Mum has started hitting people

[Fearnodarkness]

Since coming out of hospital, my mother in law is on her second care home. The really "nice" one we got her into to start with asked her to leave after a few days because she had been shouting at other residents and "acting in an aggressive way" - not all the time, but they were not set up to deal with people who need constant attention because of their behaviour (let alone frightening other residents) so she was asked to move.

Now after about a week she has suddenly slapped two people. This is quite likely to get her asked to leave again, and heading for a much more restricted environment.

We had some hope she could go home at some point (which she has been asking for, even though, before she went into hospital, she had been asking about going into a home so that she could be somewhere with more people around. But she kept changing her mind.) but I can't see how any care team is going to want to deal with someone aggressive in her own home. She has already managed to scare carers taking her out by shouting at them and being rude to them in public, so this is not 100% new, though she's never taken to hitting out at people in my presence. (She wasn't above a bit of deliberate pushing.) She has always had a temper, and she has been used to "giving herself permission" to lose her temper with people and giving them a talking to, all her life. I now see this coming out again, out of control, and I don't think it is going to get any better.

Does anyone have any experience of this, and what her options might be?

 

[karaokePete]

Hello @Fearnodarkness, this may not apply to your mum as the problem seems to be an old established behaviour becoming worse. However, I have recently read that sometimes a person with dementia may become abusive because they see their independence being taken away. It is a defence mechanism and the only way they can think to express the fear/hurt they feel. Apparently it's important to keep a person as involved with daily life as possible, even if that means letting them do things under close supervision or with assistance, rather than taking over from them, to prevent this feeling creeping in. Could this have been happening with your mum. Would it help if she were to be given some 'chores' to do to make her feel worthwhile again. Just a thought, which you are welcome to dismiss if you think I am off the target. Good luck anyway.

 

[Amethyst59]

I presume the second home knew why she was asked to leave the first? So hopefully she will not be asked to move again. It could be that it is taking her time to settle...it is very early days for her. I know that many people on TP have had this problem with their relatives, and hopefully someone with experience of this will see this thread and advise you.

 

[Fearnodarkness]

I think KaraokePete has a point. She has always been touchy about "not being paid attention to" - that could take almost any form. While she was living by herself, is she got in a mood, she could pick up the phone and sound off at one of us - which was in itself pretty stressful, as she knows how to go on the attack, but at least she was sticking to verbals. Now she has people around her, she seems to be taking it up a level. We knew she was going to need extra care soon, as she wasn't cooking properly (and managed to kill the microwave), and I was gradually trying to slide in more food delivery and more visits - but she managed to tell all her visitors or visiting carers to get lost after a short while. And she doesn't actually like housework or "tasks" in any way, though I think being by herself in the house forced her to occupy herself and her mind in a way she doesn't if anyone else is around. She is losing capacity slowly but steadily all the time, and is pretty much incapable of entertaining herself now with anything. But she can potter, and pottering is almost impossible even in a good care home.

The home did their assessment with the previous home, but I didn't hear anything about her hitting people. But then I wasn't used to the idea of her being routinely socially verbally aggressive, either - normally she saved that for family! So it was a shock when the original care home said she was being aggressive.

 

[karaokePete]

Hello again @Fearnodarkness, I’m glad you think I had a point. The point that was made to me was that even as a PWD lost their physical and mental abilities they didn’t lose their personality and feelings so will react by being withdrawn/angry etc., if they think their feelings aren’t being addressed or they are being humiliated etc., by people taking 100% control where they could get on ok with some help or supervision or people talking to them in platitudes like they are are child. An example would be with my wife where she would struggle to cook by herself but with close supervision from me in relation to ingredients/timing etc she gets on fine so still feels she contributes to our partnership. An example given to me related to dressing where people were being dressed in an officious manner instead of being assisted to do it themselves in a dignified manner so they think their dignity isn’t being respected and get agitated even to the point of striking out. I thought it was an interesting point too.

 

[Marcelle123]

My mother showed aggression when she was moved into a care home. The first one was 'respite' and after she'd raised her stick to a lady who wanted back the cardigan that Mum was insisting was her own, the care home manager told me he wouldn't necessarily be accepting her as a permanent resident, even though the trial period ran out just before Christmas.

We then got her into another home, dementia-oriented, and again she started raising her stick to other residents. I was terrified that she'd be asked to leave, but luckily the care home called in the local mental health nurse, who got her put on memantine and citalopram, an anti-depressant.

Mum was much happier then, and in fact reverted to her old self, very polite and thankful to the carers and other residents.
What had fuelled the aggression was clearly anxiety and once that was allayed, the aggression stopped, and the last year of her life, spent in the care home, was a contented one.

 

[Fearnodarkness]

@Marcelle 123 Thank you for that, if your mild mannered Mum started behaving like that, it's not surprising that our short-fuse Mum is ... normally she is as courteous as anyone but she can flip very quickly (this is not just the dementia, though clearly that is making her actions worse.) I believe the Home are going to ask her GP about "as needed" medication; they also suggest getting her mental health person involved too.

I was going to ask about her having a stick rather than a walking frame, as she's inclined just to leave it behind and cling on to the walls - I will think twice about that now.

@karaokePete Thank you for expanding, I admit I hadn't picked up on that aspect of what you are saying but I agree completely. She clearly handled herself better when she had to work things out for herself, even though she missed some things. With people around, she just asks them every step - but still expects to be in control of them! Which can lead to misunderstandings and significant rudeness. But her aggression in the Home was directed at another resident, not just a staff member (who I think tried to intervene). I think the staff are aware of giving people their personal space. She is allowing one to administer her eye drops, which she would not do with anyone beforehand. But she can get "jealous" very quickly in a social situation.

We will now have to see if some medication will help her, and what her Mental Health person says.