My dad with dementia yells at hired caregivers to leave and then yells at my mom when she returns. How do we handle?

I am sorry for what you are all going through. I had a similar situation earlier this year. My father had dementia and was on Seroquel plus Trazodone for sleep. He was uncooperative and grumpy and resistant but didn’t yell much. He had many other health problems and barely ate anything and barely drank liquids either. Skeletally thin and frail. My mom couldn’t really take care of him, but absolutely refused to consider residential care. Eventually he had a crisis and I called 911. At the hospital he told everyone who asked that he just wanted to die. He actually perked up while there I think because of the IV liquids. He was more alert and focused and talkative for those 48 hours until he got back home. He was discharged with home hospice which I was happy about. He grumbled about the aides and nurse who came from the hospice and he refused to use the hospital bed, commode, walker, shower chair or anything else they provided. Refused to be bathed or to try ensure, Gatorade, protein shakes, yogurt, fruit smoothies, or anything besides what he had already been eating before — small amounts of vanilla ice cream. He started falling a lot and my mom couldn’t get him up off the ground. Eventually after a few falls close together and the last with cutting his head and blood everywhere, I called 911 again and they took him to evaluate for concussion. I told them at the hospital that he was unsafe to return home and so they took him to the hospice respite facility. All my decision. My mom and I both had DPOA for him. She just couldn’t bring herself to do it. He was extremely mad about being there and ended up dying just 3 days later of aspiration pneumonia. I was glad he had access to oxygen, air mattress on the floor so he couldn’t fall out, plenty of experienced staff, and most of all morphine every 2 hours during his last days. We could not have managed it at home. It had become a horror show with him hurting himself, smearing excrement, and her just becoming more and more stressed out but doing nothing. Best wishes to you!

Your mom needs to get over guilt at the idea of a memory care facility. They are the people who could provide the care your dad needs now. You and mom aren't professionals. They are.

Also, share with dad's doctor the information you've told us. Doctor could prescribe medicines that will help your dad stay calm.

There is no automatic halo for keeping a person as sick as your dad in the home. There's no accolade, no joy, no warm fuzzy love moments. In this case, your dad has a condition that will eventually take his life if something else doesn't get him first. That's the stark reality. You could lose your mom over this as well, and IT ISN'T NECESSARY. Help your mom get to the point where she places dad. Enlist the help of dad's doctor and her doctor. Get her to counseling. Visit some memory care facilities. You do the legwork. Then show mom brochures and whatever else you've found. Take her to visit the most likely ones.

Once dad's placed, life for mom will improve. Yours will too, and I wish you luck in finding a good professional caregiver home for him.

Hi Serkey,

I haven't read all the answers, but I expect that most are very good and advocate a move to memory care for your dad.

I wanted to touch on your mum's guilt.
Firstly, I have learned from wiser heads, here, that guilt should only be felt by those who deliberately set out to harm others. Your mum needs to ditch the guilt - it cannot serve a purpose here.

Your mother is probably feeling grief, which can be overwhelming. It's natural that she should grieve the man her husband was and the way of life they have both lost. But she needs to move beyond that.

To combat the grief, help her to see that she isn't equipped to meet your father's increasing and changing needs. Weigh the possibility of your dad experiencing a visible cognitive decline after entering memory care against the possibility that your dad could flourish in an environment that is geared for residents with dementia. Also, there is a chance that your dad could become hurt, or hurt someone else, in an environment that isn't completely set up for someone who becomes agitated and angry.

Lastly, your mum's health could suffer because of dealing with the day to day care of her husband. If she became incapacitated because of the toll this is all taking on her health, who would advocate for your dad when he is inevitably placed in a memory care facility? Your mum needs to prioritise her own health, if only so she can be a loving wife who does the best for her husband.

Making hard decisions, when you can't foresee the outcome, is so difficult. Add emotional attachment into the mix and it can feel impossible. So, then, you have to go with the outcomes you do know. It will be physically and mentally easier for your mum to advocate for her husband when he is in memory care than when he is wearing her out in their own home.
When life is uncertain, make the choices that do have a certainty of something positive.

Your father should be placed in memory care. I did homecare for 25 years for many, many clients with dementia. Abuse is abuse. It really doesn't matter if the abusive behavior comes from a person with dementia or a person without it if you're the one on the receiving end of it. Verbal abuse usually doesn't stay limited to abusive language and getting loud. It graduates to physical abuse if the abuser is able to take it there.

In the meantime, talk to his doctor and start medicating him to calm him down. Get medication in liquid form and dose his food or drink and don't even tell him.

