Where Do Unpleasant Traits Come From?

[Sonya1]

Hello everyone, I haven't posted for a while but have been reading, and commenting on other posts where I think I may have something useful to say!
My Dad has been in his EMI/dementia nursing home now for 9 months, approximately 8 years into his dementia journey we think. Interestingly, for the first 6 months, staff couldn't understand why he had been 'labelled' as challenging, because, apart from some resistance with personal care, he was fairly placid. However the last few weeks, we can safely say they are having their eyes opened!
He is regularly being just.... well.... nasty, changing in a split second with no real obvious triggers. Baring his teeth, gripping, hitting out, biting, throwing food. Almost 'picking fights' with other residents by pulling at them and so on. Most oddly, for Dad, he is using foul language, just repeating offensive words with venom (He has barely any speech normally and what there is , is largely unintelligible)

I genuinely wonder - where does behaviour *come* from when it has been entirely out of someone's character for 80 odd years? He has always been a gentleman in every sense of the word. Calm, logical, kind, quick to avoid conflict, never used bad language or shouted, refused to argue and would use humour to avoid such. And absolutely *never* used any kind of physical force against another person.

Is it that we suppress these traits? Do they exist secretly in all of us? How can such a kind, gentle and humorous man become the polar opposite?

Obviously the brain is damaged, inhibitions are gone, 'fight, flight or freeze' is present at a visceral level but even so......

It's so distressing. My lovely Dad would be so absolutely mortified and horrified

 

[Lawson58]

I always wonder if this sort of behaviour derives from anger and frustration. I can’t imagine what it might feel like when the world you knew has disappeared and you don’t know why or where it went.

Particularly for people who had been quite independent, the fact that people are doing things to you, things you don’t like or don’t believe you need, must be awful and maybe they are trying to fight back or regain a degree of control that has also magically disappeared.

The perceptions you have are skewed, that nobody should be trying to give you a bath when you have just had one, trying to get you out of bed for a toilet visit but you are too tired to be bothered.

It must be quite horrible.

 

[canary]

Hello @Sonya1

Our emotions are controlled by the frontal lobes. When these are damaged we lose our filters (the "second thoughts" that urge us - not a good idea to do/say that) and it becomes difficult control the inappropriate talk and sudden outbursts of anger or laughter. Thoughts that pop into your head are immediately acted on. Moods can change on a sixpence and responses to irritations and fear become magnified.

Yes, we all carry the seeds inside us, but normally we can control it, count to ten, dismiss irritations, make sure our responses are appropriate, try to understand things from other peoples viewpoint. But people with dementia lose all of this

 

[Molly D]

Oh, dear. This is happening to my mum right now. So uncharacteristically nasty, swearing, pushing away helping hands, muttering horrible things about lovely people right in front of them, throwing medication, etc. Today she even hit me because she was annoyed.

To be fair, she has had a lot of things happen recently, she fell at the care home and broke her hip, so was in the hospital for a week after hip replacement, then sent to rehab for a week and they wanted to toss her out because she was wandering but then she got covid and a UTI so has been quarantined in her room for the past 8 days. On top of that they require someone to sit with her from 7am to 7pm to make sure she stays in her room, which has mostly been me. (yay...)

Other comments already mentioned are completely reasonable to me, and I would like to add that my many hours of recent observations lead me to believe that the genesis of these nasty behaviors (at least for my mum) comes from a DESPERATE need to communicate displeasure/discomfort/disorientation, etc. My mum has aphasia so cannot communicate well on a normal basis, similar to your dad. Perhaps it is a primal instinct to alert us that something is amiss?

I have noticed that if I reassure her that she is safe, she is loved, everything is okay, etc., she will settle for a bit. Reasoning does nothing, explaining does nothing...

I do make sure to apologize on her behalf to the victims of her vitriol.

Another oddity I have heard of is disrobing! Now what is that all about? Thankfully, I haven't had to observe or manage that behavior yet. I have seen special clothing on Amazon to prevent disrobing, so it is definitely a thing. The brain is an amazing thing...

 

[Chizz]

Hi @Sonya1
Yes, I agree with what @canary has said, and with @Molly D
I'm sorry to read about your dad and how terrible this is for you.
My wife's uncle went through this to a small degree. It seems quite usual that PWD in a care home or hospital are often not cared for so well when it comes to physical problems, that are not always checked or looked for. A PWD who develops some problem - such is indigestion or constipation, or some other pain or discomfort internally, cannot express the problem. Sometimes they've lost their speach or other communication skills and can't describe or pinpoint the problem - the result is a reactive behaviour such as shouting, lashing lout, or in your dad's case swearing. Then, it's this behaviour that is looked at and not the possible underlying problem that remains. Sometimes, the underlying pain may be temporary or gets cleared naturally, and so the unusual behaviour subsides or goes away and everyone just thinks the PWD has had "a funny turn" or "outburst" for no reason.
With my wife's uncle, one of the carers just said he's being nasty, but we insisted the doctor was called. The doctor did eventually examine him and found that his prostate gland was becoming enlarged and gave him great pain when trying to urinate. There was a reason, but he couldn't explain.
My wife suffers diverticular illness that often gives her discomfort. She can't articulate properly and might just say her tummy hurts, or sometimes she just moans a groan.
There may be some underlying cause your dad can't express, other than this behaviour.

