Behavior change following stroke?

I don't know what strokes do to the brain but if the resulting behavior is horrible, then you MUST NOT ALLOW THEM TO LIVE WITH YOU - OR YOU WILL BE DESTROYED. People with nasty, abusive, horrible behavior must be placed somewhere. Ther are no if's, and's or but's - they cannot be kept home.

My Grandmother was a narcissist, I always knew she was different in that she hated any woman especially her brothers wives, her sons or my girlfriends.
She adored me my entire life until at age 91 she was prescribed Pradaxa and was immediately poisoned/overdosed?
There was no antidote to Pradaxa and she went to the ICU numerous times until her death, every month she required transfusions, she was chronically anemic due to blood loss, she endured mini strokes, she was in ICU for over a month
on at least 4 occasions, in addition to many shorter hospitalizations.
As time progressed she gradually became someone I never knew or saw, at least directed to me, I was ok with her mistreating others as long as it was not me I see in looking back. I never imagined it could be directed to me.

My Grandmother asked me to be her caregiver as we were so very close and I was an EMT in my youth and was very helpful in taking care of her health, I drove her to weekly Dr appointments and sat in on her Dr visits, I was actively managing her medications which were too many, this really pissed her off when her cough syrup was cut down, I began being the worst person imaginable according to her, she began telling everyone I called her bad names , said unspeakable things to her and would not feed her or take her shopping etc etc, everyone offered to assist her and she would refuse then contradict everything she said, so I was never informed until after she died that this was happening, however it made sense afterwards as I began noticing people acting weird to me.
My Grandfather assembled an AB family trust of $2.3 million cash through decades of saving and discipline living below his means and taking care of everything he had including his family.
My Mom turned 17 2 months before I was born, my Dad was only 19 so my Grandparents were my friends parents age and they were more parents to me than my parents.
My Grandfather was a 33rd degree Mason, my Grandmother belonged to the order of the Eastern star as were my maternal Grandparents who died years ago.
My Father and Uncle were both members of the DeMolay youth group of the Masons, my Mom was in Jobs daughters.
I never knew anything other than it was a club of rich fat cats who were not as they seemed outwardly in that they were all in positions of power and were more wealthy than it seemed they should be , they all exhibited a side of themselves that was walk the line, but keep it "legal" not that what they did was ethical, almost every transaction they were involved in became an entangled nightmare, everyone was mad or threatening physical harm and that is where I came in I see now in hindsight.in addition to being a very strong back I was security and was used to intimidate, scare, coerce, terrorize, punish, inflict damage, many persons over the decades of "deals" they made and "claims" they collected, machinery(guns, etc) sold to "buyers" in Costa Rica, I was present when $50,000 up to as much as $250,000 cash was on hand for a "deal"
or a "loan" or purchase they made, they collected cars and owned hundreds over my life, my Uncle had 75 himself at one time, he told me several times I saved his life and I have zero doubt that is true from my experience being family.
My Grandmother lost nearly $500,000 to BofA via Freddie Mac, I initiated legal action for her and she was fully reimbursed by B of A.
My Father had coerced $250,000 from her unknown to me after relocating her to his home, he died shortly afterwards & my Stepmom was keeping $179,000 of that $250,000 my Dad had, she agreed after I discussed her going to prison
(if she was lucky) her being ex officer of the court, that is $679,000 I recouped to the trust she had lost and was not going to pursue it.
A contractor got her for $12,000 and vanished, I found him on Megans list! and got her $12,000 back in 1 day, or his truck was ours I told him.
I cared for her 24-7 for 4 years & she secretly cut me out of the trust !!
forcing legal war I won.

People who were lucky enough to SURVIVE a stroke(s) are generally never the same. I know one lady who was very mean spirited to her DIL.

It could be vascular dementia and Alzheimer’s.

My mother sure has. She’s always been “ difficult “ but this has an added dimension of mean. From what I’ve read vascular dementia has a tendency toward aggressive behavior. My mother’s diagnosis is vascular dementia with behavioral disturbances. Alz and vascular dementia have different ways of presenting. The end results are the same but the voyage is different. If he hasn’t been evaluated by a neurologist, it would be a good start.

My Father had Alz and I started to notice some symptoms with memory loss and odd behavior in 2008. The behavior was mostly little things like isolating himself from social events. In 2009 he refused to come to my wedding, let alone give me away. By 2011 he made a joke that if he'd seen me on the street he wouldn't have recognized me. We both brushed it off.

In 2015 he had some TIA's and ended up in the hospital. None of the many doctors was saw mentioned the possibility of dementia or Alz. At one point during the stay, he was punching the nurses. This was totally out of character for him. After the TIA's he began to have trouble speaking, and very shortly afterwards forgot what a toilet was for.

