So, some background: We do have a caregiver that comes in between 8:30am and 1:30pm then returns from 4:30pm to 8:30pm. We are actively looking for someone to come in from 1:00 to 9:00pm and cover the evening better. We also have cameras, door chimes and pressure floor mats all through the house to assure we can view things as they take place. My mother refuses to place my father in a care facility up until 3 weeks ago this was okay. We managed. Now as my father is getting worse and the dementia progresses we are seeing he is more agitated, fidgety, anxious and meaner. We are seeing more signs of aggression now as well. My father is not the man he was even 3 weeks ago. This is progressing faster than we expected and were honestly ready for but here we are.
So FINALLY (right?) my question. We want to keep my mom protected from being hurt. Has anyone had an experience like this where the parents want to stay together but one of them is getting more aggressive in his daily life. We don't know if we are missing something, again a nursing or specialized care center is not an option. What else can we do? Any suggestions are welcome at this point.
As Alva mentioned, you don’t have to be murdered to be harmed physically.
OP please consider that in order to keep your mother and father safe, this situation has to change.
Your father belongs in memory care now. There are places where a couple can stay together when one needs skilled or memory care but the other is still independent. How they work is there's independent senior living in one area of the facility where a person can come and go as they please, and a locked memory care unit in a different area. So a couple can remain under the same roof, spend their days together, but professional staff takes care of the sick one.
There are options. Your mother should be talking to a social worker and your father's doctors. She must be made to understand that her own stubbornness could result in not just her sustaining injury from your father, but also your father getting injured if she can't handle him.
With all our argument back and forth I'm afraid that's the beginning and end of it given these increasing episodes of "agitation" and "aggression" (the OP's words).
Just my humble opinion.
I second Burnt's opinion.
This is an elderly woman living with an elderly man who is now unpredictable.
I can't imagine how she is to get some sleep if they are ever alone.
I can't imagine bearing the burden of the cost of this over time with 24/7 care.
I shudder to think of the cost to her mental health to bear witness to this daily.
There has been argument here as to whether a person suffering dementia, incontinence, agitation, can/should be compared to a child.
I spent my life as an RN. What we said in the privacy of the break room was not (sadly, perhaps) always a match to our higher minds, our better angels, nor to what we were taught.
And yes, we OFTEN spoke laughingly of our narrow escapes, comparing our elder patients to our 1 1/2 year olds full well knowing these beloved babes would "grow out of it" and fully knowing our elder patients (ALSO beloved) would descent finally, should they be forced to live so long, to the fetal position.
I wonder how many here, other than the family members bearing witness and the nursing personnel on this page who stood witness at the bedside know this:
I repeat.
An elder, forced to live so long, will eventually curl right back into the fetal position: incontinent, unable to swallow or eat, unable to speak or to recognize the world around them or those they love within it.
It is quite an amazing thing to witness in all truth.
I have stood and asked myself "where ARE you? Where is the babe in the womb, likewise curled up.
It's all a mystery. ALL OF IT.
We all have higher feelings; we all have lower feelings in which our humor gets us through something beyond our understanding in order to save us. Because as an animal with severe limitations, we are on daily trial. And found wanting. But, respect? Oh, I suspect we do have respect!
What this OP asked us was how to keep her mother safe.
Her mother is elderly. Her father, the husband is GONE. That's the sad truth.
We can say his brain is broken. We can say he "isn't the man she married". We know none of it is his fault. We know our worst fear is a descent into this Hades on earth. But this issue now is how to keep mom safe.
I think that well intentioned as she is, if she is alone with her husband, and in need of sleep, she may not be safe. Odds of any attack? Probably 30 to 1 against any injury from her husband. But that alone, added to all else she daily bears witness to? Should she risk it?
If I were I the daughter I would encourage my mother to realize that her husband is now gone. Yes, he is surely a human. But all that made him what he was is going or gone.
Am I negating all he was? I hope not.
Am I saying he isn't a human? No. Am I saying he is a CHILD? Oh, if only that were true. Because in that there would be the whole world of hope for a future that doesn't leave his dear wife bereft.
On Forum we see the saddest stories ever told daily.
Our approach varies. There are times we become desperate for laughter.
There are times we say things that are inappropriate.
There are times (I especially) try to shake folks up so as to rattle loose some ways to get the thinking out of the habitually boxes it's been taped into. And on those days I judge myself cruel and wanting. But at 81 realize I am ALSO a human, one with limitations.
And we almost ALWAYS disagree.
In fact I will often tell an OP looking for answers when we have 12 people agreeing on any one question, because it just doesn't happen. My way of saying "Please listen to us, because when we agree it means something".
But for me, here, for this question--I suggest realizing that this cannot now go on longer. For the wife and mother's own sake.
I agree with the other members that an infection, most likely UTI can cause this sudden increase of symptoms.
