Dealing with aggressive behaviour

[FranL]

Hello. I’m new to this forum so sorry if this has been posted before. My mother is currently in a care home for a four week assessment following discharge from hospital. Before she went into hospital we did not even know she had dementia but she has now been diagnosed with mixed dementia including vascular and frontotemporal. We had known for a while that things were not good but she was still living in her own bungalow and managing fairly well with only the odd bit of family help from me and my son. She was admitted to hospital in early December as she was having hallucinations and had atrial fibrillation. To cut a long story short, due to a covid outbreak in the hospital she has only just been discharged to a care home until social services decide if she is able to return home or not. She has not taken that very well and has aimed all her anger at me as I’ve had her locked up.
i have never been close to my mother as she prefers men to women but my brother lives too Far away to visit very often so I get the brunt of her rages. Yesterday she had a complete melt down in the home and told me to get out and I was evil and two faced. In front of me on my mobile she told my brother and niece how awful I was for putting her in a home. She put her hands over her face and sounded like she was crying but when she put her head up, I could see she was dry eyed so it was all for affect. When I did leave, she screamed after me and was shaking the doors to try and escape. I am finding all this very difficult to deal with and really don’t know how to talk to her. I’m daring to return tomorrow morning as the carers say she is better in the morning. I’m also worried social services will discharge her home with a care package as I just don’t think she will be safe. Any advice would be appreciated. Thanks

 

[canary]

Hi @FranL and welcome to Talking Point.

Im afraid this is quite a common reaction. No-one wants to be in a home and, unfortunately, usually people with dementia lose insight into their own condition and are unaware of their own needs and limitation, so its usually the family that visits that gets the brunt. If she asks why she cant go home, be very vague and say its up to the doctor (so its not your fault). Would she accept that she is "convalescing" after her spell in hospital?

See how it goes tomorrow (was she sundowning today?), but if you get the same reaction then it might be best to not visit for a while - a visit like that is not doing either of you any good.

 

[Bunpoots]

Hello @FranL and welcome from me too.

I’m afraid the aggression you’ve experienced with your mother is very commonly directed to the person who does most of the caring. I’m not surprised you’re finding things difficult. I remember dreading visiting my dad as I knew we’d probably end up at loggerheads…

I was given two really useful tools to deal with this one was:-

Compassionate Communication with the Memory Impaired

The following piece was posted a while ago on DSF and made a big impression on me. It is something I have referred to time after time and tried hard to follow. We have many new members who may not have seen it before. Yesterday I posted it on another Thread but thought it might be helpful if...

forum.alzheimers.org.uk

Well worth a read but not always easy to do.

The other was advice from another member to never say the word no but always use “yes but” and then give a reason why the requested thing can’t be done right now - I think this came from @canary who has posted the previous post.

 

[Sarasa]

Hi @FranL and a warm welcome to Dementia Talking Point. You've come to the right place for help and advice and you'll find this a very friendly and supportive community.
My mother was a lot like yours. Her diagnosis was vascular dementia, but both her care home manager and I thought there was a strong element of frontal temporal lobe dementia too. She could have spectacular meltdowns, and it was one of those when she caused a disruption in her doctor's surgery that got her the diagnosis. Before that she'd refused to engage with the memory clinic, but the surgery arranged for a psychiatrist to see her at home. That diagnosis was what I needed to move mum into care. At the time mum was living on her own with me popping over twice a week and a friend keeping an eye on her. More and more things were going wrong, she could no longer manage her medication, wasn't really eating properly and she'd fallen out very badly with several of the neighbours, including calling the police because she thought the next door ones were stealing from her.
It sounds if the assessment in the home is the right thing. My mum too hated the home, though she blamed my fictitious horrible boyfriend for putting her there. She too could be horrible to me and she had multi-attempts at trying to escape. The home applied for a Deprivation of Liberty Safeguards (DoLS), to be able to keep her there. I knew if mum went home it wouldn't be long before a crisis would have ended her up either in hospital or sectioned so I was glad when they said mum no longer had the capacity to make informed decisions about where she lived. It sounds as though you have already had the crisis, and though your mum might improve a little it does sound like a care home is the best place for her. Will she be self-funding, as if she isn't social services might want to see if she would manage at home with carers coming in. I knew that wouldn't work for my mum as she'd either have been out when they visited or have refused them entry. If she is self-funding I think stay in a care home, though not necessarily the one she is in would be for the best. My mum settled though it took a long time. In the end what helped was moving floors. The lead carer was a man and mum took to him (she too is a big flirt, even now when her dementia is very advanced) and that really helped. Mum is now in a different care home (I moved a long way from where I lived previously) and she settled there with no problem. She still gets cross, but things are so much better than they were two and a half years ago when I first moved her.
There is nothing to say you have to keep on visiting. If your mum continues to be upset by your visits leave it for a while and just phone up to see how she is. You could send in small treats or postcards so she knows that you haven't forgotten her.

