Rages, hitting and emotional violence

[Wildwoodflower]

For those who haven't read any of my previous posts, my mum is 91 and has been diagnosed with vascular dementia.
I've written before about her periods of anger and paranoia and the confabulations, but I've only brushed on the issue of violence.
Now, at 91 my mother really isn't physically capable of hurting anyone. She doesn't have the strength. But she does quite often try to hit me around the face.
She has always had an explosive temper and forty or more years ago when I was a teenager she would frequently slap me, until the day I slapped her right back and told her she would never lay another finger on me. Not my proudest moment, but it worked. I have since come to strongly suspect that she was menopausal at that time and not coping, but it doesn't excuse what she did.
Nowadays, so many years later, her rages mostly come from being in situations where answers or facts contradict her. She'll slam the table with her hands and start shouting about how terrible everyone is to her and so on. As I'm her primary carer, it's generally me on the rough end and if I'm in reach she'll try to slap me. Today she had a tantrum and knocked my glasses off with a lucky swipe.
There are a lot of strategies discussed on this forum such as walking away or just agreeing with whatever she says, and I do try to be mindful that it is a brain injury that's talking - and not my mum - and practice them. But I'm not made out of flint and occasionally I lose my cool and tell her what I feel about being the receptacle for the horrible and ludicrous stuff she comes out with. This, for her, is a triumph as in her mind my anger or distress simply confirms everything she has been saying.
Truth is, I've don't think I've ever felt so degraded. It is relentless and she (or her illness) is, of course, remorseless. The hitting takes me right back to being a teen and the undeserved violent focus of her rages and frustration - the emotional violence that almost destroyed my relationship with her at the time. And who wants to go back there again?
So, what do I do?
Ask her doctor to medicate her?
Try and get better at never rising to it?
Stay out of reach?

 

[Jessbow]

I certainly wouldnt bother to contradict/put her right if itwas going to get me a swipe.

if she was having a tantrum i'd leave her to it, as long as she coudnt hurt herself- stay well clear.

Like a toddler, no point in a tantrum if no one is watching

 

[Helly68]

@Wildwoodflower - this is so hard, not sure I have an answer.

Although he has never hit me, my father (alzheimers) has a very short temper, and has started to say things like "they need a good punch on the nose". Now this is not comparable to what you are experiencing, but it is scary. For me, being a short disabled person, I think violence would be a red line for me. In that I would try to distance myself from caring in that circumstance. However, in reality would i?

A few things occur to me. Firstly, are you the only carer? if so, is it worth consideing getting help to see how she reacts with others? Carers in my Mum's home were great at diffusing her anger (she did sometimes hit out, though not at me) when she would not have listended to me.

I think it is worth contacting her GP and asking about medication. There are some medications that can reduce agitation and this may be worth trying, especially if you are getting swiped - even though we know it is the disease and not the person. If she has ever had a referral to a mental health team, it may also be worth getting advice from them too.
I am with @Jessbow about the tantrums.

 

[thistlejak]

After we got FIL safely into a care home I was usually the focus of MIL rages and physical assaults. We couldn't get her to the GP but , after being sectioned , medication did help when she was put onto a cocktail of drugs in the hospital.
In MIL's case most of the rages were due to her perception of loss of control in her life and extreme anxiety. 2 1/2 years down the line she is in a great home where they have had to reintroduce some of the medication as she was getting back to that level again.
You are doing a fantastic job but you are only human and , given your back story, it is understandable that you 'snap' sometimes.
In answer to your questions
Yes to medication.
Give yourself a break - you are not a robot - you are doing your best
Yes- as far as you are able to stay away from her - I was lucky we used to walk out when she got really bad .

 

[try again]

Get a social service assessment for her (and you).
You are her jailor she will direct it all to you

 

[Violet Jane]

I think that it might be time to consider a care home as you sound really low and there is no end to the caring role in sight. SS will no doubt try to keep you caring for your mother with suggestions about this or that and so you need to be really clear with them that you can no longer cope with your mother's behaviour as it is having a very detrimental effect on your mental health. Insist that medication be tried. If the doctor won't prescribe anything or it doesn't work then I think that you will need to end your caring role as you can't go on as you are.