Hunger, pain, itching all can cause increased agitation. Often people with dementia are unable to communicate these things.
Please reply with the gathered info and I could evaluate what might be happening and offer interventions to try.
He was taken to hospital where he made the emergency ward “unfunctional”.
He is now in a geriatric psych facility and the future is uncertain because he cannot go into our care system with his behaviours.
Professionals told me — and now I am telling you — your mom is in danger. Your dad would never want this.
Good luck to you all. This is a horrible disease.
My husband was also physically aggressive with me during the first year of his illness. The doc put him on seroquel (generic quetiapine) and it’s been a relatively calm life for the past 10 yrs. This drug is very cheap too. Again, you just have to find the right one.
Good luck.
With the help of this group I was able to formulate a plan when the situation arose for the next inevitable time. When she attacked me, my 91 year old father was there and she tried to attack him as well. We are no longer able to safely have her at home. The outcome could have been grave.
I called 911 and she was hospitalized, appropriately medicated and transitioned from rehab to memory care. She actually has transitioned better than I anticipated. The first week she had some agitation but now is adjusting better.
This has been an overwhelming and daunting (an understatement) 2 months but we are all safe and she is well taken care of by professionals.
My father, who is living at home, has been grieving her move but understands the gravity of the situation. He doesn't want to visit her because he feels she will never be the same.- which is true.
Good luck in navigating through this.
BUT please realize that at some point this decision to not separate them or to keep him home just is not realistic nor safe for mom.
So talk to his doctor. Try medicating but that it might take a while to find the dose and the med that will work.
It may also mean that he may be more of a fall risk.
It also might not work and that he may have to enter a facility so mom will be safe.
Let me ask you this.
If dad had been asked 5, 10 years ago this question..
"Dad if something happened to you and you started to get violent with mom what would you want us to do? "Would you risk hurting mom or should we look for a place so that you would be cared for and mom would be safe"?
Not that anyone ever thinks about the "What if's" in life but if your parents love each other I am sure you know the answer.
My mother had dementia. The doctor said more often than not comes a time when a patient with dementia can not be home with family . They need to be cared for by people the dementia patient does not have a personal relationship with .
Your mother is in danger , they need to be separated . She can visit him in memory care .
Even if this turns out to be a UTI and he gets better with an antibiotic , this aggression can happen again the next time he gets a UTI , or just happen in general from dementia progressing . And maybe Mom will get hurt the next time
Dad is to the point where he needs his behavior meds managed in memory care as well . He’s now too unpredictable to have him home with Mom alone at all .
You may also have your hired staff quitting because of behaviors .
You've done a fantastic job of setting things up for smooth caregiving, but there's no way you could anticipate everything. Your mother thinks she is doing the best for dad by refusing to place him in a care facility, but as you see now, that may be unrealistic. To say the least.
We all have our ideas of seeing our loved ones through their dementia with nobility, brilliance, singleness of purpose, and all those good things. The something that you're missing is what you've already more or less figured out. This isn't sustainable. And mom needs to be kept safe.
As well as you've planned, you're not professionals. Guide mom to understanding the difference by taking her to visit some memory care facilities. There are many good ones, but as long as her mind is closed, she'll never find that out.
I recently visited someone in memory care and it was surprisingly inviting, well-decorated/furnished, no antiseptic smell. Many of the residents were at tables in the lounge area engaging with one another…and smiling!😊
What is REALLY important?
Safety?
Care?
Togetherness?
Care & Safety go together.
Aides need a SAFE environment to provide CARE. Or aides will quit, leaving family with it all.
Togetherness is not all or nothing.
Eg What about quality time together instead of quantity?
When the needs keep growing, so must the care plan.
A. Age in place, with family.
B. Age in place, add home supports & aides - as you are doing
C. Care Home accomodation.
Find the best local option, visit often. Daily visits but separate nights, this allows the spouse to REST.
Only other option I can think of is drugs. Basically your Father would get medicated until he is not agitated. This may keep him at home longer. It may also make it harder to care for him, with poorer mobility, increased falls, drowsy, make him less likely to eat, poor swallow, incontinence.
24/7 togetherness may be possible but come with outcomes you don't want.
I am so sorry you are going through this. It is tough, no doubt about it.
This could be a bladder infection causing a mental change.
Whatever the cause it is something to be addressed by the MD. You don't want medication so strong that the person is stumbling and falling, but sometimes a low dose anti depressant works to calm, even medical cannabis now being typically used. I would discuss with an MD.
I congratulate you on the fact you have such a good set up going here, but at some point placement may be necessary and is not really a "choice" for your mom. It may be a necessity for her safety.
I sure wish you the very best in this dilemma and I hope you will update us.
I have no answers , just to tell you that I get it, it really sucks, and your not alone
However, if it's not a UTI...
Is your Dad on any meds for depression, anxiety, aggression? If not, why not? It's time. The only way to guarantee protection for your Mom is separation.