 

[FranL]

Thank you for replying. It helps just knowing this is not unusual. We are very lucky with the Care Home - lovely social worker placed Mum in one I chose after research. The plan is that you can stay there if Social Services agree she should not go home. There is no way mum would let carers go in - she won’t even have a window cleaner! She wants to go home but yesterday just demonstrated why she needs extra care. The hospital used DoLs to keep in her hospital after they had to restrain her during the admission process. I rang earlier today and they say she is more calm and her cousin phoned her too and said she wasn’t too bad today. I think I will just ring in the morning and see if she wants me to visit. I’m only 10 mins away. Thank you so much for sharing with me. ?

 

[JHA]

Hello. I’m new to this forum so sorry if this has been posted before. My mother is currently in a care home for a four week assessment following discharge from hospital. Before she went into hospital we did not even know she had dementia but she has now been diagnosed with mixed dementia including vascular and frontotemporal. We had known for a while that things were not good but she was still living in her own bungalow and managing fairly well with only the odd bit of family help from me and my son. She was admitted to hospital in early December as she was having hallucinations and had atrial fibrillation. To cut a long story short, due to a covid outbreak in the hospital she has only just been discharged to a care home until social services decide if she is able to return home or not. She has not taken that very well and has aimed all her anger at me as I’ve had her locked up.
i have never been close to my mother as she prefers men to women but my brother lives too Far away to visit very often so I get the brunt of her rages. Yesterday she had a complete melt down in the home and told me to get out and I was evil and two faced. In front of me on my mobile she told my brother and niece how awful I was for putting her in a home. She put her hands over her face and sounded like she was crying but when she put her head up, I could see she was dry eyed so it was all for affect. When I did leave, she screamed after me and was shaking the doors to try and escape. I am finding all this very difficult to deal with and really don’t know how to talk to her. I’m daring to return tomorrow morning as the carers say she is better in the morning. I’m also worried social services will discharge her home with a care package as I just don’t think she will be safe. Any advice would be appreciated. Thanks

I have been in a similar situation but I am an only child so everything is directed at me.

Just over three weeks ago I organised a respite bed for my mom and persuaded her to give it a try - prior to this she lived alone with me going over once a day and calling late afternoon. Just before Xmas she wandered out of the house in the middle of the night and I ended up being with her 24/7 whilst GP, Mental Health, Crisis etc came up with a plan - unfortunately no plan was forthcoming and after 8 days I was broken so sorted out a plan of my own . She was ok going and I left her eating lunch. Then the phone calls to me and my uncle started asking us to pick her up. She had been there just over a week and I rung to see how she was and she came on the phone and basically screamed at me - it was like a stomach punch and I did feel like walking away as boy did it hurt. It floored me for a while but I dusted myself down as I have no choice but to carry on - I need to ensure she is safe, cared for and ideally happy as nobody else is going to do it. It is unlikely that my mom will be able to return home and she is currently in hospital but that is another story.

 

[FranL]

I have been in a similar situation but I am an only child so everything is directed at me.

