda gave me a tutorial on what I need to do. How do the treat the comorbid issues? I am not seeing an answer to that. Can Dementia cause more psychosis?

How do you respond to a parent in a NH who's telling you they are going to kill her when you leave. The NH staff says she is not like that when I'm not there. There is some paranoia, but not that extreme. I don't know how to respond so I usually make it worse. She says she knows how to act with them so they wont hurt her and gets mad at me for not believing her. She has had mental issues for years and on major psyc drugs for 40 years. But now it is out of control. It tears me up every time I have to leave her when she is so scared.

There are some great responses here, but I would also add that due to memory loss, the ability to learn any lesson that you might teach them is limited. Even if you made your point to your dad, he may likely forget what he learned seconds before hand. My cousin will often forget what what said to her just seconds before hand. Memory retention varies from person to person, but my cousin's went downhill very quickly. She now mainly talks about things she knew about 30 years ago, but can't recall what happened minutes ago.

I wouldn't feel defeated though. Some times the dysfunctional behavior goes in phases and he may not exhibit these same disturbing behavior as the disease progresses. My cousin used to get very agitated, obsess and insist, but that subsided quite a bit.

A doctor could properly evaluate your dad and perhaps some medications could be helpful. They sure did help my cousin. You dad may have various mental health issues that would benefit from medication. A complete medical and psychological evaluation might be in order.

The only way that I know of to ameliorate the behavioral and personality changes that come with dementia involve medication. Not "drugging the patient into submission) but using anti anxiety agents, antidepressants and other psychoactive meds to ease agitation, paranoia and overwhelming dread. My mom's brain looks like swiss cheese on a CAT scan. Without meds, she's in abject terror of the IRS and something else so frightening she can't tell us what it is. Just cries, "I'm a bad person". I won't let her be like that.

I have heard the negative comments " all you want to do is drug the elderly" and this usually comes from people that have never had to deal with a human being that has dementia.I am all for better living thru chemistry. On the right medication regimen,and this can be trial and error because one drug does not fit all,but they can at least have some quality of life even if it is just to not be terrified all the time.,even if they never recognize their family again if they are just at peace. I know that the former Supreme Court Justice Sarah Day O'Connor 's husband has AD, he no longer recognizes her or remembers their long marriage, in fact the facility he is at he now has a girlfriend who is also a resident at the facility and Ms. O'Connor will visit and have lunch with them both. I know this has to hurt her but he is calm and happy and has quality of life and I am sure on several drugs.I believe that without the drugs this would be a miserable man and a miseable situation.

Wow, there are some really good responses on this thread! texarkana, that is one of the best explanations of the difference between dementia and treatable disorders I have read!

Aphena, we tend to think of dementia as a memory problem, but it is certainly a behavioral problem, too. And a decision-making problem. And an executive-functioning problem. As far as I've read, dementia doesn't cause other psychiatric conditions, but can co-exist with them.

There are over 50 distinct types of dementia. With luck the Neuropsych testing will help to at least tentatively identify which kind Dad likely has. That will have guide your research and learn what to expect and to a lesser degree how to cope.

Best wishes to you, and continue to share your journey with us!

I have yet to get anyone to agree to do any testing on my mom. Her dr she has seen for 30 years, the facility she is at. There is no psychiatric care at the facility and I have called all the ones in the are and get the same answer. They don't have psyc on staff or consult. They give meds prescribed by med dr. So there would be no difference. Mom knows everybody. She remembers almost everything. She sometimes has issues with days and times but who wouldn't being stuck in the same room 22 hours a day only out if bed to eat and go to bathroom. He issue is making up things in her mind that are not true. Her baby sister, who is my age and sees here 4 times a week, left her in tears tonight because mom caused her of saying mom was dying like granny did. Granny being their mother. My aunt was heartbroken. She would never say anything like that. Yesterday I was the bad guy because I wouldn't take her home so they wouldn't kill her. I don't want to see her a medicated vegetable but it would be better than her being terrified all the time. But if no one will do anything about meds I don't see anything changing.

Ditto to everything above! My mom, at 99, has been negative all her life. Progressive dementia over the past ten years has made her worse as there is also depression, she's stubborn and uncooperative. At her age, I'm all for any drug that will relieve her stress and unhappiness. Actually, its for two reasons I hope the doctor will give her some drug: I love her and wish I could see her smile once in a while and for me and my sibling we some stress relief also.

Yes, dementia can exist with psychiatric disorders. My mother is bi-polar, has Cluster B personality disorders, depression, high anxiety, paranoid delusions, and Alzheimers. She was also exhibiting signs of OCD when in her home. This combination is well beyond the capability of your average GP, but mom would never seek help for her psychiatric problems - ever. It was taboo.

