How to handle outbursts?

[Snowdrop&Hailstone]

Hi , Not sure how to explain the worries I have for my wife of 50 years who is 84 and was dianosed with Mixed Dementia in Nov 2018
In the last few years she has not been that bad as the progression of this disease is slow but, suddenly gets worse.
Laterly, she has become more argumentitive and aggressive in her manner.
This week, she does not know me as her husband and keeps saying "Dave" her husband is very late tonight and gets very angry as the evening goes on, as he has not appeared.
I have tried to explain it to her that this other"Dave" does not exist but, nothing gets though to her.
I do beleive that this Sun-Downing does occurr. as this seems to start up after lunchtime into the late afternoon.
She has been on Donepezil and Memantine but, they only seemed to makes her confusion worse.
Saying Men were coming up the stairs in the middle of the night. This really frightened her.
Since getting the tablets stopped, she has gone back to near normal, although still very confused.
After watching some programs on the TV she then thinks that they are to do with her and that she is responsible somehow.
The last few evenings and nights recently have been horrendous trying to stop her unlocking the doors and her going out into street in the middle of the night.
As all the carers reading this would understand it is very hard not to get angry but , it seems to only make matters worse,
I would value any advice on how to handle this situation.

Thanks for your time
Stay Safe
Dave Hailstone.

 

[Thethirdmrsc]

Hi @David Hailstone I really feel for you, as this behaviour is the worst for me. My OH is 80 and he takes Mertazapine, and I give him Diazepam if i can give it to him in time. I have tried anger and shouting, and then laughing off his accusations, nothing works because it’s their reality, and telling them that it’s not real makes them angrier. Now I go to another room, or the loo, and come back in about 15 minutes, and most times he is then ok. His outbursts never last long. When he sees people or things that aren’t there, I generally go along with it. When we go to bed, I lock all the doors, and take the keys out. They are on a hook to one side, but he would never look, so I know he can’t get out.

 

[White Rose]

Hi @David Hailstone , sounds like you're having a very tough time, so hard to deal with all this. Re the unlocking of doors, we have a small plastic 'child lock' at the top of our front door, my partner doesn't know it's there and it's very effective at stopping him heading out of the house at all times of the day and night.
He was diagnosed 4 1/2 years ago and until recently I've found that a walk every day and keeping him active was helpful in keeping him stable - unfortunately he seems to be now going through the sundowning phase, last night walking round and round, up and down stairs and getting agitated. When he gets angry I either walk away or I just stand quietly and look at him until the explosion dies down! Wish there was an answer, maybe others will have more useful advice. All the best to you.

 

[MalcW]

The issue is that every sufferer of this horrible disease is effected differently and you can only express fears and worries in terms of your own experiences. My wife has early onset Alzheimers for 3 years and is still only 60.
We seem to have lots of issues that have been passing phases. She too took to sleep walking and I found that, if I suggested that something needs to be done, she would be out doing it at 2:00am. We have a large equine property and one afternoon I suggested we get the staff to dig out the ragwort - a plant poisonous to horses. I awoke early hours of next morning when I noticed the yard and field lights were all switched on and she was out digging the weed. Obviously still asleep. Trouble is she sleeps naked. The old boy next door thought it was Christmas and Easter all at the same time. Be careful not to lock her down too tight. I tried locking internal doors and then found her climbing out of a window.
I think we need a lot of patience and consider myself lucky to have a strange sense of humour. It's also important to get some "me" time. If you're starting to get angry, you must get help from somewhere. Again, I'm lucky. My sister-in-law takes her out for a day in the middle of the week and I have a good old day of R & R or take the opportunity to visit friends and family. If you don't have family to help, do you have access to respite or domiciliary care workers.
I think you've already learned that getting angry doesn't help and I found this made me feel awful to think that I couldn't keep myself under control. Don't forget the issue is the disease not your wife. We're a long way from perfect and, like everyone else, getting worse. That wicked sense of humour doesn't mean that I don't take myself off for a good cry once or twice a week.
For your own sanity get some outside help. Alzeimers Society and Carers First are both good starting places. I find it helps to take advantage of local events and have made several good friends with whom we can all have a good natter, laugh and cry. We also bounce lots of ideas off each other. Remember, your wife may not remember who you are, but she will remember how you make her feel, so that feeling has to be pleasant.
Good luck with it and keep venting here. You will start to get answers to problems as they arise and don't save them up.

 

[karaokePete]

Hello @David Hailstone and welcome to the forum.

My wife has most of those behaviours but to a lessor extent. I would suggest the action that I took - talking to the GP about meds and asking for a referral to Social Services for a needs assessment. Taking that action helped me a lot.