I never tolerated verbal abuse or any other kind from a homecare client. I always made myself plain that no one speaks to me abusively. There were times when clients got physical with me and I defended myself. Dementia doesn't always mean weak and feeble. I'd go to my car and call the police and tell them that a violent person with dementia is alone in the house and I'm not willing to risk my safety trying to calm them down. The homecare agency is useless in these instances. The cops will handle it. I have yet to call the police for one of my caregivers. I'll drop abusive client from our service. I won't take a chance of a caregiver getting hurt.

Talk to the homecare agency and request they send you a male caregiver until you can get your fathe placed. I find in my long experience that elderly male clients, even ones with dementia, behave very differently when the caregiver is a guy. It's worth a try.

Please help your mother to get him placed in memory care. She's in a dangerous situation every day she's alone with your father.

The little pills have helped my LO be more accepting of care. Still moans & fusses - wants only their favorite, but the edges have been softened somewhat.

He is experiencing anxiety that leads to this agitated behavior. He may do better with some medications to help him relax. Talk to his doctor.

Only your mom can determine when enough is enough. She needs to get a break. Even if it is just a trip to the hair or nail salon just to keep her spirits up.

Being yelled at is abuse, and I don't advocate trying to redirect a person when they are having a screaming tantrum with the propensity of the interaction escalating.

My grandfather had a tantrum and started choking his granddaughter when she was trying to help him. He was bedridden but he was still strong. My mother had to make him stop.

I see a lot of information online about placating an abusive personality when these seniors lose their filters making the caretakers life a living hell and chasing aides away. However, I've seen little to no support of caregivers taking care of themselves and sometimes just telling these these entitled folks an outright no.

It is okay to be selfish, set boundaries, take care of yourself and ignore tantrums.

Just keep in mind that one day a person will get tired of the abuse and that walking on eggshells feeling that comes from tiptoeing around an explosive person.

I agree with everyone here about medications. Respite care may help as well once your father's moods are stabilized. Maybe your father being a couple of weeks away from home will give your mom a break to decide which direction this situation should go.

I wish all of you the best.

your mom and the caregiver needs to stay calm,find out what makes Him agitated.lower your voices when you are communicating with Him in the Friendly.Do not Resist what He is communicating to you. Redirect Him always.

My husband and I have been married for 54 years. Old habits are hard to break. I put him in memory care after his dementia and verbal abuse was too much to handle. With the help of a therapist, I have overcome my guilty feelings. It was a real hard decision and it's true you worry about the care they are getting. However, I am now able to concentrate on my own health and appointments that I couldn't make because of the situation. He has been in MC 1&1/2 yrs and is just now finally adjusting. He still has a dream that we will some day live together. I tell him "that would be my dream too". Of course that would never happen.

The manipulation and verbal abuse that your father is dishing out to everyone needs to stop.

Dementia patients become like unruly toddlers, and they'll tell you to leave home if you let them.

Your dad is behaving this way because he's getting away with it and it's getting him what he wants in the moment.

He needs to learn quickly that his behavior will - henceforth and forever more - be getting him less of what he wants. When he threatens to not eat, drink water, etc., okay - no problem.

When he commences with the yelling, stop talking to him - go outside - do something else - don't argue back - don't cajole.

IMO. Dementia patients in the moderate stages are not mental vegetables. They may have forgotten people, places and things but they still know how to act out and manipulate.

My sister, with progressive dementia, was horrible to my niece, her caregiver, who was at her wits end. My sister was placed on medication, which was a God's send and which quieted her and made her sane again. After a while she regressed, the medication seemed not to "work" and so was adjusted by the doctor. After a number of adjustments, she seems to have hit a sweet spot, amenable, but not "spaced out". Her dementia is still progressing, but the temper tantrums have again ceased and there is peace in the valley...

Talk to his doctor about medication. There may be a remedy.

So sorry you and your family are dealing with this. There are many of us on a similar "dementia journey;" and obviously no one wants to be on this journey ever. But here we are.

Cultural expectations (obligations?) are hard to work through; and what might have worked in generations past may be entirely unrelistic to follow. Folks live so much longer there are greater numbers than ever of frail older family members with cognitive issues/dementia. Families are smaller, there are often NO multiple sisters, brothers, aunts, cousins who can help and they all have their own lives. Families are spread out, and many live in states or countries away. Female care givers may have full time jobs and their own families to care for it they are adult daughters. Communities are not as cohesive as in times long gone. All to say this caring for a loved one (LO) with dementia used to take a village, but the village does NOT exist now. One has to adjust to today's realities

It is sad, scary, frustrating, on and on. But NO ONE should feel guilty. It is NOT your mom's or anyone else's fault this disease came to your dad; to your family. It is NOT any one fault this is such a terrible and hard disease to have OR to be a caregiver to someone with it. It just sucks, period! Get angry at the disease, that is what is at fault here -- the disease!

