Mum has become aggressive to carers

[nellen]

Hi my mums dementia seems to have deteriorated in the last month or so and I'm wondering what I can do about it. She has been in a nursing home since last sept and has become verbally aggressive to the carers (and me) and threatens to hit carers, swears at them when they attempt any personal care or give her food or drink. If I talk to her about it she denies it "I wouldn't do that to the girls" it's become so bad the home has set up a behaviour chart to look for triggers and what might help in dealing with.

My mum has never been like this, she always used to go out of her way to be pleasant to carers and was well liked by all who came into contact with her

In addition to dementia my mum has complex needs, she is blind with age related macular degeneration, deaf, immobile, doubly incontinent and has chronic back and knee pain. As part of her dementia she has long two way conversation with all my relatives - alive and dead. E.g. Is that you Mary? Yes it's me nell, how are you Mary, etc etc its like she's in a parallel world and if you speak to her she seems confused, as if you're intruding.

I've spoken to the nurse about my mums aggressive behaviour and suggested that if she refuses to comply with eating, drinking and personal care they shouldn't push her as I wonder if it's her way of giving up on life. Also it's very distressing for the carers to be verbally abused swearing, called names.

I'm not sure what I can do? Should I speak to mums doctor or the home manager about getting a review set up in view of her recent worsening state? It's very distressing for us and I worry the home will refuse to look after my mum.

 

[jaymor]

As distressing as it seems to you, all your Mum's behaviour is very common for someone suffering from dementia. I am sure the carers in your Mum's care home, like the carers in my Husband's nursing had, heard it all before and are not distressed by it, they come across it daily and I am sure some things a lot worse.

Our daughter works on a dementia floor in a nursing home and she has been kicked, punched, scratched, bitten and swore at on a daily basis and believe it or not, she loves her job.

Please don't worry about it. Like all episodes, it will pass only to be replaced by something else.

The carers can only encourage, they can't force so have to accept no for an answer.

 

[nellen]

As distressing as it seems to you, all your Mum's behaviour is very common for someone suffering from dementia. I am sure the carers in your Mum's care home, like the carers in my Husband's nursing had, heard it all before and are not distressed by it, they come across it daily and I am sure some things a lot worse.

Our daughter works on a dementia floor in a nursing home and she has been kicked, punched, scratched, bitten and swore at on a daily basis and believe it or not, she loves her job.

Please don't worry about it. Like all episodes, it will pass only to be replaced by something else.

The carers can only encourage, they can't force so have to accept no for an answer.

Thanks you Jaymor I guess you're right and it's me and my worries about them thinking they can't handle mum. She's on the nursing floor rather than the dementia floor - although the home specialises in dementia but in view of mum being almost bed bound, and having a bedsore when she first went into the home they decided she should be on the nursing floor. I've witnessed my mums aggressive behaviour on a few occasions and it's very unpleasant and a lot of four letter words. Some of the carers are quite good at dealing with it but others see it as a personal insult rather than the dementia speaking. I wonder if we ought to have a review so that there can be a more consistent approach to coping with my mum. I'm not really sure who to see to set one up though.

 

[jaymor]

If the carers are taking it personally then it is time their training was reviewed and they understood dementia.

Our Son and I went to view the nursing home my husband went in. We were being shown around and we walked through the conservatory. Sitting by the door was an elderly lady, well into her eighties with a slight blue rinse in her hair, twin set and pearls and sparkly slippers. She asked the nurse showing us round why the man (our son) was there. She was told he was just having a look around. She looked at him and asked him politely to please go away. Well not that politely, she used two short words, one of them being off.

I don't know who was more embarrassed, the lady sitting with her or our son. When we got home he said the last time a lady of that age had spoken to him she gave him a peck on the cheek and a bag of sweet and not told him where to go.

My husband started to swear when personal care became part of his daily routine. I had never heard him swear and our two children were in their forties when they heard their Dad utter a few choice words for the first time. It is all part and parcel of dementia and should be fully understood by carers.

Have a word with the Manager of the home. Tell her you are a little worried about your Mum's behaviour as she advances and he/she should be able to assure you that it is all normal and they can deal with it.

 

[Amy in the US]

Jaymor is absolutely correct, if the carers at the home are upset or taking things personally, they need better training or a different job. I'm sure it distressing but it's part of the dementia.

My mother (Alzheimer's and no short term memory) is in a care home, what we call in the States assisted living, which is not full nursing care or a dementia floor or an EMI unit, as best as I can make out. She's lived there for about 18 months now.

Early on, I got a phone call one day from one of the staff, telling me how my mother had inappropriately talked to her and what they were going to do about it. I was flabbergasted and very upset, as you might imagine. I contacted the nurse manager, who has extensive training and experience with dementia, and she dealt with this. My mother had done nothing more or less than behave as a person with dementia might be expected to behave. Unfortunately my mother has a negative attitude towards the staff member in question, for whatever reason, and while I appreciate that my mother was very rude and inappropriate by normal standards, SHE HAS DEMENTIA. My attitude is that the staff person can get over herself, get more training, or get a new job, and it's not my problem to deal with. I've had no further phone calls at home from that staff person!

I was watching some of the Teepa Snow videos recently on YouTube (finally getting around to this) and she was talking about how language is controlled in different parts of the brain. According to Teepa, the part of the brain that stores and controls profanity and "forbidden" words is a different part from regular speech, and the same general area as music. This part of the brain often still works when other parts do not, or are damaged, which is why the person with dementia might still recall song lyrics when regular speech isn't working, or might swear fluently, or use language that they never did prior to the dementia.

Definitely talk to the Manager or the head of nursing/staff, if only to set your mind at ease.

Best wishes to you.