Dad wants to throw mum out in the middle of the night

[Polarbear]

Hi everyone, my wife posted on Sunday for the first time regarding her father. We seem to be going through quite a rapid change in his capacity at the moment and my mother in law (MIL) is really struggling to cope.
We received a phone call at about 0630 this morning from MIL saying that he was starting to be quite aggressive with her. He had told her that she didn't belong there and to get out of the house and taken all the keys. He had threatened to hit her but I am not sure that it was a genuine threat as much as the frustration and confusion however I wasn't there so its hard to tell.
He has only been recently diagnosed with Vascular dementia and Alzheimers and the changes in him seem to be so rapid at the moment that we are bouncing from one crisis to the next.
Does anyone have any advice on what she should do if he acts like this again, especially in the night. My wife has spoken to the dementia nurse this morning who has not really been of any help, She has been told by the nurse that the only way to deal with this if she feels threatened is to call the police but that would result in them taking him away, and that would be awful for everyone. There doesn't appear to be any support for MIL, other than to ring us so that we can try to calm him down.
Up to now he recognises both me and my wife which has meant that we could calm him and separate him from MIL long enough for her to be re introduced as his wife, which has worked since Sunday.
We just worry that if this escalates again in the night MIL may end up outside in the middle of winter, in the middle of the night waiting for us to arrive. or even worse he could follow through on his threats.
Any strategy or suggestions would be greatly appreciated. Thank you.

 

[marionq]

Calling the police when someone is aggressive is the correct advice and can have positive results. Yes he might be sectioned but this can lead to a more careful monitoring of behaviour and medication. The police must send reports to Social Services and so this too can lead to more help.

Your MIL should call if she feels threatened.

 

[Risa]

Is your FiL on any medication? If so it might need tweaking. Also have him checked for a urinary infection as this causes behaviour to change. Make sure his GP has been informed of his behavioural changes.

Make sure there a room in their house which has a lockable door that your MiL can go to if she feels threatened. Your MiL should also keep a mobile phone with her so that she can call someone in an emergency (if she can't get to the house phone). Don't disregard calling the police though as your MiL must put her safety first. As horrible as it would be, having your FiL sectioned (if his violence escalates) would really be helping him to get on the right medication.

 

[Beate]

I agree. It's the only thing you can do that will generate prompt help. Your MIL can't live in fear, she must be safeguarded too.

 

[stanleypj]

Taking him away may or may not be 'awful for everyone' but surely you show that you are concerned about the potential awfulness that your MIL might face if he continues to treat her in the same way or worse.

The advice to her should be quite clear, as marion has stated.

 

[Amelie5a]

I'd just re-iterate the advice to check for a urine infection - along with all the other good advice you've received about keeping MiL safe.

With my Dad, over a year ago, we went through a time when he didn't recognise me on rare occasions, and thought his home was a holiday rental. A urine test at a hospital appointment picked up a urine infection; the GP did a more specific one; and then Dad had antibiotics. They had a real impact and those issues from over a year ago haven't recurred - touch wood!

It certainly taught me how profound an effect a urine infection can have on someone elderly with dementia.

 

[tigerlady]

I agree with everything that has been said. I already slept in a different room from my husband when his dementia was getting worse, as I needed my own space after recovering from various operations etc, but I used to lock myself in at night, in case he woke up and thought I was an intruder, and tried to harm me. He sometimes didnt recognise me in the daytime and tried to get me out of the house.

Your MIL's saftey must be your first concern, and as others say, it is important that she has somewhere safe to go in the house where she can lock herself in with access to a phone. Sectioning - although it sounds awful - is the way to get your FIL properly assessed and medicated. If he is aware of his problems, maybe you could persuade him to go voluntarily, but it is usual for people with dementia to deny there is anything wrong with them.

Eventually I asked the social services for an assessment team to come to the house one day, and I prepared a record of his behaviour, as he always put on a good show when anyone came to the house, and it was all done calmly. An Age UK guy, who had formed a bond with him, came as well at my request, and was given permission to take him to the hospital in his car, saving my husband the trauma of going in an ambulance.

Hope you manage to get through this difficult time xx

 

[Polarbear]

Thanks to you all for replying. The medication that he is on is donepezil 5mg/day. He first took this 4 days ago. We have taken a urine sample to the GP to check for the urine infection earlier today. The suggestion that my FIL being taken away would be "awful for everyone" was said by the dementia nurse who gave my wife the impression that this should really be the last resort, even though it was her suggestion to him that to phone the police was all we could think of.

 

[sinkhole]

It's difficult to know whether to react to verbal threats alone. My aunt has suggested to both myself and my mother that she would kill herself, my mother or me at various times if she doesn't get want she wants.

So far, these 'threats' have no actual intent behind them, I am very sure.

Verbal aggression can be very frightening, but may never turn into physical aggression. However, you should always be prepared just in case and don't hesitate to ring the Police if you really believe someone is in danger.

I'd agree that a 'safe room' is a very good idea as are strategies to defuse/de-escalate tense situations when they occur.

 

[RedLou]

How mobile and agile is your MiL as compared to her husband? In other words, could she get to that safe room in a hurry or would it be difficult for her? --Her safety comes first and I'm sure your FiL, when in his right mind, would want this. The use of emotive words from the dementia nurse is really not helpful.

 

[Mrsbusy]

Personally I would ring GP and ask if he can try a different dose in respect of medication. Maybe the tablets are making him act like this. Could your MIL cut the tablet in half, maybe it's too strong for him. Tablets in this country are given in a set dosage not taking into account the size or weight of the person taking them. If the person is smaller build or shorter or lightweight they may not need such a large dose to have effect. Scandinavian countries administer drugs by the weight of the person taking them not just a set amount as we do in this country I was told.

Try halving the tablet for a day and see if that helps maybe?

 

[RedLou]

Don't think you should halve the tablets without speaking to the GP - what if it made him worse?

 

[Slugsta]

Don't think you should halve the tablets without speaking to the GP - what if it made him worse?

I absolutely agree, 5mg is a very low dose anyway. I would strongly suggest talking to GP about medication. Might it be making things worse or, conversely, might it need increasing?

 

[sinkhole]

Not all drugs doses are linked to body mass.

It depends what they act on, how they are absorbed and into which organ(s), how they are metabolised etc. etc., so it is very important to talk to the GP before changing dosage of any medication up or down.

 

[Polarbear]

Once again I can't thank you all enough for your comments and advice in this matter. The medication has been prescribed by the hospital consultant. The local GP has been very "backward at coming forward" in the initial diagnosis. We will not get the results from the urine infection until Friday so we will continue with the medication as prescribed until then. Although the idea of a safe room is a good idea, they live in a small terrace property and MIL is quite immobile, so she would struggle to make it there in a hurry.
Fortunately we don't live far from MIL so we can attend at a minutes notice.

Thanks again to all.