That's when I moved both parents into my home. On the 4 plus hour trip, he claimed I was kidnapping him. Although we stopped frequently I actually had to stop and pour him a G and T to calm him down.

Once at my home he settled in, but he also became much more psychotic as well, especially at dusk when Sundowners occurred. There were days when he was walking around the house swearing and cursing. On one occasion he pulled himself and Mum to the floor on their walkers, and then went into a rage. When he wasn't in a rage, he was crying.

Eventually he ended up in a psychiatric hospital, but still even there, there was no diagnosis of Alz. Eventually in 2016 I got both parents into the Cleveland Clinic but by the time I got him there he was again in a psychotic state. There were no tests necessary since to the trained eye it was obvious (to them) what was going on. Finally a diagnosis! Thankfully they were able to adjust the meds and with their help he seemed to be more calm. With the new drugs we were able to spend some time together before he passed.

Any type of brain injury can cause behavior changes and rage. This is sometimes the hardest part of long-term recovery of brain trauma. Some people are treated with beta blockers to help with those issues. A family member of mine couldn't tolerate the beta blockers in combination with his other medication for seizure, so they went out on a limb with an unconventional approach and had a pacemaker implanted to create a similar effect and it worked.

Highs and lows with post stroke patients is common. It does not mean bipolar. Depression, crying one minute, happy the next and laughing is very common with stroke victims, depending on the area of the brain affected.

Yes, strokes, head trauma, age all affect brain function which in turn affects behavior. My mother had head trauma after surgery resulting in TBI. She has depressive and manic episodes, is occasionally delusional and sometimes has hallucinations. She has been diagnosed as manic depressive which is a logical but inaccurate diagnosis. None of these behaviors can be “fixed” but there are medications than can lessen them. I continually looked for a cure but there is none. She has been prescribed depacote and seroquel which work for the most part, but twice a year like clockwork, she has manic-type episodes that last five weeks and then she’s back to a relatively normal state for her. She lives in assisted living where the routine has been good for her and she’s happy there. I’ve lived with this for forty years and I’ve come to accept that everything than can be done is being done to manage her symptoms.

So sorry for your situation.

Sort answer, yes I think strokes can cause changes in behaviour. My own experoence I've seen halucinations with delerium or ALZ not stroke though but I'm no expert. I agree with 97yroldmum - low sodium, UTI, dehydration could cause systems like this. Also an ongoing bleed in the brain? If UTI or dehydration suspected he may need a doctor/transfer to hospital. UTIs common in older folk & behaviour so much worse but clears when UTI does.

My Mum's stroke last year has certainly caused personality changes - oh yes! Also did the mini-stroke (TIA) the previous year where she lost spacial awareness of how to hang the washing line cord. Dad didn't think too much of that until the spacial awareness also mean she kept crashing the car... Mum's damage was at the back of brain but she also has some 'emotional lability' which I think is more common if damage to frontal cortex. She can swing from happy to crying & can't stop for ages. We were given a handout from the rehab on this 'emotional lability'. Basically said be understanding - nothing you can do :(

As a volunfeer of a Stroke Survivor group for a time I met a man who looked perfectly normal, but blurted out inapproptiate things (sexual inc) & swore at random times. We accepted that but was very hard for him out in tbe world.

I hope it's just a simple UTI & things improve soon.

patience, I hope you get some good responses here and that the experts at his facility will be able to guide you well. 🙏 Hang in there.

He belongs in a Nursing Facility, Everything is Affecting his Mind, Even his Age.

It depends on which parts of the brain were affected by the strokes as to the end result. Different parts of the brain control different skills, behaviors, and thought processes. So, yes, behavior can change after a stroke - sometimes dramatically.

Multiple strokes can result in vascular dementia. That can explain the sexually oriented behavior. (I saw this with my own father.) It's also possible that he has had underlying bipolar disorder that was never diagnosed or treated.

Patience
Its good to remember that dementia can be in addition to other health problems. In other words he could have dementia AND strokes. The highs and lows sound like bipolar.

Usually doctors can try to treat symptoms even when there are no meds to *cure* dementia.

My FIL had a severe head trauma that caused hallucinations. In his case his sodium was low. After a long Hospitalization and rehab and sodium tablets his hallucinations went away. Later he had dementia but no more hallucinations. He died years later from the effects of a second fall.

UTIs can also cause hallucinations as can dehydration. Something has gone wrong in the brain or is affecting the brain. Exactly what is causing your dad’s hallucinations might be difficult to unravel or might show up on a blood test or culture.