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Meisha91 Asked October 2019

Dementia causing disruptive and hurtful behavior. How do you handle this?

Hello! My grandma is 92,and honestly in overall good health! As long as I can remember she has always been a bit paranoid, and accusatory, but the episodes were few and far between. Over the last few years she has started to accuse my dad of cutting up her clothes, stealing, breaking things, and trying to frame her. For a while she was having hallucinations associated with smell, but that has calmed down now that she has a diffuser. My dad who is also in a geriatric population (upper 60s) is retired and getting the brunt of the accusations. She has started to tell others outside the home that he is harming her, and tormenting her. My parents are very frustrated because my grandmother refuses to go to the doctor or even entertain the idea of mental health. I’m not sure how to help my parents, I want them to have a fun and relaxed retirement, but I can see my grandmas behavior is really affecting them and their marriage. Has anyone dealt with this? If so how did you handle it?

97yroldmom Oct 2019
Hi Meisha,
is your GM your dad’s mom or his MIL? I’m sorry your family is dealing with this. I know it’s tough.
A few standard things to suggest.
Read the book “Being Mortal, Medication and What Matters in the End” by Atul Gawande.

Check out Teepa Snow on YouTube and her website. Think “horse whisperer” for elders with dementia.

Read about confabulation.
Here is a link from agingcare with some advice from Teepa Snow.
https://www.agingcare.com/articles/communicating-with-dementia-patients-150914.htm

Use the search here on Agingcare and put in the word “lying”. You will see many posters like yourself who are dealing with this.

https://www.agingcare.com/search?term=Lying

Your parents might decide that they need to get their affairs in order by going to a certified elder attorney well versed in Medicaid. Not that they need Medicaid but just to not make mistakes that could be costly for their future health care. They could at the same time learn what they need to do to prepare legally for this journey of caring for your GM. Even though she is healthy now, all her parts are very old. One accident. One fall can change everything literally overnight. So rather than push the doctor, encourage your parents to get their own legal documents such as their will, POA etc in order and make sure GMs is as well. She might be willing to go along if she sees the younger generation taking care of this paperwork.

Anytime she “acts out” especially bad, suspect a UTI as they can cause accelerated dementia like symptoms in the elderly. You can buy a pee test at the drug store or take her to an urgent care to get this test. It takes an antibiotic to clear up and a culture to tell which antibiotic. They don’t always have symptoms of burning etc. just the acting out.

There is no proof that dementia meds help but it’s believed that some can slow symptoms. I take my aunt (93 with dementia) to a geriatric doctor once a year. She’s been on memory meds for several years.

She went through a short time of confabulation. Now she just says “I don’t know”. With dementia, the personality changes as the disease progresses.

Even though you know the person is ill, it can still be very painful to deal with. Warn your dad about burnout. It’s hard to come back from. Give dad extra hugs, encourage him to get out for walks and to sleep and eat well.

GM should take care of her personal needs and when she can’t it is time to look for help for your parents and for GM to pay for it. Every little bit helps.
Be sure to familiarize yourself with IADLs and ADLs. Activities for Daily Living. You might be surprised how dependent your GM really is.

I hope some of these suggestions help. Sorry for the information dump. Your parents are lucky to have you looking out for them. I could not do what your parents are doing. I suffer from burnout just from managing care. When you live with the parent it is so much harder.
Make sure your parents take vacations, have date nights etc without GM. Let us know how it’s going. Hugs

Isthisrealyreal Oct 2019
I think that your parents should find out if her insurance company will send a doctor to the house.

She is no longer the adult in the room and what she wants has become secondary to what she needs.

My grandma beat up 6 nurses because she thought they stole her teeth. It is an awful disease and steals our loved one while leaving a fairly healthy, strong body that has animal instincts without human reasoning. Scary and sad.

I would encourage your parents to think about a memory care facility before this situation costs them their own health amongst other things, like their marriage.
lealonnie1 Oct 2019
"Leaving a fairly healthy, strong body that has animal instincts without human reasoning." VERY well put, Realyreal. It is VERY scary and sad, you are right. I see my mother now as ONLY concerned with herself, with no thought whatsoever as to what someone else may be going through. How her fellow residents are bothering HER, but no thought to what THEY are going through themselves. She's all agitated and yelling and carrying on, and there's no reasoning with her or calming her down. So I say 'goodbye' and hang up the phone. That's what's left; just the animal instincts w/o the human reasoning.

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lealonnie1 Oct 2019
Meisha, unfortunately, there isn't always medication that can help with issues like your grandma is having. My mother is 92 also, with moderate dementia, and has issues with agitation and paranoia, etc. Her doc does not prescribe anything for her, because meds like Xanax can lead to falls and even MORE confusion than they're already experiencing. So, your grandma not going to the doctor may not be as big a deal as you think. Of course, something may happen when she has no other choice BUT to go the doctor or the hospital, and that's when the dementia is diagnosed and dealt with, frequently.
Best of luck!