The dementia emphasizes, exaggerates, and amplifies the psychiatric behaviors. She lived with us for 3 1/2 weeks while her apartment was being readied in the residential facility. In less than a month, she had all 4 of us hiding from her, dreading her theatrics, her demands, her negative domineering talking, her tantrums. We couldn't even relax in our own house anymore. She refused to let me or anybody else assist with her medications. She had 19 different meds to take, and she had it so mixed up there was no way she had the right things at the right times which helped nothing!

Were her behaviors from her psychiatric disorders or her dementia? I struggled with that for a long time. I figured out that dementia had taken away her reasoning skills, so anything process related or that had more than one or two steps was gone. What little emotional regulation she ever had was gone. Her ability to process visual and auditory information correctly was gone.

Her angry and negative responses to everything was not dementia. Her attention seeking stunts were not dementia. Her hissy fits and tantrums were also not dementia. Her mean spirited way of talking to any of us was not dementia. Her trying to hit me in the head with her cane while we were driving down the highway was not dementia.

These things had always been there in mom, I'd lived through it as I grew up, but now, they were a lot closer to the surface because of dementia. She had very little control over it anymore. She used to behave in front of strangers, neighbors, and people in authority, so nobody outside the house really knew what was going on behind closed doors. She can't hold it together anymore, and that is dementia. She's not as clever and devious, which is dementia.

At some point though, it no longer matters what the cause is. The treatment approach is the same. Anti-psychotics and anti-anxiety meds. A secure memory care residential unit where people know what to expect and how to handle it.

You will need to plan ahead for your dad and your family's preservation. Someone will need power of attorney and probably guardianship. He will eventually need to live somewhere other than your house.

amygrace - my mother at 102 has Borderline Personality Disorder and the accompanying narcissism and negativity. In the last few years she developed paranoia and was diagnosed with vascular dementia. During a prolonged stay in a geriatric psychiatric facility, she finally agreed to taking a antipsychotic med. She was put into the facility because of expressing suicidal thoughts. I wish she had been treated earlier in her life, as she has been miserable for herself and those around her. Finally I saw some smiles the last time I visited her. It was so nice to see - she has not smiled a lot in her life. She will be discharged to a mental health facility, where, hopefully, she will be able to live out her remaining days with dignity. I, as POA, am advocating the continued use of the drug whether she wants it or not, as it makes such a difference to her quality of life. I hope your mother gets the help she needs.

sandwich - I agree at some point all that matters is getting the right treatment in the right setting. These problems can be to great too be managed in a home.

Boy is it difficult to get the right treatment. I am switching my mother's doctor soon. She seems to have written Mom off and unless I request something, she is content to just look in her ears, eyes and throat and listen to her heart. It is hard to find someone who actually cares about helping someone her age. She gets the obligatory 4 minutes with the doctor having the computer perched on his knee. It isn't hard to tell anymore, what doctor genuinely cares and who is just going through the motions.

Amygrace I agree. Same with my moms dr. Problem is mom never has and never will give anyone poa. So she is still in control of her dr. They can talk to me but that's it. Nh days she is not at point of stste appointing guardian so I am suppose to solve all her problems with no power
to do so and she rejects any of my suggestions.

amy and tina (((((hugs)))) I know how hard it is. Mother was not diagnosed with BPD until she was 96. and even then it was not followed up so she got no meds at that time. Her regular doctors were no help, and she changed her dr every few years. It was only when she was hospitalized, age 100, for trying fly across country alone without proper id that she was seen by a geriatrician and a psychiatrist. They were not entirely useful, but did assign visits to her by a community mental health team, who monitored her. Even then she snowed the nurse, but the psychiatrist saw through it, as had her case manager (assigned to her the previous year as she had home health care.) Between them and me and the ALF Health and Wellness Coordinator keeping in touch and us letting them know what we saw and heard, finally the psychiatrist decided that she needed to be hospitalized whether she wanted to go or not, Fortunately she went willingly and has been evaluated and treated there. A shocker to me is that they still consider her competent, not that it makes a great deal of difference to my job. I keep my distance. She did not assign POA until she was about 96, and only then after much convincing by her financial advisor. She did not want to give up control. I told her I had zero interest in taking anything over for her as my life was busy enough, but if she had a stroke for example and needed help I would do it. At my age (77) I hardly need to be looking after someone else. Mother has been negative and controlling/manipulative all her life and still is, though a little modified by the meds.

I eventually figured out that she did not want solutions, she wanted problems and to complain about them and try to get people to do things for her, and when they did it was never enough or good enough, so she could complain about that. Last time ( a couple of months ago) she complained to me that "things" were not being handled well, I asked her if she wanted someone else to do it. She changed her tune.