Best wishes.

 

[maisiecat]

Hello @Sonya1,
I agree with all the others that if behaviour changes rapidly its worth making sure a UTI has been excluded, also check on constipation as many drugs in capsule for absorb beyond the stomach so constipation can prevent drugs working. Get the staff to check for any sores or cellulitis as well as even low grade infections can be a problem.
Apart from that dementia is a very mixed bag,my lovely gentle husband thinks nothing of punching anyone who annoys him. Its the disease not them.
Best wishes

 

[Sonya1]

Thankyou everyone - many of your thoughts echo my own, and I especially agree that where there is loss of speech, behaviours are the ONLY way tht the pwd can communicate. The home staff are very responsive to Dad and he has a 24hr 1:1 too, plus round the clock nurses for each house group ( 4 house groups of 12 residents) the ratio is very good.
I can only begin to imagine how bl**dy awful it is to be unable to communicate your feelings and needs and it's that, more than anything, that breaks my heart .

I think I'm just confounded as to how a formerly non swearing, non agressive, conflict avoiding person can become so ..... 'feral' on occasions. Canary's explanation about frontal lobe damage is perhaps the scientific answer, plus the return to a more basic 'uncivilised' self as the things that make us behave in a so called socially acceptable way, are no longer able to function. It's just so sad.
...and even worse, what if sometimes he KNOWS?? to be trapped without speech, unable to write etc. A living hell.

 

[upsanddownsdays]

Hello everyone, I haven't posted for a while but have been reading, and commenting on other posts where I think I may have something useful to say!
My Dad has been in his EMI/dementia nursing home now for 9 months, approximately 8 years into his dementia journey we think. Interestingly, for the first 6 months, staff couldn't understand why he had been 'labelled' as challenging, because, apart from some resistance with personal care, he was fairly placid. However the last few weeks, we can safely say they are having their eyes opened!
He is regularly being just.... well.... nasty, changing in a split second with no real obvious triggers. Baring his teeth, gripping, hitting out, biting, throwing food. Almost 'picking fights' with other residents by pulling at them and so on. Most oddly, for Dad, he is using foul language, just repeating offensive words with venom (He has barely any speech normally and what there is , is largely unintelligible)

I genuinely wonder - where does behaviour *come* from when it has been entirely out of someone's character for 80 odd years? He has always been a gentleman in every sense of the word. Calm, logical, kind, quick to avoid conflict, never used bad language or shouted, refused to argue and would use humour to avoid such. And absolutely *never* used any kind of physical force against another person.

Is it that we suppress these traits? Do they exist secretly in all of us? How can such a kind, gentle and humorous man become the polar opposite?

Obviously the brain is damaged, inhibitions are gone, 'fight, flight or freeze' is present at a visceral level but even so......

It's so distressing. My lovely Dad would be so absolutely mortified and horrified

I could've written all of the above except about my mum .
I visited her today with my husband and was planning to go out for a walk . She refused to have help to go to the toilet and started shouting and swearing at the carer . I do agree that it's their way of trying to hold on to some control . She was saying stop mollycoddling me to the carer.
My husband stepped in and she calmed down . It's so horrible for her and us to see .
You come home exhausted and very down .
Is there anything to help these meltdowns does anyone know ? I just worry that if we could've found a way to care for her at home she'd not got like this . Just feel so bad she's in a place she doesn't recognise all the time with people who aren't her family .

 

[canary]

She was saying stop mollycoddling me to the carer.

She has lost insight into her own condition and does not realise that she needs help. In her mind there is nothing wrong with her, so she just wants to be left alone, which would, obviously, be a mistake although she cannot see it.

This, along with the damaged emotional control, it a massive double whammy and leads to the behaviour you have seen. There is no way to have prevented this - it is part of dementia.

 

[Chizz]

I could've written all of the above except about my mum .
I visited her today with my husband and was planning to go out for a walk . She refused to have help to go to the toilet and started shouting and swearing at the carer . I do agree that it's their way of trying to hold on to some control . She was saying stop mollycoddling me to the carer.
My husband stepped in and she calmed down . It's so horrible for her and us to see .
You come home exhausted and very down .
Is there anything to help these meltdowns does anyone know ? I just worry that if we could've found a way to care for her at home she'd not got like this . Just feel so bad she's in a place she doesn't recognise all the time with people who aren't her family .

Hi @upsanddowndays
There is no way you should feel guilt that "if only" you'd done this or that then your mum would have been different.
You did what you thought best at the time for your mum - you cannot do more than that. You cannot change the way the illness has, does and will affect your mum, and therefore how she behaves or reacts to others.
Do not beat yourself up about this.
Best wishes and a hug.