Katiekate Oct 2019
You should start looking into a memory care facility. It is sad to see our parents disappear before our eyes, but that is what is happening. There is no one to blame, the dementia is not the fault of the victim.

but, also understand that this is not going to improve. Very often Alzheimer’s ends with violence. My close friend tried to keep her Dad at home, until one night he tried to stab her. He was trying to protect himself from her!!! Thought she was coming into his room to kill him, when all she was really doing was the final evening check on him. He was so sure she was a danger to him that he took a knife and hide it in his room.

Just try to remember, the grandma you knew...the Mom your Dad knew very often isn’t there any more.

AlvaDeer Oct 2019
This is very common. We spend our lives trying to "defend our goods". It's what we do. Try to stay safe. Then we go into dementia, and TRUST ME, my bro is so overall "well", but the invasion of his space disturbs him big time, and it tends to go into a paranoia of people trying to get his "stuff". This is the way of it. We are not an especially pleasant animal overall. Sorry. That's what I think. And when we descend into illness it is our more unpleasant tendencies that seem to come to the fore. I will just say--I could just say--it's the disease. It is. And it is US, and how we are. Sorry you are going through this, but it is not in the slightest unusual. Join the club.

lealonnie1 Oct 2019
Continued:
7. Keep duplicates of frequently misplaced items
If you notice a pattern where your older adult frequently hides and then loses a certain item, consider buying multiples of that item.
For example, if they’re constantly misplacing their wallet, buy another of the same style so you can offer to help them “find” it.
 
8. Seek support and advice from people who understand
Being accused of stealing, abuse, or other terrible things can be devastating. Even if you can hide your true feelings to avoid further upsetting your older adult, it still hurts inside.
To help you cope, join a caregiver support group – either in person or online. You’ll be surprised and relieved to learn that many other people have been accused of similar untrue things. It truly helps to know you’re not the only one it’s happening to.
 
******************
Best of luck!

lealonnie1 Oct 2019
Here is an article I found when Googling your dilemma:

8 WAYS TO DEAL WITH FALSE DEMENTIA ACCUSATIONS
Seniors with dementia falsely accuse family of terrible things
“You stole my wallet and all my money!”
“You’re keeping me prisoner in my house!”
“You’re trying to poison me!”
Seniors with Alzheimer’s or dementia commonly accuse the people closest to them of theft, mistreatment, or other terrible things. While cases of true abuse do exist, oftentimes these accusations are completely untrue and are caused by delusions – strong beliefs in things that aren’t real.
It’s important to remember that your older adult isn’t creating these delusions to hurt you. Their brains are failing and the delusions and paranoia are symptoms of the disease.
We explain why this happens and share 8 ways to calm the situation and kindly deal with these dementia accusations.
 
Why seniors with dementia make false dementia accusations
Their accusations may sound crazy, but the situation is very real to your older adult. Their minds are trying to make sense of the world while their cognitive abilities are declining.
People with dementia often feel anxiety, frustration, and a sense of loss. Those feelings, plus memory loss and confusion, can easily lead to paranoia. That’s why many seniors with dementia feel like people are stealing from them or mistreating them.
When they can’t find something they’ve misplaced, their brain leads them to believe that someone stole from them. When you prevent them from wandering and getting lost, they think they’re being kept prisoner.
These dementia accusations can be extremely hurtful to hear, but it’s important to remember that they’re not personal attacks against you. Their brain can’t make sense of what’s happening and has created an alternate version of reality to compensate.
 
8 ways to deal with false dementia accusations
1. Don’t take it personally
Remember that your older adult is only making these accusations because of their declining cognitive abilities. They’re trying to make sense of their reality as best they can.
Do your best to stay calm and not to take these accusations personally. Focus on reassuring them and showing that you care about how they’re feeling.
 
2. Don’t argue or use logic to convince
It’s important not to argue or use logic to convince someone with dementia that they’re wrong. You simply can’t win an argument with someone whose brain no longer processes logic properly. And arguing will only make them upset and more insistent.
Instead, let them express their ideas, feelings, and opinions. It will be easier to calm and distract them if they feel heard and validated.
 
3. Use a calm, soothing tone and positive body language
When responding to someone who is worked up over something they strongly believe, it’s essential to stay calm.
Bring the adrenaline level of the situation down by speaking in a gentle, calm tone of voice. You may also want to try reassuring them in non-verbal ways like a gentle touch or hug.
4. Create a calm environment
Creating a calm environment is another way to reduce the tension in the situation.
Reduce noise and commotion by turning off the TV, asking other people to leave the room, or playing slow songs or classical music at a low volume. Aromatherapy is another way to create a soothing environment.
5. Stick to simple answers
When you respond to their accusations, keep your responses short and simple. Long explanations or reasoning may be overwhelming and cause more agitation and confusion.

6. Distract with a pleasant activity
The best way to stop them from obsessing about their accusation is to validate, then distract. Switch to a fun, engaging, or satisfying activity as soon as possible after sympathizing with how they feel.

Maybe it’s a good time to offer a favorite snack or drink. Or you could ask for help with a no-fail task they enjoy, like folding “laundry” (aka lots of hand towels).

Continued
Meisha91 Oct 2019
Thank for this! We have been implementing some of this, and will try to implement the rest of the items on this list. It is just so hard because she clearly needs medication but is refusing to go to the doctor.

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