Dad with dementia fights everything and everybody. What's wrong with him?

Dementia is a cruel disease. Sometimes a person keeps their personality, but fades away. Other times the personality changes completely. Most likely it depends on which parts of the brain are affected. I know there is little that we can do but watch and hope that our loved one finds some peace as the disease progresses. I understand the need to sedate your father to keep him from harming himself or other people around him, but I know it is hard for you. There is nothing easy about this disease. My thoughts are with you and your father, childofvet.

My dad used to be very kind and easygoing most of the time. He could get very angry sometimes, but most of the time he was nice. Many people thought so. He has always been very impatient about somethings, and when he wants something, he wants it right then and there and doesn't want to wait. And no one could ever tell him what to do. Other than that, he was nice. His personality has really changed and he can often times be very difficult. In fact, all the nursing homes that he has been in have said he is one of the most difficult patients. It is his dementia.

whoops...I meant "severe" and not "severed" - lol! It has been a long day.

Thank you everyone for your helpful answers and insight. Actually, I was told to day that my father's dementia is severed. He is going to receive hospice care in the nursing home (he's already a resident there). He cannot walk, but he didn't seem to grasp that the times that he tried to get out of bed. Actually, he was able to get out sometimes, BUT he always ended up on the floor. The different homes that he has been in put mats down on the floor beside his bed to help cushion his fall - and the beds are very low so he would not have such a long way to fall. The finally put him in a bed with handrails, and the nurse made the comment that it "took an act of congress" to get that. This time a year ago my dad was still walking and able to have conversations with people (you had to scream at him because he is very hard of hearing and always refused to wear his hearing aids). He had BOTH legs this time last year, and he walked by pushing his wheelchair in front of him. Actually, he kind of shuffled, but he was still walking and able to find his away around the assisted living home that he used to live in. He never got lost there and always knew what times meals were (very important to him). Then he broke his hip (June of last year), and it has been all downhill after that. Apparently he had a minor stroke after breaking his hip. His dementia really became very apparent. I mean really. Then he had to have his leg amputated (circulation problems). And now he is in hospice. Hard to believe.

As if being a caregiver weren't difficult enough now you have the issue of how best to manage your dad while he's in skilled care. I don't know if I wrote this before but just because our parents go into skilled care does not mean our job as caregiver is done. Far from it! Once, my dad went into physical rehab for 2 weeks and I did indeed skip around the house, drunk on the respite. But once my dad became a resident of a facility there was nothing to skip about. The job of caregiving shifts but doesn't end. And once in the facility the family has nurses, social workers, Dr.'s, business personel and God-only-knows who else to contend with. On top of figuring out how to pay for it and going through that hell known as the Medicaid process.

If your dad tries to hop around on one leg I would imagine he is a handful and I don't know about you but when my dad was in skilled care I never saw this ghost of a Dr. I heard about, much less ever talked to him. Is your dad eligible for hospice, childofvet? If he is I would highly recommend it. Our idiotic Dr. at the nursing home refused my father hospice and only approved it when my dad was circling the drain and was way past the point of being able to appreciate everything hospice had to offer. It might be worth inquiring about. Our hospice people were amazing. There was little they could do for my dad (although they made damn sure he was on the appropriate medication at the appropriate dosage for his situation, something the staff at the facility cared little about) but they did monitor him and send out aides who would trim and shape my dad's beloved beard. My dad was barely conscious at this point. The hospice nurses came by often and advocated on our behalf with the facility which was such a burden that was lifted. In a nursing home our parents are just one among many but in a hospice situation our folks are the only patient. I don't know how I would have gotten through the last couple of weeks of my dad's life without hospice.

Doped up or agitated are not good choices, I agree. How committed is his Dr. to working on this? There has to be a medium.....there IS a middle ground, the Dr. just has to be committed enough to want to find it.

When my dad lived with me I thought about him every second of the day. He was my #1 priority. When he had to go into skilled care that didn't change. I worried about him constantly, worked like a dog to get him what he needed, visited him all the time, and when I wasn't visiting him I was on the phone taking care of his business or advocating on his behalf at the facility. The caregiving certainly does not end and I think I know how you're feeling. We still have to take care of them whether they're with us or not. And it's stressful and exhausting.

Thank you. I appreciate your insight. And yes, he is in a skilled nursing facility, and they do already give him meds to keep him calm. It is a no-win situation often times. Either he's doped up or he is agitated. He has been called "difficult" by caregivers and indeed he is. The last time he was in the hospital (about three months ago), he had to have a sitter sitting beside him because he would often try to get out of bed - on his one leg. He is very spry for a man in his condition (with all of his ailments).

I'm sure this is very upsetting for you. This is the not the dad your grew up with, not the dad you knew. And the physical outbursts are definitely scary for you.

I'm going to go out on a limb and blame it on the dementia. Dementia is progressive and people with dementia are often combative. I work in home healthcare and I've been socked in the chin a few times myself. But it was easy for me to not take it too personally. For you it's very personal. And you've learned one thing: Dad will pipe down when your husband is around. That's good to know.

Is dad in a skilled nursing facility now? Can you request that he be given the anti-anxiety medication (or whatever kind of med he was on) more regularly? I know how difficult it is to get things accomplished when a loved one is in skilled care but once it goes through the Dr. and let's say the Dr. okays it, you can call and check that your dad is getting the medication.

Is he losing his mind? Yes. That's dementia. Just because he knows your name doesn't mean that his dementia isn't progressing. My dad knew my name but he also told me that there were people trying to kill him and they had guns and knives. That he still knew my name meant little to me.

At this point all that can be done is getting the combative behavior under control. Even though he has dementia, your dad can't be happy feeling combative a lot of the time. You can't reason with him anymore. What you're left with is medication. You have to be your dad's advocate right now. It's up to you to see that he gets what he needs because he can't express what he needs anymore. This is your job. I had to do the same thing with my dad while he was in skilled care and it was like a full-time job that made ME crazy and caused me to lose almost 30 lbs from stress (it was 20 lbs but I keep losing).

But now it sounds like, if you want to communicate or just 'be' with your dad you're going to have to crawl into his dementia because he's unable to be with you in your world anymore. Don't fight it. Try to get it managed with medication and be with your dad wherever he lives now mentally, if that makes sense.

For an elderly man who seldom eats much (he is on a puree diet, too) and who is now thin from having lost a lot of weight, he is quite strong. His grabbing me and pulling me towards him and not letting go of my arm when I told him to and tried to pull away has me alarmed. He was never this way before. For a moment I felt like some angry caged animal had grabbed me and was pulling me towards it. Scary. He had such a angry look in his eyes. He is often like this, but this is by far the most aggressive I have ever seen him. We have always been very close, so this is upsetting to me. He is angry all the time, but cannot express himself very well at all because of his dementia.