Hi Cajunlady09,

My father-in-law has begun to get aggressive this year after the hospitalization for his heart failure. He has mid-stage 6 Alzheimers. He was always hard to deal with but he was able to communicate (he used to communicate very well) with the caregivers before this year. This year, we think he gets a little worse and so he gets aggressive. But there is a way to avoid - try to do what he wants to do or trick him into the stuff that we need him to do, for example, calm him down or get him to bed or distract him from his stress or fantasy that was out of hand...

At some point in later stage (late moderate stage), Alzheimer's patients get anxious and aggressive as they cannot understand things around them anymore. The more they are confused, they more they would fight and get aggressive. My father-in-law at times would use his cane to warn us or hit the caregiver (she was not hurt as her coat was heavy in the winter) this past Feb. He had never tried to hit people physically last year or before. He now told me he would be strong to hit people ten times more if the person hit him or goes against him once!! I had to tell him it is wrong to do ten times more and that please don't use physical force.... He wanted to use force... We had to tell him using force is wrong. It is just his imagination that the caregivers are against him or that he didn't understand the help they offered. i.e., he forgot he ate the soup and demanded for too much soup...

I saw your post and I think your Mom has been through so much changes that she is very confused. The fact that she moved in to the nursing home and moved back to your home gives her stress for sure as she would be confused with her environment and naturally she would be aggressive and combative. You can try to calm her down by explaining what you are trying to do and try to use the same routine to help her daily so she can get used to it. She would hate too much changes. For her, changing caregivers, family or professional, is very hard as it causes her confusion. Also she would get embarrassed if someone changes her diaper when she is not ready or not used to. I don't know if she still knows you, try to calm her down and use some white-lies tricks. Say this is underwear, and don't say it is diaper or treat her like a baby. It is hard but she wants to be treated as adult.

Usually some patients can be calmed down and they would not get aggressive. It all depends on how we cope with it. If she is really combative, then maybe the nursing home is the way to go. Try some of the Alzheimer's unit or memory unit in nursing homes so the caregivers can use special skills to care for her.

Take care,

Nina