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taimedowne Asked January 3, 2024

Solution for mom-in-law getting physically abusive.

My mom-in-law (diagnosed with Alzheimer's) has started this new trend over the past two months where she is getting physically abusive with her caregivers. She hit one of them on two separate occasions when she didn't get her way. She didn't hit very hard and no one was hurt, thank goodness, but she did hit her. The caregiver even offered to keep coming back but we decided maybe that caregiver had run her course. We don't need an assault charge or lawsuit cropping up later.


 


We took her to the doctor to get evaluated because the caregiver said based on previous experience it might be a UTI (we have dealt with these before), but she is physically fine. We just assumed that the caregiver was getting on her nerves and she just needed another one.


 


With the holidays we haven't been able to find another one so we have just been taking care of her ourselves. She lives on her own, but we visit every day. She has been acting normal, better than usual in fact.


 


Today my wife went to visit and take her mom to lunch. When they got back home her mom's mood got sour and she said she wanted to take a nap. That is usually the sign that her mom is in a foul mood and it is time to go so my wife started gathering up her stuff to leave.


 


Her mom told her that she was missing the charger to her phone and wanted to go look in the car for it. She hadn't taken her charger with her. It's not a mobile charger, but the kind you plug into a wall. My wife assured her it wasn't in the car but her mom insisted that my wife must have taken it and wanted to search the car.


 


There's a bunch of stuff in the car at the moment and it is really cluttered and my wife didn't want her mom to go rummaging through all of it so she refused to let her look and told her she would help her look tomorrow. When my wife started to get into the car to leave her mom grabbed her by the wrist and told her she wasn't leaving until she searched the car. My wife says she grabbed her really really hard and it scared her. My wife was embarrassed that someone might see and started to move away from the car and to the backyard and her mom grabbed her other wrist and was twisting it. She said she couldn't break free and the more she struggled the harder her mom held her. She said her mom had this crazy look in her eyes and she really felt scared. Her mom has never done anything like this before. She finally cried out "Mom, you are hurting me!" and her mom let go. She raced to her car and called me from down the block in tears.


 


This is new behavior for mom-in-law and it has us concerned. Will she do this with the new caregiver? Are we exposing her to liabilities? A lot of AL and MC won't accept violent patients. We don't want her to get that reputation. What if the caregiver calls the police or something like that?


 


I know that when my wife's grandmother got really abusive they put her on antipsychotics and they basically made her a vegetable. It also meant leaving her own home and going into psych care so that her medications could be managed. I am not sure we are there quite yet, but my wife is very upset that her mom would do that to her but also that this could be the beginning of a new undesirable behavior which leads to her mom in an institution.


 


What do we do now? Do we take her back to the psychiatrist? This is the third incident now in about 6 weeks. There had never been any violence prior although she has had episodes where for lack of a better word she looked "crazy" when she got really mad.


 


Not enjoying this New Year's development. Advice appreciated.

Grandma1954 Jan 3, 2024
MIL should not be living alone.
There are medications that can help with the anxiety and agitation.
One of the "problems" that go with the dementia is that she is going to lose the ability to tell someone that she is angry, frustrated, upset. Just like a toddler when they get overwhelmed the first thing is to vent that frustration and it may come as a hit, slap, throwing a cup or glass or whatever is handy. (I am not saying this is an excuse it is just the first way to express when you can't use words)
Start looking for a Memory Care facility.
but discuss the outbursts with her doctor these need to be curtailed ASAP

Fawnby Jan 3, 2024
It's very clear that MIL has crossed a line - the one where she could hurt someone seriously. She needs to be placed where she has 24/7 care by professionals who know how to deal with it. A change in her meds is called for as well, so you need to talk with her doctors and find out what they recommend. There are probably a few choices, and they'll likely start out conservatively to find out what meds create the most desirable behaviors. Get over the "like a vegetable" thoughts. There are many meds to choose from now. Doctors are less eager than you are to turn MIL into a piece of broccoli.

Important: Do not leave MIL alone at all. For safety's sake, do not allow her to be with only one other person, for instance your wife. At least two people need to be present at all times in case MIL gets freaked out and attacks. In that situation, the extra person is not only a witness to the incident but can call 911 for help. Do not think this is casual advice. It's critical.

Never underestimate a person with dementia. They can do really bad things.

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lealonnie1 Jan 3, 2024
Please wake up and realize that MIL has advanced dementia now, needs to be on medication to stop this violent aggression w/o making her a "vegetable", and placed in a Memory Care Assisted Living facility once she's calm enough. Dismiss your preconceived notions of "institutions" and psychiatric hospitals where shock treatments are administered to poor unsuspecting victims. Your MIL has dementia. Along with millions of other elders in the world today, including my late mother. It's nothing to hide from or shush up, either. Or close the curtains behind, but a fact of life to learn about and understand.


I suggest you pick up a copy of Understanding the Dementia Experience by Jennifer Ghent-Fuller on Amazon.

https://a.co/d/hgptqxO

Knowledge is power.

