We have night home helpers (very expensive!) because the worst he does happens at night -- sundowning. He has had two people with whom he got close. One of them had a tragedy at home and had to stop working. So yesterday I was told that a new one, very nice and experienced, would be taking the 3 days the other one took. I told them he objects to strong scents and conversation unless he starts it and she was informed of this. So at about 7:30 she called me (my husband and I live a few small houses apart, thank goodness) and said he got very angry at her, told her she was wearing perfume (she wasn't) and ordered her to leave, go home immediately. I talked to him a bit and said this meant I (who right now am quite sick with some kind of stomach flu) would have to go to his house and take care of him. I calmed him down by saying that she seemed very nice and intelligent (he agreed) and if it was so bad, couldn't she go upstairs and take a shower? He began to mellow. I talked to her about the shower idea and she said she was familiar with the "invented anger object" in people with dementia. We talked over his pill schedule (he yelled in the background "NO TALKING!" About 10 minutes later I called him (partly because I was so angry myself, although I know an angry response from the spouse does NOT work) and he said cheerfully that everything was all right. I told him that lately his demands have been embarrassing to me and cruel to both me and anyone else in the picture. I asked if he still wanted her to go and he cheerfully said "No, we worked things out." (I think he had demanded that she get no closer to him than across the the room--difficult to give meds, water, and so on) and probably she said that she would take a shower with his OWN soap if he demanded it and certainly would before she comes the next day. I, still angry, said that his display when she arrived was not acceptable. He responded with what has become his standard excuse for these things: "Oh, I was just joking around with her."
We haven't been able to get a diagnosis on TYPE of dementia except for "dementia and cognitive decline" from our PCP. (He does take Seroquil at night to calm him down). Does this kind of "anger demonstration" happen with a specific type of dementia? During the day his main problem is that his short-term memory is just GONE. And does anyone have suggestions about how to deal with these little "shows"? Frequently they involve a demand to change something that either CAN'T be changed or would be hugely expensive and involve a lot of work to get in place. I'm 73 and have some chronic illnesses. Dealing with a hospital stay of 3 weeks (serious infection) that brought sundowning to the fore (I got about 5 hours at home to sleep for 3 weeks) and then trying to take care of him myself (he absolutely refuses to leave his home) drove me into a near collapse. What kind of future can I expect, does anyone know?
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I’m concerned about having the aide showering at his house. Not only is it an unusual request, it’s a vulnerable situation for her and opens a Pandora’s box of possibilities of misunderstanding. It doesn’t seem like a good idea for either party.
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How long ago was the hospitalization? At 93, following a 3 week hospital stay, did he spend any time in a rehab? Three weeks is a long time to be in a hospital. It might be too soon for an accurate diagnosis on his dementia but I’m wondering if he has been tested for a UTI? UTI’s can mimic all sorts of mental issues. You can have him diagnosed with a simple pee test at an urgent care, right now, today. Ask them to run a culture if it shows he is positive for one to make sure he gets the right antibiotic. Often he will be given an antibiotic immediately, that’s fine, but also ask for the culture just in case the one he is given doesn’t knock it out.
if it is a UTI and he gets proper treatment, he can noticeably improve.
I actually mentioned a UTI in the hospital and since; no one seems interested. I need to get our PCP (whose clinic has a lab) to run a test and a culture. This is a good idea, thanks!
You should try to speak with your husband when he is calm to let him know that if these episodes continue in which he is abusive to caregivers, that he will be unable to stay home, that he will have to move to memory care for his own safety and for the safety and health of others. If there are ANY control mechanisms remaining this may help a little, but it is overall unlikely.
I am so very sorry. You will have to wait and see, and come to some decisions. If this care causes your own health crisis you will be no good at all to your hubby; I know you know that.
I will assume here your husband has never been easy to live with hence the 2 houses. You do realize he will continue to decline and need more and more care. One day you will not be able to reason with him at all.
She may not have had perfume on but smells from soap, hand cream, hair spray and washing detergent may be very strong. You may want to tell the agency that husband is sensitive to smells period. Ask that aids coming into his home be scent free. There are laundry detergents that have no smell.
I think you should contact his doctor now and see if another medication could be tried or an adjustment in the dose.
You just never know when anger issues could become violent.
I understand that he does not want to leave his home BUT this might be a situation where for his safety and the safety of the caregivers he is in a Memory Care facility.
Your future?? His dementia will not get better, his anger will probably get worse, he may become more violent. These are just guesses but I am probably not far off.