 

[Grannie G]

Hello @Wildwoodflower

Time to hand over the reins to people who are paid to do the job. No one should be expected to tolerate this level of degregation , dementia or not, nor can physical aggression be accepted.

As carers for family members I think we are guilty of growing with the role , not appreciating just how dreadful it is until we are on the verge of breaking point.

Please read your post as if it was from another person and think how you would react.

For your own mental and physical well being, make that difficult decision. I doubt you will regret it

 

[Pots and Pans]

So difficult. Experienced same from OH who could and dud hurt me. Tried medication at home but this affected mobility so he wasn't safe at home as high risk if injury with just me around (and shadowing upstairs or into garden too) so had to stop thus. It's a balance - your mum may very well respond fine to other meds and stay mobile too but I had to go down the residential route just recently. First week OH very aggressive too but now on same meds but care home can. handle mobility as more hands available. For me still seems very sad but needs outweighed wishes. Two points - because if aggression we were assigned a mental health social worker who could liaise with doctors better than general purpose social worker. May vary in different areas - I am south west And secondly if looking at care do be honest about issues as don't want to find they can't cope. Maybe try day respite or day centres first as she may respond well to stimulation there and you can see how she behaves with carers too.
Finally if you get no help ask for a carers assessment - you can probably get some funded help. You need the breaks. Good luck!

 

[Wildwoodflower]

Thank you all for your thoughts and care.
We are in France, so things with social services, funding etc are done a little differently.
Yes, she is due for an assessment with social services here and then there will be some help available.
I am particularly low at the moment, that is true.
The last few days seem to have been especially difficult for her and so she is going through the standard cycle of anger and blame, unfounded accusations and paranoia. This evening has been particularly awful. Thankfully she will be in bed soon.
It will be three years in July since she came to live with me, first at my home in Scotland and then, thanks to the pandemic, in France. I have not had a single day off from it and I'm pretty much frazzled. Carer burnout, I believe they call it.
Anyhow, there will be a point at which she will need 24/7 residential care. I don't know if that is now, but if it isn't then it may not be that far off.
Her doctor says he is hopeful that her condition will stabilise for some while. That's good for her, but I do wonder how long I can live in this netherworld.

 

[Frank24]

Thank you all for your thoughts and care.
We are in France, so things with social services, funding etc are done a little differently.
Yes, she is due for an assessment with social services here and then there will be some help available.
I am particularly low at the moment, that is true.
The last few days seem to have been especially difficult for her and so she is going through the standard cycle of anger and blame, unfounded accusations and paranoia. This evening has been particularly awful. Thankfully she will be in bed soon.
It will be three years in July since she came to live with me, first at my home in Scotland and then, thanks to the pandemic, in France. I have not had a single day off from it and I'm pretty much frazzled. Carer burnout, I believe they call it.
Anyhow, there will be a point at which she will need 24/7 residential care. I don't know if that is now, but if it isn't then it may not be that far off.
Her doctor says he is hopeful that her condition will stabilise for some while. That's good for her, but I do wonder how long I can live in this netherworld.

Hello I’m so sad to hear what your experiencing and I wanted to offer my experiences to you. I kept my mum at home with 24 7 care from a private cater and running myself ragged from a distance filling in the many gaps. Don’t feel you have to do this. It’s a progressive disease. I wish I had got my mum settled in a care home earlier. I reached total burn out break down. I suffered a back injury and I could no longer mobilise. It took this for me to realise I wasn’t coping. With Alzheimer’s I think long term care is often inevitable. Don’t destroy yourself. ♥️

 

[Muttimuggle]

Hello Wildwoodflower. This sounds like a difficult situation for you. You say you are down at the moment but your current relationship with your mother must surely be making you worse - a vicious cycle of down-ness. In situations like this we need to be able to look at it with fresh eyes and think(so requiring some sort of temporary escape out of the situation). What changes could you make to improve things for you? If you can feel a bit better and a little more in control of your own situation then your mother will most likely benefit too.

You don't seem to have any care in place at the moment and are waiting for an assessment. Do you know how long that wait will be? Is there any possibility of finding something which could be paid for while you wait with the aim of having someone else for your mother to communicate with? (My mother will "behave" better with an outsider than me). These may not be your solutions but something looks as if it needs to change.