They tend to put you in a lose lose situation - d*mned if you do and d*mned if you don't. Until they do something dangerous to themselves or others I don't think there is much you can do except look after and protect yourself from the criticism, negativity and demands. It has taken a long time to get to this point (((((((Hugs))))))

Tina, will the regular doctor at the NH prescribe an antidepressant?

Please do yourself a favor and read "The 36 hour day".

You are a thoughtful person and will benefit from more education on AD. It is yes to most of your question.

My husband suffered from Alzheimer's, or more accurately -- we all suffered from his illness. It's a difficult progressive illness mentally and physically. It's as though they regress gradually back to an infant stage where they can no longer care for themselves regarding hygiene, dressing, walking, eating, drinking, bowel & bladder control, etc. The mental aspect is definitely the most difficult part to deal with. I found these strategies to be helpful:

Distraction - when they're being argumentative, bring up another subject pertaining to something in their life that made them happy, proud, peaceful, etc.

Delaying -- for example, if they refuse their medications, bathing, eating, and the like. Say 'okay, that's fine' and try again in 15 minutes or so. Chances are they won't remember their little "fuss" a few minutes ago and may be more cooperative.

Tasks - Give them a simple task to do. For example - sorting buttons, tearing up junk mail, folding towels, sorting things by color, finding items in a catalog, looking through magazines or picture books, sorting old photographs, etc. This will make them feel useful and get their minds focused on other things.

Research: What was life like when they were a child? You can find out a lot on the internet. Ask them questions about it, such as what type of music did they like, who were the most popular movie stars, what kind of clothes did they wear, what were the popular books of the time, how many children were in their school, etc. This is a great way for grandchildren to get to know what their life was like, and usually the person really enjoys reminiscing!

Hygiene: Remember that when they were children, people probably bathed only once or twice a week. You can use no-rinse shampoos and pre-moistened towels especially for this purpose as they may be afraid of falling in the shower/tub or embarrassed about their inability. They probably didn't change clothes every day either when they were children, so they don't understand the need to do so now. Unless odors or health issues are a concern, cut them some slack as far as frequency in bathing, changing clothes, etc.

Protect yourself: If their behavior becomes aggressive, combative, or violent, back away. You don't have to subject yourself to injury! Walk away for a few minutes and if need be, ask a friend or neighbor for help.

Speak calmly: No matter how riled you may get, try to speak in a calm and even tone. Watch your posture -- are your fists clenched, are you leaning into their face, are you clenching your teeth, etc -- your care receiver will pick up on these cues and it will escalate their behavior. Go outside for a few minutes and calm yourself before continuing.

Medication: Yes, there is a time when medication is necessary. I was also reluctant to medicate my husband until my daughter pointed out that he would be mortified by his behavior if he had the capability to see himself as we did. This will help in some way to maintain their dignity as much as possible.

Communicate with Doctor: Keep the doctor informed of new symptoms as they develop, even if it's only through e-mail. When you're finding it difficult to maintain quality of care, let the doctor know that you need help.

Hallucinations: You won't be able to convince them otherwise, so it's best to just acknowledge what they're seeing or hearing, then distract.

Take care of yourself: This is so important -- eat healthful foods while sitting at the table (not on the run), get enough sleep, keep in touch with friends and family for support, drink plenty of water, take your own meds and keep up with vaccinations for flu, pneumonia, tetanus, etc, and make time each day to do something that you find enjoyable.

The more tricks/strategies you have up your sleeve, the better. When one doesn't work, you can try another. Don't try to go it alone -- enlist the help of others and keep the medical team in the loop.

I wish you the very best!!

Marti1140, How very WISE of you! The suggestions you posted are what I would expect of a professional....however, we cannot find anyone to give us advice, so THANK YOU from the bottom of my heart!

Sandwich42Plus, I realized just a few months ago that my mother had always been like yours, but I don't know why I never saw it. It was only when her own brother told me that she "always had her spell cast on you" [me!] that I recognized Mom had manipulated me all of my life. I cried for weeks about her using me as a puppet, but my own brother consoled me...."she did it everyone around her." Anyway....thanks for your kind note of the differences between dementia and not.

Mom has moved into a new phase in dementia. She thinks she has to have a bowel movement all the time. We have been to the doctor, had all kinds of examinations, and everything seems normal physically. She is not constipated and her stools are soft, but she thinks she hasn't gone and needs to. Every ten minutes all day and about every twenty minutes all night she goes to the toilet, does nothing, gets up and in a few minutes does it again. I've tried to explain to her that she just did all that, but I realize that means nothing to her now. She lives with us and I am exhausted. I can't keep her in bed at night and she falls easily so I am concerned about not watching her. I checked into hiring someone at night and it was going to cost $260 a night! I am at the end of my rope.

