Mother in ALF having anger issues and refusing care. Any advice?

My Mom used to be like that but eventually she calmed down. She still does have outbursts. She has always been difficult too. I think you're right that she's angry because her life is out of her control.

I've been trying to learn to "detach with love" and realize that I can't control her behavior. It's difficult.

We've had the same issues with my Dad this year, since his placement in January. He was in two other places and 3 hospitals before his current residence. What helped him was getting him admitted to a geri-psych unit where there were psychiatrists and staff experienced with the dementias and the medications that helped. He is now in a memory care facility called Pacifica that only deals with the dementias rather than also assisted living, and they have on staff, geri psych MDs and Nurse Practitioners who follow his care. He is totally calm and happy now, with the meds. Not sedated either. The first and consistent drug ordered that seemed to help was resperidol. You could start by just finding a geriatric specialist to take your Mom to for evaluation. If you want to keep her in this ALF as she is, there is nothing to say, you cannot find her the medical resources outside of there to help her. And, of course, it just may be the stage of dementia and once she moves past this, she may be more calm on her own. My Dad was this was for about 5 months though and was actually hurting people and getting sent to the hospital and then the facility refused to have him return once he was out, so we had to look for another one all the time. This facility is committed to keeping residents and working through the behaviors with the medical support.

I went through same situation with my mom who had lived with us with moderate dementia and became violent to us and herself. We had to put in Assisted Living and had to be put on risperadol and then changed to seroquil. You just have to be careful not put on too much meds but sometimes they don't have choice when they become violent to caregivers there. Very hard to deal with but talking to people who have had same situation was a big help to me. Unfortunately my mom passed away a year later from complications of a fall. Take care and God bless

Can only send hugs.. going through that now, but Ma has been quickly going thro the levels of care and just now gone to a secure dementia unit. She is angry because all she remembers is so muddled, and cannot realise that maybe we did not just grab her and take her with out discussing things.. discussion of course is now really a waste of time, but is still done. It is the dementia, whether you can get her to realise that her brain is not longer as sharp, that its like a paper doily, and so yes she is losing control as more and more memory is falling through the holes. I guess she is in a panic. Maybe work out what is remembered and concentrate on that. Even going back to her childhood, and then writing up what you remember being told as a child and now, so that the staff can hold a conversation with her on that topic..e.g her first job, where she lived, brothers and sisters, going to school.
And hope the transistion to no memory at all is fast and not too painful

This may not help, but I can share what I do with my mom. I keep everything slow and easy. I don't make her follow my schedule, I follow hers. I talk slowly, quietly, and simply. I don't force anything. Changing clothes: I start by asking her if she is ready, if she immediately flares up I drop it until a little time passes. I ask her if she can do me favor. Usually she will say yes. If not, I wait. When she says yes I ask her to lean forward or I am behind her and gently lean her forward. She usually does like it when I begin to raise the back of her shirt, but I go slowly and explain what I am doing. Then I unhook her bra all the time letting her know what I am doing and that I won't hurt her and that I'm not doing anything "bad". Then I ask again if she will do me a favor. When she says ok I ask her to raise one arm. I am touching under her elbow and gently start to raise the arm. I am saying thank you the whole time and explaining what we are doing. I have the pj's there and let her see them and we talk about how soft and warm they are. After the first arm is out of the clothes I repeat the process with the other arm and eventually go through the whole routine to get the shirt over her head. Sure, it takes longer but so what? It is reassuring to her and easier than getting her all riled up and having to force her. My mom can't walk, can't express herself, can't do anything for herself. I imagine that everything is terrifying so I try to make her feel safe and secure. I can't imagine that my mom was anything but tender to me when I was an infant and I try to treat her the same way.

Geedeeoo, you are a caregiving pro. The elderly need to feel safe and secured/loved. I always asked my dad to help me with his care. Ex. "Dad I need you to sit up so I can wash your back" etc. He was always will to try to help God love him. I never made any of his care something I was doing for or to him. Rather we were working together to help him get bathed, fed etc. Getting their
acceptance is so crucial. If he didn't want to do something, I would ask him if we could do something a bit differently or delay the meal if he wanted to read or rest. Everything takes tons of time as they move towards 90 yrs old. Rushing never works.

hi every one I have this with my mum mainly anger only when my older sister stays with her

Onahastie, does your sister try to rush or boss her?

Geedeeooo, I have read books that talk about managing elders without drugs by being responsive to their needs and their reality. It sounds like you have it down!

