Dad is borderline, narcissistic, and has dementia/ALZ. He's mad he's in an ALF and has outbursts about how he shouldn't be there. I'm all he has. Help!

I am having the same problem with my father. My mother and father are in assisted living. Mom has dementia and we fear father does too. Has angry outbursts curses and yells at my mother and me. Mother says she can’t take it any more. When I try to help she says she can’t leave father. He claims my husband beat him up during one of his outbursts. I was there it was a verbal altercation. My father started cursing and yelling at me and mother. Husband told him to stop several times but he didn’t. I said I would call police if he did not stop. Police say he is demented. He was trying to drive mother to doctor my husband and I said no we would drive her. Father is still driving but on meds that say not to drive and Dr said not to drive. We took keys away and other sister had a key. He called her cursing and yelling so she took him his key. Police told him not to drive father balled his fists at police. Police told him his daughter was going to drive. Father has put my husband and I on list at facility not to let us in. He told us he would kill me and my husband. Threatens suicide. Told my mother they should commit suicide together. A nurse overheard this. APS was called. No one is willing to do anything. At this point I have stepped out because I cannot continue to help and get cursed at when I do. I feel so bad for my mother because at times she wants to get away from him. Then he brainwashes her and apologizes to her and she forgives him. I feel so guilty leaving her with him but she does not want to leave him. I now have anxiety attacks and am completely hurt and miserable.

Expanding a little on what Countrymouse was suggesting. Maybe agree with him, "side" with him on trying to get him back to IL "the other place" and strategize that one of the best ways to do that is to "prove" he belongs there by cooperating and not complaining. Make it a challenge or game of sorts for him and then of course you will likely have to constantly remind him but maybe after having a meeting of the minds with him on it reminding him each time his behavior could be seen by "them" as proof he can't be on his own or something to that affect. He may not have enough self control or reasoning for this to work but maybe it's worth a try. Even if it just creates a good way to redirect his fire when it's aimed at you it would be worth it and the fact that your giving him back the perception of power "I agree, your right" might help.

Can he have something for the anxiety? A lot of people are very confused as to how they wound up in some strange place. And in my experience, people just get MORE the way they already are. He's probably always been kind of diffcult to deal with, as he ages, it's harder as he doesn't connect the dots anymore.

Talk with his psych doc, See if he can't be given something to help ratchet down the anger and anxiety.

And visit as often/little as you feel you can handle it.

The professionals understand that his talk comes from his disease(s) and it's not personal. They do not take it to heart the way that you do because he's your father and you are sad for him. There is nothing you can do to change the course of his illness(es).

Leaving packages for him instead of visiting him is a great idea. Perhaps put a short and loving note in there for him to read.

Bragging rights are important to those living in independent living, assisted living, and even memory care. Showing off cards or family pictures that you send to him may help him feel important. It's also a great conversation starter for the staff.

Whoops, replied to another person -- but your sitch reminds me how much the illness focuses the bad parts of what they were before and just cuts out the good things he's done. There's no way around it, it's just plain awful. Might a visit every other week be best for both of you? I certainly agree that dialoguing lengthily with him via phone doesn't work, but calling him first to say your visit is soon and does he want anything, etc., and then cutting the talk short if he blasts, might be an option.

Oof. Difficult.

His talking about how important a person he is, and how essential it is that everybody should recognise this and return him at once to his former status: as long as it's just talk, it's probably best and safest simply to go along with it while doing nothing. Yes, absolutely, you're completely right, we'll have to find out what we do about it, blah blah blah. Reprise.

Don't argue, don't contradict, don't try to persuade. You cannot change his mind, which is sad, because he can't accept his position if he doesn't understand it; but on the other hand you don't need to change his mind to achieve the aim, which is to have him safe and comfortable in an appropriate care setting. Which you've already done.

I think you should stay away if it helps you. I'm not sure it will make any difference to him, or to his responses to you; I don't think anything you do that relies on his connecting cause and effect will work, because he can't follow that kind of rational process (and never was inclined to even when he could, unless it suited him). But that's fine. He is fine, or at least as fine as he is going to be. You are confident that his care is very good. Isn't that quite a lot to have accomplished?

You're not still wishing for the kind of father who respects your opinion and appreciates all you do for him, are you?

Does he take medication to help his mood and agitation? That helped my LO quite a bit. Whoever is the Healthcare POA, might explore it with his doctor. You might also consult with the AL staff to see if there is a pattern of his agitation. If he only happens after your visits, then, I'd likely postpone the visits, until his behavior changes. Normally, with dementia, the behavior will change as they progress. And, the meds might help as well.

If you do visit, I'd practice scenarios of how things will go. So, have planned topics to discuss, quick responses on hand and do not let him steer the conversation. If he shouts an order, you respond, "Why not try these awesome new jelly beans we brought?" If he makes demands, you say, "Do you want to go for a stroll through the courtyard? It's a nice day." I'd learn how to deflect and redirect. It might seem disrespectful, but, its for their own benefit.

If he won't comply, then, I'd leave abruptly with a smile. And, if he upsets you a lot, then, I would just call or send cards and care packages. Don't be so hard on yourself. No one deserves that kind of verbal insults. Also, I would give up on any more rational conversations. With the dementia the brain really robs the patient of that.

How long has he been in this phase?

You can relieve some of the pressure by making up little parcels for him and leaving them with the staff, perhaps.

The anger is very difficult. He IS angry, so that no matter what techniques you use, once he remembers he's angry he's going to express it. I don't think it benefits anyone, not you nor him nor the staff, to risk the triggers.

You're happy with how he's doing there otherwise, yes?

Look. You ARE there for him. Here you are, caring away on this forum, worrying about him, wishing for his good. It isn't your fault that direct contact with him, at least for now, is just not working.

Unless you get better ideas and advice, I think if I were you I'd just wait and hope that this extreme mood will burn itself out. Are you getting input from psych specialists?

Yes, same here, I feel that my visits to mom's NH are a triggers of her anxiety, but in the same time I understand that I need to be there for her.