Best of luck to you.

JoAnn29 Jan 3, 2024
You MIL has ALZ. She should never be alone. When she wanted to search the car, she should have been allowed to. You don't try to reason with someone who has lost the ability. She is now being aggressive. Not a good thing and she needs to be medicated. If you and wife can't care for her 24/7 then you need to find her a Memory care. She will not get better, she will continue to decline. In these circumstances, there is no "we want to keep Mom in her home". Mom is no longer capable of caring for herself.

AlvaDeer Jan 3, 2024
Ummmmmmmmmmmmmmm
With all you told us do you actually think that your mother would agree to go to a PSYCHIATRIST?
Because if so, then YES YES YES.

Also back to her MD to say she needs a "full workup from neuro-psyc " to assess if she is competent to live alone.

Without any history of psychiatric problems and without a UTI this is certain a bit puzzling. You have a woman here competent to live her life on her own complete with CELLPHONE, and yet one who is suddenly behaving with violence. There is no way to know whether this is mental illness or dementia, but whichever it is, there should be no more hiring of caretakers and there should be no more visiting alone without medical diagnosis.

I am so sorry. Don't quite know where to go with this, because you are correct that no care facility will want a resident in this condition without GOOD medication. Better a vegetable, as you call it, than a violent felon who does injury to innocents.
But let's don't go there until steps are taken to find out what's going on here.

I think you may know more if you and family sit down with mother, and DISCUSS honesty what you just told us, and see what her reaction is. I hope you will update us. I can't imagine this on my plate. I am so sorry.

Scampie1 Jan 3, 2024
Time for MIL to get re-evaluated and into Memory Care asap. I had a client who was very combative. The agency was not honest about the client's behavior. Most of us are not trained to handle violent clients. I was washing clothes for the client and had just dropped a load in a dryer that was broken. So, it took a couple of cycles before the clothes were dry. This person had been yelling and screaming at me all day for some reason or the other and doing laundry was a respite from her verbally abusive behavior. She kept turning out the lights in the basement, and I couldn't see where I was going. I got to the top of the stairs and she blocked me with her walker telling me that if I touched her she was going to call and report elder abuse. When she moved out of the way, I clocked out, went home and called the agency. I told them that I would not be returning to this client because she was a danger to any home health aide and herself. Of course, they were angry. So, I didn't get called for any clients after that which I didn't care at this point. I did get calls from the coordinator when this woman would chase the other aides off the premises. Her doctor just kept writing prescriptions for Tylenol with codeine. Nothing was being done about her state of mind, and the agency didn't do any follow up about her care. With Medicare and Medicaid, it is state and federally mandated to report changes in the client's mental and physical status. With home care, I don't think there is any type of follow up with them at all.

KNance72 Jan 3, 2024
What happens is they get paranoid and by you Not letting her search your car she got mad . This is Not uncommon . My Dad tried blaming the neighbor for His stuff Missing . Then when the neighbor Moved he hid everything .When my sister showed up the Blame was Placed on me . I can't tell you how Much stuff he lost everyday and I would have to find it - because I did Not Know he had dementia I got Physically exhausted playing these games . It was one thing after another - OCD behavior , Manic behavior , Paranoia . He was pretty good till he got some Manic episodes . The doctors dismissed me Often and told me " To have him fold laundry. " Often times he did great on His cognitive tests and some days were Much better than others . He eventually had a stroke and for over a year I kept him in a schedule and had help coming Into bathe and do Light house keeping But I was with him 24/ 7 . So Its a toss up - Do you want to move in with her or Place her in assisted living ?

BurntCaregiver Jan 3, 2024
As a caregiver myself with 25 years experience in homecare and the owner of a homecare agency, I stopped reading after, "She lives on her own, but we visit every day". This is where your post should have ended. Then you should have picked up the phone spent the day calling care facilities to see if they have any availability for her.

People so often don't realize that ther are limits to what homecare can provide.

If your MIL is hitting and getting violent she belongs in a memory care facility that is locked and fully-staffed 24/7. It is wrong and unsafe for you and your family to allow some poor aide (probably making minimum wage) to provide for the care needs of a person with advanced aggressive dementia.

Yes, your MIL has advanced dementia. When the hitting and violence starts that is not grandma is a little forgetful and needs a bit of help around the house. She is not safe in her own home anymore and neither are her homecare workers.

Many times over the years I have been put into dangerous and unsafe situations by homecare agencies. I took an injury one time from a client early on in this work. Only one time because after that I did not have a problem hitting back or pulling out the pepper spray if needs be. It makes no difference to me if the person has dementia, mental illness, special needs, you name it.

Don't put the homecare workers, yourselves, or your MIL in a dangerous situation where someone is going to get hurt. She needs to be placed in the appropriate care facility to meet her needs.

I will tell you something else, and this too comes from 25 years doing this line of work. My safety always came first before the client or their needs. This is what I tell all my aides every day. Their safety is more important than the client or their needs. If a client gets aggressive they are dropped from our service because no worker should ever be put at risk.

