i am a caregiver of an alzheimer client. What do i do when she comes at me in anger?
The person I care for is in her 90's and has had this diesease for 10yrs now. She is getting violent and angry alot. I have been with her and this family for some time now. I feel bad but I think it's time for me to move on. I understand some of the alzheimer disease but I do not think anyone fully knows. She has come at me in anger many times, thrown coffee mugs at me, hit me with a cane, shouts profanities at me, tells me i am here doing drugs, and that she is going to find something to take my head off! I am usually the only one in the house with her at the time, everyone else is at work or school. Please help!
According to our home care service for my father-in-law, this anger has 2 situations:
The first one is the obvious choice: the patient is at the latest stage when caregivers are going to be hurt/injured. At this point, the home care service would tell us that the person can no longer work for the patient and the patient needs to go to a nursing home as she gets sicker in end stage or near end stage.
The other situation is a matter of how you cope with the patient. I was told that lots of white lies like what we do now to my FIL, and do not disagree with the patient. Go along with her to do what she wants to unless it is very dangerous for her to do so.
You probably know better as a professional. If you are afriad, you should talk to the family or home care or your supervisor to discuss this. If anyone can calm him down so you can go on working, then it is great. If the patient is really very sick, she has to go to a nursing home.
In my FIL's case, the home care is saying when my FIL does not recognize the caregivers whom he likes, he will get very agitated and more frustrated. If he gets incontinent, he would be more mad and throw food at you if he stops talking. This is when he would have to go to a nursing home as the home care service cannot put their workers in danger.
Thanks for your reply to one of my quesionts.
Hope this helps,
Nina
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Chelle
Monday, July 06, 2009 at 04:47 PM
N.C.
Monday, July 06, 2009 at 05:22 PM
The son sounds like my husband. Sometimes some family members have no clues about Alzheimers and don't want to know as it is depressing. You are the professional, you need to tell him that she is very very sick and you need to move on. Just ask your agency to support you. However, like Dorian said, if any medications or changes of methods can help, then try them. But I can understand why the son cannot see it. he is like my husband who does not get educated in Alzheimer's and yet is a "loving son".
Nina
N.C.
Monday, July 06, 2009 at 05:26 PM
BTW, even if the husband and wife are medical doctors, it does not know mean they understand esp. if they are not American-trained. My husband is a Ph.D. in microbiology. My FIL was a professor in pharmacology and yet he has no clues as he does not practice his MD in the states at all.
So it depends on whether these trained doctors care to be educated about human beings who suffer with Alzheimer's or not. If they only study labwork and the cat's brain like my FIL, they would not understand it at all. They are just trying to be responsible but they may not really understand Alzheimer's. They are NOT psychiatrists or neurologists.
Nina
Hi, Chelle,
I suggest that you bring this to the attention of the person's family so they can discuss the person's actions/reactions with her doctor. Perhaps her medications need to be altered and the doctor can prescribe a medication that will stem the anger.
You also may want to deflect the anger by changing the subject, playing soothing music, or turning on the television to something that would keep her interested (such as Andy Griffith). Also, I learned with my mom that if I left the room for a brief period of time when she was having an outburst, it would eventually subside. I also learned to read the indicators that Mom was becoming upset and then started working to defuse her anger a lot earlier. I learned to keep a really calm and sunny disposition and didn't let Mom's emotional outbursts trigger similar reactions in me because that only fed her anger. If you don't feel like you're seeing a difference in her actions/reactions, then you may want to consider moving on.
I hope this helps! Takie care and keep us posted!
Dorian
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Chelle
Monday, July 06, 2009 at 04:40 PM
First of all thank you for responding. I would just like to fill you in a little more on my situation now that I know how this site works. This family is also from India. Their beliefs are very different than some of ours. I would love to turn on soft music or tv, however there isnt one for me to turn on. I have played the white lie tricks and most of the time she will just shout over me. I can't walk away because she follows me also. Now as for the medicine adjustment I also thought that may help, but both the son and daughter in law are doctors. The daughter in law is also scared to death of her just because these outbursts get so bad, but the son, he just yells back and has her go to her room. This usually works for him, but I wouldnt dare! Not only that but you and I both know it is only a matter of time until this no longer works for him either. They are now in the process of moving her to a facility, I just dont know how long it will be or if I can expect to hang through this. I called my boss again today and she told me she can pull me out of here and all I have to do is say so. My heart goes out to the 2 children who can't even be home if their father isnt here anymore. This is a difficult situation for everyone. If you have anymore outlook please let me know, your comments are very appreciated and welcome. Thank you again
Dorian Martin
Monday, July 06, 2009 at 04:49 PM
I am guessing that the husband and wife are the type of doctors who don't deal with patients who have Alzheimer's/dementia. One idea is to suggest that they talk to a colleague who deals with these types of patients. You also might suggest the book, "The 36-Hour Day", which is written by Dr. Peter Rabins and Nancy Mace. And you may want to encourage them to view the HBO documentary on Alzheimer's, which is available online:
http://www.hbo.com/alzheimers/
There's a wealth of information on this site for caregivers, children who interact with people with Alzheimer's, and researchers. Being doctors, the couple you work for might benefit greatly from this site.
I'll keep thinking on this situation. Again, take care!
Dorian
Hi Chelle
At times nursing someone with Alzheimer's in their own home can present some difficult problems. It can be scary, not having other people in the home who can provide you with backup when you feel you are in a potentially dangerous situation or feel compromised by their behavior. It sounds as though you are doing the right things and so far your client's violent episodes have been not been too extreme, although it is mentally stressful and anxiety provoking for you I am sure.
There are a number of things you must do:
1) Keep your employers and your client's family informed about all the episodes of verbal and physical violence. Keep a written record of them all with details of;
(a) the type of violence, (b) any things that appeared to lead up to the incidence i.e. you asked her to go to the bathroom, change her clothes etc. etc. (c) What you did- i.e I waited until she was calmer until I tried taking her to the bathroom etc.
Always record when you inform her relatives and your employer. Record any injuries that you or your client may get as a result of her behavior.
This will help you with all queries, should anything untoward happen. It will also help your client's doctor and any specialist that may be called in ( a psychologist), with diagnosis and future treatment.
Here is the link to a sharepost I wrote about Aggression and Alzheimer's disease
http://www.healthcentral.com/alzheimers/c/57548/50050/aggression
that gives you lots of advice and ideas that may be helpful
Christine
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We are definately in the late stages! I never argue with her, I am very calm, I dont ask too many questions, nothing. She could be fine for 6hrs then come out of her room as mad as can be. I know this is all a part of the disease, but I am dealing with the when is it time to walk out? They are in process of putting her in a facility, she is now going for activities 2times a week. It isnt supposed to be much longer until they have room for her. The problem is the son I believe. He just says dont take it personal, hang in there, and well she's harmless....I as a 14yr caregiver know that is not correct! They can be very harmful...Im stuck in a hard place but I have spoke to my boss again and she agreed that if its dangerous I should be moved...They are a great company and Im glad to have them on my side...as well as you. Thank you and please feel free to reply anything can help now I hope.....