Just over three weeks ago I organised a respite bed for my mom and persuaded her to give it a try - prior to this she lived alone with me going over once a day and calling late afternoon. Just before Xmas she wandered out of the house in the middle of the night and I ended up being with her 24/7 whilst GP, Mental Health, Crisis etc came up with a plan - unfortunately no plan was forthcoming and after 8 days I was broken so sorted out a plan of my own . She was ok going and I left her eating lunch. Then the phone calls to me and my uncle started asking us to pick her up. She had been there just over a week and I rung to see how she was and she came on the phone and basically screamed at me - it was like a stomach punch and I did feel like walking away as boy did it hurt. It floored me for a while but I dusted myself down as I have no choice but to carry on - I need to ensure she is safe, cared for and ideally happy as nobody else is going to do it. It is unlikely that my mom will be able to return home and she is currently in hospital but that is another story.

I’m so sorry to hear that. Similar story. I might as well we an only child as my brother is miles away so practically he cannot help. My mum was in hospital for nearly 6 weeks. Terrible time. Stay strong ?

 

[Lovemymumsomuch]

Reading your post I felt I was reading about me !
I could never confide in her and I too am not close but have always been around and cared for her.

I am alone with this and beginning this "traumatic" journey with my mum she has not even been assessed yet.
Mum still lives alone with a registered nurse visiting and giving insulin.
My mum has always been a bully to me when younger and I tell you what every now and then when she starts to shout at me - it is cutting and takes me back to when I was younger. Sometimes I think I hate my mum and could walk away, but of course I can't. She has never listened to me - so I don't expect her to now.
On the outside looking in - I would stay away for a bit. I don't think your mum would suffer but you would with the "guilt" I would give it a few weeks and of course you could call every day to put your mind at rest on how she is. take care x

 

[FranL]

Reading your post I felt I was reading about me !
I could never confide in her and I too am not close but have always been around and cared for her.

I am alone with this and beginning this "traumatic" journey with my mum she has not even been assessed yet.
Mum still lives alone with a registered nurse visiting and giving insulin.
My mum has always been a bully to me when younger and I tell you what every now and then when she starts to shout at me - it is cutting and takes me back to when I was younger. Sometimes I think I hate my mum and could walk away, but of course I can't. She has never listened to me - so I don't expect her to now.
On the outside looking in - I would stay away for a bit. I don't think your mum would suffer but you would with the "guilt" I would give it a few weeks and of course you could call every day to put your mind at rest on how she is. take care x

I actually visited today. I rang first thing to see how she was and they said she was in a good mood. she was completely different although she could remember being nasty and said it was because I brought her clean clothes in which made her fell like I was dumping her there. I might add she was wearing the clean clothes I took in! Whilst there were several glimpses of reality, and anyone who did not know would think she was fine, she told me that the one story building had an upstairs and that several people left this morning on a trip but she wasn’t allowed to go with them. She is near the airport and said that they were being attacked by helicopters shooting at them. I did manage to explain that she had been assigned a social worker who would tell her what happens next. I felt so sorry for her as she kept saying that she just didn’t want to stay and if I brought things in that it made it feel more permanent. So very difficult and I do feel for you because at least mum is safe and being assessed. I wouldn’t say she was a bully when I was a child but she was spiteful to me, as she has been to my sister in law and my niece. The dementia just seems to magnify her bad behaviour. Good luck with your mum x

 

[JHA]

I actually visited today. I rang first thing to see how she was and they said she was in a good mood. she was completely different although she could remember being nasty and said it was because I brought her clean clothes in which made her fell like I was dumping her there. I might add she was wearing the clean clothes I took in! Whilst there were several glimpses of reality, and anyone who did not know would think she was fine, she told me that the one story building had an upstairs and that several people left this morning on a trip but she wasn’t allowed to go with them. She is near the airport and said that they were being attacked by helicopters shooting at them. I did manage to explain that she had been assigned a social worker who would tell her what happens next. I felt so sorry for her as she kept saying that she just didn’t want to stay and if I brought things in that it made it feel more permanent. So very difficult and I do feel for you because at least mum is safe and being assessed. I wouldn’t say she was a bully when I was a child but she was spiteful to me, as she has been to my sister in law and my niece. The dementia just seems to magnify her bad behaviour. Good luck with your mum x

I need to pluck up the courage to visit my mom. Not long after she was admitted to the care home they went into lockdown so my planned visit had to be cancelled. Then the phone calls started and they were still on lockdown so I backed off but I know that at some point I need to get my big girl pants on and face the music. Hopefully she will have forgotten the last few weeks and will be settled and happy - I can live in hope.