Find a memory care facility and go on a few tours.
strugglinson Jan 3, 2024
Hi BurntCaregiver,
thanks for this perspective .
how about yelling and essentially verbal abuse to the agency Caregivers ?
a couple months ago when I was considering the idea of my dad going back home , an agency approved it and was willing to send caregivers. We did not try it out. Part of my fear was that my dad will yell at caregivers I’m sure , and send some home , if they do not leave themselves and ask to not be assigned to him any more . How much yelling would caregivers take ?
im curious to this . The more solid arguments I have against home caregivers the better for me. I would like to be able to flat out say to him and family “he’s not able to be managed at home with home agency caregivers , period “. In hindsight I wished the agency had flat out refused him 2 months ago. Of course , their manager saw him for just 30 mins when he was on his best behavior . I’m pretty sure within a few days of care, yelling and sending people home would have started .
anyway, for now I’m sticking to my general statement of “you need assisted living , cannot go home “
BarbBrooklyn Jan 3, 2024
MeDolly, so interesting what you say about neuro/psych in terms of usefulness in dealing with dementia and meds.

Where I live, the neurologists invariably defer to psychiatrists when it comes to prescribing behavioral meds for dementia patients. It may be a local thing.
waytomisery Jan 3, 2024
By me too. Maybe it’s a North East thing .
MeDolly Jan 3, 2024
She needs to be placed somewhere with 24/7 licensed care. By hiring caregivers you are opening yourself up to the possibility of being sued.

Those with dementia can be dangerous, very dangerous, remove all objects that could be used as a weapon. A neighbor of mine whose husband had dementia and was violent, attacked her with a knife it was not pretty.

Everyone, including his doctor said he should have been placed long before this incident. She was a weak person, he was the ruler of the home and he wanted to stay home.

Long story short, he was placed in MC, then in a physic ward where he died. She, well she developed lung cancer, the doctors thought it was because of her many chest wounds inflicted by him two years before.

A psychiatrist won't be of much help when it comes to dementia, a neurologist one that is trained to deal with dementia patients.

In the meantime, when she does it again, call 911 have her taken to the ER and have her evaluated.

Start doing your homework, looking at facilities, exploring your options. She will get worse, that is the bottom line.

Sending support your way.
BurntCaregiver Jan 3, 2024
Well said, MeDolly. I agree.
MACinCT Jan 3, 2024
5his is going to get worse. Start removing any weapons and sharp objects. Obviously her strength CAN hurt someone. MIL did an assualt. To fix a problem that will become chronic. Your wife had every right to call 911 to take MIL to the ER. From there she could have said that MIL was a danger to others. Next time, make that neuro appointment but do not wait if it happens again. Start Journaling the incidents. Call 911 if it happens before and request a 72 hour hold to assess and treat. Look up the term Baker Act.
My experience with violence by dementia was when my cousin was a victim of murder suicide. Her partner still had guns.

waytomisery Jan 3, 2024
In addition to needing a new med , I do not think it’s safe for her to live alone anymore. Sounds as if her Alz has progressed and would need 24/7 supervision in a facility . If you are able to get her in one , the sooner the better for her to adjust . Paying for 24/7 care at home is very expensive . Do not use any of your own funds. The mother’s house can be sold to pay for a facility . Does anyone have POA ? Good luck .

Beatty Jan 3, 2024
When I saw my LO hitting out in anger, it shocked me. This was new behaviour, was discussed with the Doctor, medication prescribed. Don't know what type, but something to 'smooth' a little. Now calmer & happier. Able to bear dissappointments much better. I had always leaned a little away from medications but if a few pills help keep everyone safe, I am for it.
I consider myself converted.

Geaton777 Jan 3, 2024
I don't think she needs a psychiatrist... she needs a neurologist who is experienced in treating dementia patients. That kind of physical aggression isn't uncommon in dementia and there are medication solutions. It may take a while to adjust meds so that she isn't a "vegetable" like your Grandmother. Hopefully your MIL will cooperate in taking meds. If she doesn't... well, she may need to spend some time in a psych ward until they can get her to accept medication.

BarbBrooklyn Jan 3, 2024
I don't know when gma was on antipsychotics, but I know several folks currently on Seroquel and they are fully functional human beings. Not vegetables. Psychiatric meds have come a long way in the last years.

Do you know what kind of dementia mil is diagnosed with?

Heading back to the psychiatrist is the first step, I think.

strugglinson Jan 3, 2024
Oh no, sorry to hear about all this.
I suspect this is going to just get tougher with trying to find at-home caregivers.
You may want to consider quickly getting her into AL or MC as soon as possible. Then , they will be better prepared to deal with situations and advise on whats needed. Its a more secure environment.

I'm not sure if you are getting home caregivers privately or via an agency. Either way, that could become dicey, with caregivers quitting quite easily.

Of course , any medical help on the issue would be good too.

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