Now that you have found us do keep posting as the membership are experienced and helpful

 

[Hazara8]

Hi , Not sure how to explain the worries I have for my wife of 50 years who is 84 and was dianosed with Mixed Dementia in Nov 2018
In the last few years she has not been that bad as the progression of this disease is slow but, suddenly gets worse.
Laterly, she has become more argumentitive and aggressive in her manner.
This week, she does not know me as her husband and keeps saying "Dave" her husband is very late tonight and gets very angry as the evening goes on, as he has not appeared.
I have tried to explain it to her that this other"Dave" does not exist but, nothing gets though to her.
I do beleive that this Sun-Downing does occurr. as this seems to start up after lunchtime into the late afternoon.
She has been on Donepezil and Memantine but, they only seemed to makes her confusion worse.
Saying Men were coming up the stairs in the middle of the night. This really frightened her.
Since getting the tablets stopped, she has gone back to near normal, although still very confused.
After watching some programs on the TV she then thinks that they are to do with her and that she is responsible somehow.
The last few evenings and nights recently have been horrendous trying to stop her unlocking the doors and her going out into street in the middle of the night.
As all the carers reading this would understand it is very hard not to get angry but , it seems to only make matters worse,
I would value any advice on how to handle this situation.

Thanks for your time
Stay Safe
Dave Hailstone.

Alzheimer's with Vascular dementia can be varied in each case, but the latter can sometimes develop quickly and behaviour accordingly. But an imperative which is best learned early on, is DO NOT ARGUE WITH DEMENTIA . You will almost certainly lose. The disease dictates and reasoning with or challenging it can prove a fruitless and painful task. However contrary to instinct or indeed warranted response, if one conveys the opposite one can induce a positive result. Not always and by no means, but the calm and collected response to a hostile bout of behaviour, or simply letting it drift over the top of your head, can prove beneficial. Challenging and a new discipline for most of us, but dementia makes the rules. Drugs are always a last resort but often required depending on circumstances. The " reality " inside the dementia mind is as real as our own and when you challenge it, then it bites back with a vengeance. Perceive antagonistic behaviour as impersonal, evolving out of brain changes which interpret differently than before and yet become the norm for the one living with dementia.

Dementia is a mysterious place and unpredictable. There was a case in America where a Care Home resident constantly refused to return to her room and was physically aggressive.
Having tried to fathom the cause of her reluctance to enter her room, it finally turned out that the elusive culprit, was a particular coloured cushion. It was subsequently removed and a complete transformation took place and the resident returned to her room without ceremony.

That coloured cushion can sometimes be other things, like losing one's temper or a sudden change in tone of voice. Barring UTI's or underlying pain or depression, dementia can and will meet all our endeavours with total disinterest. The loved one it inhabits however needs all the support and all the love we can muster, because they cannot help themselves and that is a fact.

 

[canary]

Hi @David Hailstone
Your wife is locked by the dementia into a sort of parallel universe. You will not be able to bring her back into reality, so you will have to enter her reality in order to reach her.

She thinks that you are not around (and maybe are having an affair?) in the evenings. You cant bring her into the reality that you are standing in front of her, so tell her that Dave is working lates this week.
She thinks that what is happening on TV is what is happening directly to her? Dont try and explain, switch it off. Mums TV had to be severely censored and eventually only used for DVDs that were "safe".
She wants to go out somewhere in the middle of the night? Tell her its too dark now, but you will take her in the morning - even if she wants to go home to her mum and dad. (also, lock the door and put the key somewhere where she wont find it in case she sneaks out while you are asleep).

Have you come across Compassionate Communication? Its not the be all and end all, but should give you some pointers

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

 

[hardworker]

Hi David I like you am having proplems with my Husband, It is 3am and I am up thinking how I miss the man I love and have loved for 45 years. He as started to see people up a hill that is not there Ive tried to show him they are not there Ive agreed with him and none of it works, Ive spoke to the Doctor about it with no answer, but reading your message I am now wondering if it is his medication He is on.Donepezil and Memamtine. I have not heard of sun downing so will look into this as it seams he always as outbursts and seeing things after Lunch. take care.

 

[malomm]

I can relate to everything so far in this thread. My wife is now in a late stage of alzheimers. In agreement with her ASL(NHS) geriatric consultant, we are able to control a naturally agggressive nature with a 10 mg dose of quietipiena morning and night. The PWD is locked into their childhood memories, and need all the good humour we can give them.
Keep smiling,
malomm

 

[Snowdrop&Hailstone]

Hi' Thank you all for the your help and support.
Will now have somewhere to bounce problems off the forum, who most likely have been in similar
situations themselves.

Thanks again.

KInd Regards
Snowdrop & Hailstone