Saturday, November 01, 2014

Monday, May 03, 2010 madladluc, Community Member, asks

Q: How do you handle a combative Alzheimer's patient who's still deemed mentally competent?

There are many things that "should" happen like someone with alzheimers should stop driving, should shower themselves, should take their meds...but there is nothing requiring them to do that. Nothing requiring to go to the doctor, nothing preventing them from giving large sums of money to people they hardly know.  Pretty much if they can feed themselves and write their name - there is no real support for family with a combative Alzheimer's family member.  Does anyone have any ideas on how to make this manageable?  For example, if we just took my father's keys away so he can't drive or took his car...we could be arrested for theft if he called!  It's so frustrating.  Does anyone have any ideas on how to make this manageable?

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Answers (2)
Carol Bradley Bursack, Health Guide
5/ 4/10 9:24am

Has he been diagnosed with dementia? If that is so, you would not be arrested. The police should be on your side. If you are just guessing that Alzheimer's is present, but it hasn't been diagnosed, it's trickier territory.


Keep records of his behavior and try to get him to a doctor for some other reason, if there is no cooperation about memory and judgment issues. You do need a third party to help you with this. If you can't get anywhere at all, try your local social services. If he lives alone, they can do a welfare check and hopefully be able to get some help.


Good luck. This is horribly frustrating for many people. A diagnosis give you some help.



AFA Social Services, Health Guide
5/ 4/10 3:51pm

Individuals with Alzheimer’s disease may become resistant to interventions, such as help with finances or care because they do not have the insight to recognize they have a problem.  Alzheimer’s disease damages the brain and can impair an individual’s judgment and decision making.  This being said, if at any point you feel your father’s behavior is dangerous or you are worried about his safety you should call 911.  More so, if you are concerned your father is at risk for harm, you need to report it to someone.  To get help, you can reach out to a doctor, a friend, or a family member you trust, or contact the help hotline of the National Center on Elder Abuse at 1-800-677-1116.  Specially trained operators will refer you to a local agency that can help.
You are correct that it is difficult to “require” individuals with Alzheimer’s disease to do things they are not agreeing to do.  However, there are legal and behavioral interventions that can be successful to promote health and well-being for your father.  For example, you asked about the legal ramifications if you took his car keys away.  If you have identified that he is no longer safe to drive, you can take responsibility and action immediately.  As the caregiver, it is important that you take a preventive approach, rather than await something more serious. You should consider bypassing the need to convince him to stop driving, and focus your energy on simply stopping the risky behavior.  This might include asking the doctor for a “prescription” note that advises the individual that driving is no longer possible and must be stopped.  In some situations it is important to consider other ideas, including hiding or removing keys to the car, dismantling certain features of the car engine system so it is inoperable, and removing the car entirely.  Although it may seem as if these interventions are forceful and strict, they are sometimes needed in certain cases.  There are many risks associated with driving when an individual has dementia, including impaired reaction time and poor judgment on the road.  Laws about driving vary state to state and many cities offer a driving assessment program that is either administered by, or run in cooperation with police departments and motor vehicle departments.  Such programs will take away a license if the participant is too impaired to pass the assessment.  Inquire about such programs by calling your local Area Agency on Aging, police department, and motor vehicle bureau.   
Lastly, it is essential you reach out for support.  You may want to think about joining a local support group or contacting a social worker.  You can also feel free to contact the social services team at the Alzheimer’s Foundation of America Monday through Friday 9am to 5pm Eastern Time at 866-232-8484.

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By madladluc, Community Member— Last Modified: 04/02/14, First Published: 05/03/10