 

[upsanddownsdays]

Hi @upsanddowndays
There is no way you should feel guilt that "if only" you'd done this or that then your mum would have been different.
You did what you thought best at the time for your mum - you cannot do more than that. You cannot change the way the illness has, does and will affect your mum, and therefore how she behaves or reacts to others.
Do not beat yourself up about this.
Best wishes and a hug.

Thank you , even your reply makes me cry .
I tried so hard to keep her living in her bungalow but it got too hard . She wouldn't even let me help her change her bedding , threw me out of her house . I couldn't battle anymore . Now they are getting the abuse but you still feel the responsibility as it's your mum at the end of the day and you don't want her to suffer .
That said an hour's walk and a mince pie and all was well again !

 

[Palerider]

Hello everyone, I haven't posted for a while but have been reading, and commenting on other posts where I think I may have something useful to say!
My Dad has been in his EMI/dementia nursing home now for 9 months, approximately 8 years into his dementia journey we think. Interestingly, for the first 6 months, staff couldn't understand why he had been 'labelled' as challenging, because, apart from some resistance with personal care, he was fairly placid. However the last few weeks, we can safely say they are having their eyes opened!
He is regularly being just.... well.... nasty, changing in a split second with no real obvious triggers. Baring his teeth, gripping, hitting out, biting, throwing food. Almost 'picking fights' with other residents by pulling at them and so on. Most oddly, for Dad, he is using foul language, just repeating offensive words with venom (He has barely any speech normally and what there is , is largely unintelligible)

I genuinely wonder - where does behaviour *come* from when it has been entirely out of someone's character for 80 odd years? He has always been a gentleman in every sense of the word. Calm, logical, kind, quick to avoid conflict, never used bad language or shouted, refused to argue and would use humour to avoid such. And absolutely *never* used any kind of physical force against another person.

Is it that we suppress these traits? Do they exist secretly in all of us? How can such a kind, gentle and humorous man become the polar opposite?

Obviously the brain is damaged, inhibitions are gone, 'fight, flight or freeze' is present at a visceral level but even so......

It's so distressing. My lovely Dad would be so absolutely mortified and horrified

It is soul destroying to see someone change in the way your dad has. I honestly think we are all capable of such things but we have a complex way of developing and conditioning that prevents most of us from allowing our brains to indulge. I do believe dementia destroys a lot of what was good about a person, it destroys the many pathways that make up our conscience and stops us from having insight as well as many other positive qualities simply because the wiring that connects these things has been destroyed. It is hard to believe how fragile our brains are, but I am sure you know that already. There is nothing you can do other than try to brush off the nasty side and not take it at face value. Most importantly all we can do is the best we can in the circumstances whatever that is for each of us.

 

[MatthewB]

Hello everyone, I haven't posted for a while but have been reading, and commenting on other posts where I think I may have something useful to say!
My Dad has been in his EMI/dementia nursing home now for 9 months, approximately 8 years into his dementia journey we think. Interestingly, for the first 6 months, staff couldn't understand why he had been 'labelled' as challenging, because, apart from some resistance with personal care, he was fairly placid. However the last few weeks, we can safely say they are having their eyes opened!
He is regularly being just.... well.... nasty, changing in a split second with no real obvious triggers. Baring his teeth, gripping, hitting out, biting, throwing food. Almost 'picking fights' with other residents by pulling at them and so on. Most oddly, for Dad, he is using foul language, just repeating offensive words with venom (He has barely any speech normally and what there is , is largely unintelligible)

I genuinely wonder - where does behaviour *come* from when it has been entirely out of someone's character for 80 odd years? He has always been a gentleman in every sense of the word. Calm, logical, kind, quick to avoid conflict, never used bad language or shouted, refused to argue and would use humour to avoid such. And absolutely *never* used any kind of physical force against another person.

Is it that we suppress these traits? Do they exist secretly in all of us? How can such a kind, gentle and humorous man become the polar opposite?

Obviously the brain is damaged, inhibitions are gone, 'fight, flight or freeze' is present at a visceral level but even so......

It's so distressing. My lovely Dad would be so absolutely mortified and horrified

poor poor people. is most scare thing can be

 

[SherwoodSue]

Hello all. This is so challenging isn’t it? I wonder if different parts of the brain being damaged or remaining and firing is behind the swearing?
Do you remember the lovely film the Kings Speech. The scene where the stuttering is awful but there is fluidity in the swearing, the more profane the better the effect on the free of speech?
I once had a chat with a sweet elderly lady. She sat at her husbands bedside. He had had a massive stroke. All speech gone bar a few words. Jargon dysphasia. Sadly the words left were those he learned in the war. His poor wife. So embarrassed. The consultant explained it was all to do with the altered structure and function of the brain. He really tried to ease her distress. Not our fault or theirs.