Caring for a LO with dementia (any type) is VERY hard, especially as the disease progresses. Working on "what next" NOW before there is an emergency is best. What if mom has a serious health issue, is hospitalized, etc. Then what?

Spend your time with her now researching the best long term nursing home (a SNF) facilities w/memory care (MC) in your area. Ones with high marks! So you have a list of the top three.

Work with your mom's attorney (get one they do NOT have one) to get all the paperwork and legal stuff prepared. Wills/Trust, POA, advanced directives, access to all account w/on-line access. Again, if something happens to mom, having all of this before is key for you as the adult daughter. Work through the financials of how this will be paid for OR does dad need to spend down for Medicaid?

Get dad on Rx meds for anxiety, depressions or adversarial behavior (work with a geriatric-focused MD on this). Calming the situation down is best, and these Rx meds can take time to work.

Consider an adult day care if that helps. Considered structured 2 or 3 day breaks for your mom away, w/24/7 care if they have the resources. Be ready to call 911 or adult protective services if/when he is out of control.

Encourage your mom (you too) to get with a therapist to work through this trauma, it is a trauma!

And have a time line of when to "move him" to one of the top SNF/with memory care that you have scoped out. The facility and attorney can help with this and YES it will be tough. Options are: 1) call 911 or APS, have him taken to hospital for overnight observation; then discharge to SNF, 2) wait until he is hospitalized for something else (fall, UTI); then discharge to SNF, 3) seek guardianship through the courts to determine he lacks capacity and decisions then can be made for him even if he does not like the decision.

None of this is fun. Mom wants to care for him and getting him the proper care HE needs now even if she is not the one doing the "hands on" care is GETTING HIM CARE. Nothing to feel guilty about: sad, angry, scared YES but not guilty.

Just like mom probably did NOT allow you have candy for dinner when you were 2 -- that was NOT proper care for you at age two -- and you may have hand a tantrum; Mom has to focus on what is the proper level of care for husband at this time AND the what if IF she cannot do this, has a accident, is hospitalized herself?

She cannot care for him, IF she runs herself into the ground trying to sustain this. IT IS NOT SUSTAINABLE, SAFE, much less a reasonable exception for her to attempt.

best of luck with this - hugs

The yelling cannot be controlled. It’s part of your dads dementia. Your mother needs it to roll off her back, and not worry about it. Would medicine help control your dads yelling?
some people with dementia get angry, others have a sweet gentle nature.
my own mother turned angry, she was always nice in her right mind.

You need to understand dementia. Educate yourself by reading, watching You Tubes, going to TEEPA SNOW's website.

* Your dad will not change.
* Your mother will continue on deteriorating.
* It appears to me that it is up to YOU to make decisions. However, you likely need legal documents in order to do that.
* If nothing changes, this is a downward spiral for all concerned.
* Someone (you?) needs to talk to your mother in ways that she will 'get it' in terms of placement. Perhaps you need to hire an independent medical social worker or someone else to 'help you' talk to her.
- Guilt can keep her stuck and nothing will change - unless she gets the support she needs. These decisions are not easy for anyone, let alone a spouse who is older, too. However, she needs to become aware that only by taking care of HERSELF will she be able to support her husband (in AL or wherever he may go).

* In my experience, even with dementia, a person CAN hear when limits are set - when there are CONSEQUENCES of unacceptable behavior (not empty threats). Tell your dad in no uncertain terms that screaming / disrespecting caregivers - and your mother - will not - is NOT TOLERATED.
- The consequences of his behavior if it doesn't change? Perhaps medication (adjustment), leave him alone to deal with himself, get your mother out of there for 1-2 weeks and get a caregiver in there to do what is needed. He won't like it although he might get it.

Bottom line: you need to get legal authority to do what is necessary to make needed changes. Do it for your mother. She deserves more. I only hope you can - and that she doesn't legally or otherwise block you. She is likely very ... committed / bonded with your dad and 'used to' his unacceptable behavior.

Perhaps she can get a therapist or certainly some professional support to intervene. She may not 'hear you' as you are family - she may listen/hear a professional who is independent and not family. This is very common.

Gena / Touch Matters

I see questions like this often. I have given it a lot of thought. One thing people miss is the fact is the patient does not want this and they are frustrated because there is nothing they can do. There is no cure no rosey outcome. They are locked in an uncooperative jail with no way out. Memories may be confused but there are times of clarity. The problem with our care system is there is no way to just let nature take its course. I have dealt with several family members who have not had peaceful endings.

T

Guilt is inappropriate. Mom needs to be told that she did not CAUSE this and she cannot FIX this and guilt requires causation and a refusal to fix.