I'm sort of a fan of medication, because I know two difficult people who became lovely people when on antipsychotics. Taking the time to gentle the elder into cooperating lines up more with my philosophy, but I might not have the patience to carry it out.

The aides in facilities vary. Some are sweet and gentle and loving. Others react badly to resistance, or are rough, or sometimes even MEAN. Well, they don't get much money or respect. Old age ain't for sissies.

I have heard people recommend videos by Teepa Snow. They sound really helpful.

My mom is in an ALF now and recently she began having anger issues and outbursts like you described. Evidently from what I have learned on this site, the elderly with dementia very often get "Sundowners Syndrome", where these behaviors just seem to come out of nowhere, usually the late afternoon and evening hours. She too, has gotten verbally abusive and has hit the aides with her cane. Her neurologist has put her on medication to help with this and so far it seems to be working for her. She is not a zombie, but the meds do help to calm her down and keep her mellow. It did not matter who was with her either, since they would call my niece and then my brother if they couldn't get her to calm down and go to bed-in her room! Sometimes that worked, sometimes she would just get as angry with them and accuse them of just abandoning her at the ALF. Never a rhyme or reason, just something that would happen. It really is sad, my mom is not my mom any more, but I still call her and see her whenever I am in town, about once a month at least! It's hard, very hard. Prayers for you and your mom.

sorry no answer, but if its any help, my mom is doing the same...very mean to me and my brother....she calls me all times of the nite...I have to work 49 hr weeks as well and she is still in her house, alone, as she wants it..she still does all her work, takes her bath, does her hair, fixes her food...everything, I do she fights me...help, if you get it...let me know

Free massive open online class (MOOC) starts tomorrow though coursera, google it, on caregiving for those with Alzheimer's and other dementia.

coursera. Johns Hopkins free online course DO IT!

My dad was dementia. alzs. also. we had a very hard time. my mother was his primary caregiver, last 6 weeks she had to put him in a nursing home, he refused my help got very angry. at sometimes he would let me do a few little things for him. my mom still took care of him went everyday 2-3 xs sometimes feed him and watched out for him . she wanted to do this we all were trying to get her not to go so often , however she went. he became more angry as time went on he has passed away. alot of our prayers were answered , this is so hard on the family, when i would visit him and if he started to yell or get real angry i would tell him i love him , i would get him to where he had to be alot of times he would sit in his wheelchair at the nurses desk, he had to be restrained for he could not walk, he was medicated i dnk what was given it helped with sundowning, caregivers are a true godsend work with them too, times they get it just as hard.. keep your mom medicated to help and try, but not to the point it takes away your life, all cases are different , because all people are different...

Thank you everyone, helpful to know I'm not alone. I can handle my mom and , but the anger issues are directed toward the CNA's and companions. If mom could have me 24/7, she would be OK. But unfortunately we aren't financially blessed & I must work and rely on others. I've decided there are worse things in the world than if she wears her clothes to bed a couple of nights a week. She did tell me last night that she didn't want men to realize she was in a nightgown and try to come on to her. There is only one male CNA, and I have no reason to think there has been any problem...and this concern would be typical of my mom's personality. Hopefully this concern will fade away. I've directed her companion to try and get her ready for bed, and if she gets angry, back off and try again later. And if still a problem, let her wear her clothes to bed and I'll change them the next day. Geedeeooo, I like your style. I'm going to send that to the companion and see if that helps her. Thank you everyone. Helps so much not to be alone.

I think we need to make sure the elder is comfortable with the aide in the NH or home health aide if you employ help to be with your parent while you earn a living. My father's primary home health aide made my dad's days pleasant. When she was unavailable due to a sick child (she was a Mom), he was never as happy. I did get aides who were more interested in using their cell phone on our living room sofa than attending to my dad. I tried to make sure they did not come back. My dad was paying for the aides so we needed to get aides which met his needs and a were pleasant.

I do think elders lived in a different world then ours. They are reluctant to take baths , disrobe with all the aides. They want to maintain their privacy and I think we should allow for that. My father was only bathed by the primary aide and me. He told me he did not want to have just anyone off the street, bathing him. I would bath him later, after work on days when the primary aide was off. If it makes him feel better it really isn't asking too much. They like to keep their dignity.