No, there is no way to get a "handle" on dementia since each person afflicted with their dementia has their own limitations. That is why dementia is so difficult to treat, cure and endure. The best you can do is try to manage your father's behaviors which work best FOR HIM. Don't try to psychoanalyze this disease because no one has yet been able to find a cause or a cure. Psychiatric disorders are a brain disease just like dementia and one can have both, and the brain of that person is unique for that person. There can be similarities, but do not try to group a condition to fit all. I am glad your son is doing better, and your father will not follow through with plans because his brain is unable to. You will save yourself a lot of grief, time and effort if you just make charts so he can look at them every day just as a reminder. Keep him busy and interested in what he likes to do, send him to a senior day care center to interact with others, and give yourself a break from both your father and son. You deserve a break too!

I think my mom is in advanced stages of dementia. She is 94 years of age and has no short term memory any more. My siblings and I have discussed the problems of her living alone with my 61 year old brother who is deaf. I live 500 miles from her, a sister lives in Georgia and the other brother is moving to Florida. In the past year she has cut way back on her eating, she is not taking her medication properly and refuses to let anyone help her, Even when you set it up in the pill organizer she goes in and plays around with it or leaves some behind. She is on thyroid medication, which isn't the same dosage everyday and I wonder if this could be what has caused her lack of appetite. She has become aggravated and I understand that this could be caused by dementia, although she has not been diagnosed as when she goes to her doctor, she is good at convincing her doctor that she is fine. How do I go about getting her doctor to make an appointment to get her in for a memory test without have POA in her medical and financial affairs? My brother is limited in his understanding of her problems although we are all aware that something is happening with her. She is on social security and has been sending checks repeatedly to charitable organizations just because she receives the requests over and over again. She is also ordering merchandise from catalogs and then doesn't remember doing it. How do I get them to take her off their mailing lists?

Notalonenow: I hear your pain. For two years my mom went through the obsession that she was constipated. She kept sneaking to the facility store and buying milk of magnesia and hiding it all over the apartment, lying and saying she didn't take any. Then she would overdose (because she couldn't remember if she took it or not) then she would have diarrhea, then a few hours later we were back to her saying she hadn't "gone in 4 days". Because she couldn't remember she had the runs a few hours ago. Maybe your mother doesn't remember if she went or not, and she is "stuck in a loop". My mother went through a lot of those "stuck in a loop" thinking. About three months ago, overnight, she stopped buying the MOM, and stopped talking about her constipation, just like she forgot her obsession of always having to carry around a container of "my pills" (mild tranquilizer). She's forgotten all about them too. Last month the doctor diagnosed her with Alzheimers. What we thought was just senile dementia was just the progression to what she has slowly become. Maybe your mother will forget she has a bowel problem too (as long as there is nothing physically wrong with her).

Mom has been on major anti depressants and psyc drugs for 40 years. Tranzene and now risprodol (sp). They tried to give her adavan a few months ago and she refused it. They have tried over the years to change the tranzene to something else but nothing else worked. She has had nerve problems all her life. And I just found out recently had been diagnosed as bipolar years ago but didn't tell me until dr said something. I didn't even know about the nerve pills and psyc drugs till about 8 years ago.

To Eyerishlass:

All I can say is wow! So well said. Everything you wrote is what I lived through for several years with my mom. Seeing it in writing is amazing. It's one of the best descriptions of dealing with someone with dementia. Even though my mom passed two years ago in August, I still remember going through many days of uncertainty, but would do it all over again if I had to. The only difference would be that I know there are people like you out there to help others. Thank you so much. I hope others will receive help by your comments and those of others as well.

Marti1140 - wow what a great posting. AgingCare - you should ask Marti to write an article for you, that was great!

First of all, check out the nursing home staff -- they're not automatically trustworthy by any stretch, and they may easily use that as a means of getting your mother to cooperate when she gets balky, "do this or I'll kill you.". If she's been on major psych meds for 40 years, it may be time to have her reevaluated, and/or move her to a different facility. We all have to get out of the mindset that everything is either the patient's fault or our fault. And we have to accept that the nursing home/assisted living industry is predatory -- look to them first, because your mother is an easy victim for accusation, and you are a prime target for guilt. If she doesn't act like then when you're not there, then maybe you shouldn't go too often, and then they can leave her sitting in her own mess for a week, and they will. Please, have her reassessed by competent medical authority, have her meds reevaluation, and try to find another place. She may have every right to be scared. "Crazy" is not the same as stupid.

AmyGrace: Thank you! It helps to know that you also faced this behavior. Helped me realize too that Mom has exhibited behavior similar to your mom for some time now. Dementia has just made it worse. I am hoping she is able to forget about this obsession soon.

Yes medication is the answer to deal with this behavior. It worked in my situation.