Your mother is making poor choices for herself and her health.
There is little you can do but tell her that this is the case, and that you cannot enable her in these poor choices, therefore will not be helping her with care, that she must place her beloved so that he can safely be cared for by two to three shifts of multiple caregivers, and where he can be medicated (hopefully) so that he is not miserable.

You are correct that your mother's health is at risk. There may, quite honestly, be nothing you can do about this. But be certain you do not contribute to these terrible choices you mother is making out of misplaced guilt.

I went through something similar. My husband has had vascular dementia since 2010 due to multiple brain aneurysms. He was 58. He would encourage me to go out and do something but when I got back, he would just scream and holler at me. It all came to ahead in 2022 when he got so angry at me for calling a support hot line that he called 911. The police and a psychiatric unit came out and decided it was necessary for my safety and his to admit him to the hospital for observation. When they thought he was ready to come home I told them no, and I placed him in a memory care facility. Talk about mad when I went to visit him the first time and if looks could kill I would’ve been dead 100 times over . Adult protective services came out and checked on me the following week as my husband told the police that he had hit me which was not true. The badgering and yelling lasted 24/7…it could be heard on the phone when I called the support hotline. I now visit him about once a week bring him snacks and I worked hard to get his medication straightened out. For the most part, he is happy I believe in the facility.

Serkey, you “often hear that patients deteriorate a bit more quickly in such facilities”. Many patients cope better without any change (other than their own deterioration). Any changes are what lead them to “deteriorate a bit more quickly”. But it IS just ‘a bit more quickly’. They would soon be there anyway, just given a bit more time.

serkey, first before anything, take Dad to his primary doctor and have him tested for an Urinary Tract Infection. Such an infection can cause a person to lose their temper and other unwanted behavior. If it turns out your Dad has a UTI, it can be correct with antibiotics.


If your Dad doesn't have a UTI, see if the doctor can suggest medicine that could help calm your Dad.


Tell your Mom not to feel guilty about placing Dad in a Memory Care center. Let her know that 40% of family caregivers die leaving behind the love one they were caring, and you don't what that to happen to her.

What is Mom guilty of? She did not cause this disease.
Sadly, as it is with long progressive diseases it will only het worse. Mom’s health is just as important.
I am going to say it again, just because one life is destroyed does not mean another has to be as well.

Up to 40% of caregivers die before the person they are caring for .

If your Mom dies from the stress of this , Dad will end up in memory care anyway .

I am really not one to say MC or NH , as the solution for elders, like some do, I'm not knocking them at all or saying they are wrong, they are often more experienced and right.. I'm just saying that is not my usual go to solution. But in the case of an elderly man that has dementia and anger, and an aging wife caregiving, that in my opinion is the only solution there is.

Your moms health is the most important. My dad was very angry and dangerous in his later years. Should of not been around my mom, but mom would of never allowed it.
Anyways good or bad he passed before it got worse.

But I feel very strongly that an angry elderly man should be in a facility, because it's never likely to get better, only worse.

I am very sorry you and your family are going through this, it's horrible thing to go through. 🙏😔

Please look out for your mother, she can’t continue to hold up to this, nor should she. At the least, your dad needs medication to calm his acting out. It’s not to make him a zombie, it’s actually a gift to him not to feel so anxiety riddled and out of control. Consider heavily if mom can live in the same home with dad after the meds or if the cost to her health remains too high

Mom needs a break? That's for sure. A BIG one. If mom insists on keeping him at home, he needs meds. He needs to be calmed down. That yelling isn't good for anybody.

It's normal for mom to feel guilty about MC. But you need to talk her through that. Get her to give him meds and see if he's tolerable. She needs to have help at home, with or without meds.

Call dad's doctor, explain his agitation, and get some calming meds prescribed immediately. No Memory Care Assisted Living facility wants a resident who's yelling and agitated all the time either!

Guilt should not play into the Memory Care equation because dad is no longer manageable at home. Unless mom feels that her life is less valuable than his. They both need a calm lifestyle, in reality.

He needs to be either heavily medicated, in a facility, or (lost likely) both.

It’s time for memory care , NOW .

Dad needs to be in an environment where he does not call the shots. I was told by a doctor , when it gets this bad at home , they have to be moved to facility care where he does not have family as his hands on caregiver to try to boss around , guilt trip , or manipulate . He needs a village to take care of him , where there are trained staff in these behavior issues , as well as he can receive meds as necessary under the supervision of medical staff .

Move Dad to memory care ASAP, before your mother either gets injured by Dad getting violent or your mother dies of a heart attack or worse she lives bedbound from a life altering stoke.

Your mother can’t live like this anymore .