I do not think I could do what you are doing and have my mother living with me. It has been stressful enough visiting and assisting from 15 minutes drive away! Interestingly enough for me - my mother did not think she wanted or needed a 2nd care slot each day...but I thought she did and medication dosing made it a good reason to do it. Since this was introduced however she seems a bit happier. For me it was proof that she doesn't always know what makes her happier - the company and the visit from more people has done her good.

No-one deserves anything which feels like abuse. Sadly it makes us respond in not the best way too(me included in this). This is why you somehow need to step away for you! You need this. You are important, just as important as your mother. I understand too how it drags up memories from one's past, things which were not right in our upbringing...and then makes us hurt all over again. Your feelings about the past and about now are still valid. Of course, yes your mother has dementia and it distorts and changes her thinking but your feelings are the same and we can't help trying to read the emotion behind the person with dementia's words or actions.

 

[Wildwoodflower]

Again, thanks to all for the empathy and thoughtful advice.
I have got some private help, but just for three hours a week - a British lady who has worked in the care sector and has known my mum for years. She's brilliant and mum loves her and behaves immaculately when she's here. But three hours is all that's available.
Today has been the polar opposite of yesterday. She has been sweet, gentle and undemanding, with nothing at all said about yesterday's accusations and fury. She even managed what for her was a fairly lengthy walk. Damn this disease, you never know what's coming.

 

[Yankeeabroad]

Hi @Wildwoodflower
I would say from what you describe respite care or a care home is needed now.
My dad was/remains the main target of my mom’s aggression, not me. I still find her aggression and delusions difficult sometimes. I found out later that the brilliant caregiver that both my mom and dad get along with (they both have dementia), almost refused the job after the first day due to my mom’s aggression (physical and emotional) towards my dad. My mom has never been physically violent and just tries to slap, so I can only imagine you have it 10 times worse.

Shortly after the new caregiver came, we moved my mom to emergency respite for my dad’s safety and mental health. My sister was with them for 2 weeks right before respite and literally ruined her health (she‘s recovering from cancer/chemo) during that time.

This is serious stuff, even if you know it’s due to dementia.
As has been said many times here before, a care home should allow you to return to being a daughter and not the evil caregiver. In a CH, I can walk away, get a glass of water, calm myself and return while at home I can’t. If my mom is having a good day, then we both enjoy ourselves. Makes a world of difference.

 

[Chaplin]

Hi @Wildwoodflower some helpful advice but just wonder if your mum suffers with frequent UTIs. My mum does and she is normally a gentle soul but her mood and behaviour change is noticeably different with a UTI. I appreciate your mum has some history with lashing out but might be worth exploring.

Knowing you are in France, I guess a care home could be a challenge if your mum doesn’t speak fluent French. At the very least you need to get more carer support at home while other avenues are explored. Take care of you too.

 

[Wildwoodflower]

There are care homes around here that cater for english-speaking residents - after all, there are so many older people here who do not want to leave the lives they built over decades. Brexit has made their lives much harder.
It is common for people to lose their second language, especially if, like my mum, they learned later in life.
Thanks for the reminders about UTIs. It is something that I keep an eye on. My mum has no history of UTIs and there is no evidence that I have seen to suggest that she is having them now (I do get UTIs, so I'd know one if I saw it). She is daytime continent and happily wears night knickers.
It seems to be cyclical - days of relative calm, then restlessness, an upturn in hallucinations and outbursts, some but by no means all with efforts to slap me. I can see how that might suggest UTIs and I will ask her doctor to check.
Yes, it may be time to start considering a care home. It will be a terrible transition for my mum, who often says I want to put her in a home while ignoring that I put my whole life on hold for - so far - three years to care for her and it has cost me my saving.
When she was younger, she would say 'If I ever get like that, please don't sacrifice your life. Put me in a home.' Yet here we are.
Things are calm again today. We have visitors later this week and again next week, including my caring and kind Dutch 'half-sister' who my mum adores. So, she will be on good behavior for a week or so and I will get a few days of help.

 

[canary]

When she was younger, she would say 'If I ever get like that, please don't sacrifice your life. Put me in a home.' Yet here we are.

Please remember this. This is your true mums voice.
What she is saying now is the dementia speaking.