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My mother has started being extremely nasty and belligerent with in home caregivers. Within 30 minutes she says that she doesn’t remember. Do we “chastise” her?

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Yeah....chastising them just makes them double-down and get nastier/more belligerent, in my experience.  (I learned the hard way.)  Trained caregivers should have lots of experience dealing with this, though, and sometimes have little tricks up their sleeves to work around the behaviour. It's usually harder on the family members. 

If the behaviour is upsetting the caregivers, you may need to find someone with more experience with dementia patients.
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I think this stage is heartbreaking! (And frustrating. And stressful.)


Do these outbursts happen in a pattern? Are they worse at certain times of day? With certain people? Under certain conditions, such as not getting her way, or not being understood? I wonder if there are triggers you could minimize.


Is she taking anything for generalized anxiety?


Teepa Snow has several videos on youtube where she deals with calming dementia patients who are belligerent or out of control.


Chastising her may

1) relieve some of your tension and discomfort

2) make you feel guilty later

3) upset her more

4) not do a darn thing to change future behavior.
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Usually when going into a hospital with routine blood work a UTI will be tested for. I’m not sure about frequency in a NH. But anytime there is a sudden change of behavior, an escalation of dementia type symptoms it is a good idea to check for one. Some people have them often. Some can hardly get rid of them. They can be toxic.
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97yroldmom: How often do they test for UTI'S in the hospital or nursing home? I'm new to this because my mom is just getting diagnosed in the Severe stage.
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No. You don’t chastise. However make sure you get her tested for a UTI to make sure that isn’t the problem as it could be.
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My mother gets that way when she feels like she's being pushed around ... she wants her own way and she wants OUT ... so she screeches instead of talking normally, threatens to kick people, etc. She was like that today when I went to visit her at her memory care. So I took her OUT ... to the rose garden, where we sat in the sun, watched the fountain, and listened to the birds. Then we went inside and she got involved with eating lunch. You, or caregiver, have to be calm, give the person as much of what she wants as makes sense (the smallest things help), do what calms her. I've found that it seldom helps to "chastise," when my mother is in her I Want My Way mode ... and there is definitely no purpose in trying to chastise after she's forgotten.
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