I also found some of the younger aides did not have the ability to talk or have a conversation with an elder. The day is just too long to have them in the home if they are not able to talk to an elder--show them caring etc. Many of the younger aides aren't talkers because they text their BFFs all day long. I did have a young male aide who was able to talk sports to my dad and he so enjoyed those conversations. I tried to request him but of course he was in demand by the agency because he was a pro.

Hang in there, error on the side of compassion. Old age isn't the time to try to change or control an elder. Their time with us is short.

Well as you can see from your answers many people are in the same situation, such as myself. My mother is in an assisted living, in a wheelchair, takes Lexapro, refuses to get help dressing, showering, etc......just today the occupational therapist called me to let me know that my mother refused therapy in an angry/hateful way. When all of this caregiving starts up it seems like your the only one with a parent that acts-up, but no I am starting to realize that many act-up (if you will). I try using a little humor when my mother begins to complain. It does not always work, however. I also try to remember that I do not have control of my mothers behavior. I can only try to encourage her to think in a more positive way. It is what it is. I try to think about how the last few years of your life has to be scary at times just to think about it. I have been dealing with this now for about 3 years. My mother has called me up to 14 times in a day. As aggravated as I get sometimes, I know I will not have her one day and I will hate that. Stay strong.

My mom has been in ALF since January. She was born angry and does now have dementia. She has always called her own shots and now has no control, she has acted out, yelled, hit, quit eating, the whole gambit, For us the only thing that has helped is lots of visits, megace to up her appetite, and Risperadone to calm her down and make her less mean and delusional. It's sad to me when you have to resort to drugs, but nothing else works. Good luck to you, it's a tough time of life!

I think most caregiving children do their best. I was blessed in that I never had to place my father in an ALF or NH. Many people would have sent my father to one, but he wanted to be in his home and he drew peace from being in his home. I did not have to use any drugs to "improve" his personality etc. Trying some of the mood altering drugs may work but sometimes the elder reacts poorly to them as well. I found keeping his life and daily routine as normal as possible helped. My world revolved about what he needed. I did not ask him to
jump into my life and tag along with me to various places I might enjoy. While this to many is not allowing me to live my life, taking care of him was part of my life for a significant period of time. Now he has passed and I can do as I please without any misgivings for not being there for him. I have a peace of mind that his ending golden yrs though not perfect were the best I could make them for him. Our nonsense of not wanting to be a "burden to our children" is silly. If you live into your upper 80's or 90's it is likely you will need help or "be a burden" to those that love you. Otherwise you are at the mercy of paid caregivers in the NH or ALF and that surely isn't ideal. Caregiving is a learning experience and I learned a lot about old age and how we as Americans care for our elderly.