 

[FranL]

I need to pluck up the courage to visit my mom. Not long after she was admitted to the care home they went into lockdown so my planned visit had to be cancelled. Then the phone calls started and they were still on lockdown so I backed off but I know that at some point I need to get my big girl pants on and face the music. Hopefully she will have forgotten the last few weeks and will be settled and happy - I can live in hope.

I’m not sure my mum will ever be happy in a care home. She wants to go home but I cannot see how she can manage. Some days she is very lucid but other days she has no idea what is going on around her and she is very confused. I don’t know which is worse. Be brave and good luck x

 

[canary]

Its early days for your mum @FranL - she may well settle
Nevertheless, we all want our PWDs to be safe, well cared for and happy, but sometimes we have to settle for two out of three

 

[JHA]

Sadly I think we are in the same boat. Like you, I am not sure if my mom will be happy in the care home. She was in a discharge to assess bed last year for just over four weeks and she did seem to settle but there was the possibility of returning home this time that is not an option.

My mom is at times very with it and realises what I have done (basically left her in a care home) then other times she thinks she is in an old office where she worked and having Xmas lunch with her boss (she was actually in her own home and had Christmas lunch at my house).

 

[FranL]

Sadly I think we are in the same boat. Like you, I am not sure if my mom will be happy in the care home. She was in a discharge to assess bed last year for just over four weeks and she did seem to settle but there was the possibility of returning home this time that is not an option.

My mom is at times very with it and realises what I have done (basically left her in a care home) then other times she thinks she is in an old office where she worked and having Xmas lunch with her boss (she was actually in her own home and had Christmas lunch at my house).

I’ve tried to find her a nice care home which is safe but she doesn’t like the other people in it - says they are all fr sicker than she is. To a degree with is true but I’m unsure what else I can do. I’ve looked at other homes which are more like hotels. We are self funding so although it would be a stretch, we could probably make it work. Do you think it helps to move her?
like your mum, she also thinks she is at work sometimes and keeps saying she is in the union. In the hospital she tried to collect union subs from the nurses!

 

[jennifer1967]

couldnt the carers give her little jobs to do so that your mum feels useful. folding tea towels, washing up etc.

 

[JHA]

I’ve tried to find her a nice care home which is safe but she doesn’t like the other people in it - says they are all fr sicker than she is. To a degree with is true but I’m unsure what else I can do. I’ve looked at other homes which are more like hotels. We are self funding so although it would be a stretch, we could probably make it work. Do you think it helps to move her?
like your mum, she also thinks she is at work sometimes and keeps saying she is in the union. In the hospital she tried to collect union subs from the nurses!

The staff at my moms care home seem lovely and compared to the one that SS organised for assessment it seems a lot nicer.

My mom is also self funding and our choices are limited as this was one of two that said they could manage her when I first started to look for a care home. My mom is an escape artist she managed to leave the hospital last year just before they were discharging her to the assessment bed - she knew exactly what she was doing as she had left her heavy bags in the hospital. The police were called by McDonalds staff when she nipped in there for the toilet - they became concerned when she told them she was looking for her Dad. She has now begun to wander at night so needs somewhere with key coded access or she will be off on her travels to goodness knows where.

My mom is of the opinion that there is nothing wrong with her all these problems have happened after I took her for the memory tests. Apparently at 83 she can be expected to forget things. She has literally no comprehension of her care needs and as a result puts herself at risk.