Oh Lizann, I SO wish we could have done this with my Dad, as it was his wish! But he did not have his dementia progress in any kind of peaceful manner. My Mom could not handle him. They had lived parallel lives in the same house for so long, and he had been the one in charge of everything, and the decision maker. He had permitted her strange behaviors and self centeredness because it was easier than fighting with her over everything I guess. NOW, I am seeing how hard she is to be around!! She was not capable of catering to him; of cooking him regular meals; of buying foods he liked (unless they were 'on sale'); of creating one shelf in her fridge for foods he could easily help himself to; when he started to get worse, she made it worse, by nagging him constantly about what he did that she didn't like; and by fighting with him because he could no longer remember all her 'rules' for the house, like wearing shoes inside and not going out to get the paper in your stocking feet etc. Her entire life was about cleaning house, and going out shopping for sales. He reverted to drinking to block out her nagging and complaining. She complained when he forgot a bill, but she couldn't step up to the plate and do them herself. That made her 'too nervous' because he had always done them. She just could not understand dementia and thought he was doing these things on purpose. I tried to get her to go to a dementia group....but she just said she had it worse than any of these others did when they talked about their caregiving. Yet she wasn't 'caregiving' at all. She was only complaining. I instituted the POA that was ready to go, so I could pay the bills, and three months after that, I got a caregiver to come into the home to assure he was getting fed, and bathed and someone was having a conversation with him that was normal. He loved her...and Mom, of course, hated her! It was a struggle and Dad kept drinking cause they kept fighting. Police were called a number of times, before we removed him for evaluation. So, to me, I think people should consider it a bad sign if their parents are both still alive, and they've not ever been good friends for years. If neither of them are able to step up to the plate to be a caregiver for the one who needs help, it's not going to work out to stay at home. My Dad was up wandering all night long in the end. Mom would call me 20 times a day, even though I am 5 hours away, complaining to me about what he was doing that she didn't like...and wanting me to talk him into doing what she wanted....change his clothes, take a shower, take his meds, go to bed....but she couldn't take to him in a soothing way to convince him to cooperate. She wouldn't agree to taking the alcohol out of the house, because she 'had to have' her 'little drink of boubon' in the evening....and SHE wasn't about to go without, no matter the reason. He was hungry for dinner at 5 pm and she didn't like eat dinner until 10, so she'd be damned if anyone was going to eat before SHE was ready. Life was all about her and how rough things were for her.....she wanted to call all the shots, and still does...but she wants me to make all the decisions so she can blame me if she doesn't like them or they don't work out well! It's still my fault that he 'got taken away' in January...though what happened is that he threw a half full half gal liquor bottle right at her, and she had a newly diagnosed fractured spine and was walking around with a walker. She had been told that just twisting or falling one more time might cause paralysis. The episode was witnessed by a caregiver and our daughter while I was on the phone with my daughter, cause they were fighting....but Mom still insists that we were all telling a lie and he never threw a bottle. We just wanted him out of there and we planned it all! Of course, if I counter that we could bring him home if she could take care of him, well.....can't do that, unless I were to move in with them and take care of him!! Well, I am married, with my own health issues and trying to run a home business and almost 70 yrs old myself, with a husband who is not well either....so that isn't going to happen. So every night, I hear how terrible it is that she's home all alone and her husband isn't sitting next to her, and cannot go to bed with her and how lonely it is, and how unhappy he is where he's at etc.etc. NOW...I say, well, should we plan to bring him home with caregivers? OH NO...THAT will never work out...they will get her house dirty. They will sit on her good couch. She doesn't want any strangers in her house. EVERYONE ELSE she knows has family who help out in these situations.....etc etc. I just say, "Well, I am doing all I can do. I cannot move in, so we need a different plan." I know 'everyone she knows' didn't have family, because her neighbor across the street took care of her husband for 10 years after his stroke, by herself....and her other friend took care of her husband for 7 years after a number of bad strokes....but Mom conveniently forgets what she doesn't want to look at!! And now this past year, it's obvious she has her own dementia going on and is getting more frail and weak and tired...so she couldn't have him home with her now even if she wanted to try to do it. So....for some, it's just not possible to carry out their parents wishes cause their parents are not able to cooperate at all.

Joannes I do realize it isn't possible to keep all elderly parents at home and NH or ALF are needed. Yours is a complicated situation with both parents with a high level of need. I took care of both parents but at different ages, mother was a cancer victim and died at 51 yrs father died of old age 38 yrs later at 93 yrs.
He was able to help with the care of my mother which made it possible. I was able to care for him with paid caregivers for approx. 4.5 yrs.

Both parents were easy to care for as they were mentally sound, the bodies were on the decline. It was a blessing.

Your love for your parents shines through your post and you have been dealt a extremely difficult caregiving hand. You are doing the best anyone could do in the situation. Don't feel badly, we all have to accept things as they are. With elder care we all know the ending, we work on helping them in the margins.
Take care of your own health.

Lizann, thank you for those wonderful remarks. It's been a very emotional struggle. I get better daily at not being manipulated, but there are days when I am extra tired, and one snide comment from my mother can bring up all the old 'stuff' and guilty feelings. I genuinely feel bad that I could not honor my Dad's wishes, as he knew for 8 years what he was dealing with, and he was the good one with the strength, in the family. He earned the money, invested wisely and at one point had a million in stocks....but then losses. He cared for Mom, but as dementia set in stronger, he couldn't handle the chaos she created in the home. I don't understand a wife not being able to step up to the plate and even FEED a husband what they like to eat, when they are hungry! So I want to show my love to him, as I don't feel he gets it from her....and that makes the guilt easy to trigger when I hear that he's talking about who put him there and why can't he go home etc. I try to tell myself that he never talks like that when I am there, so I also have to consider that it's HER game with me and he doesn't really say this to her at all too. But it's hard to have all those 'games' coming at me, while I am dealing with their bills, the qualifications for VA and/or Medicaid benefits to pay for his care, and plans to be sure there is enough for her in the end...selling a vehicle, trying to lower their insurance expenses and so many other things that seem MUCH more important to their well being to me!! Thanks for caring, and the hug and all that. This is such a good site....people are so helpful as we go through this 'walk'.