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They can carry on a mostly normal conversation with others but as soon as they are alone with their spouse the aggressive behavior starts.

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Haha, my mom is generally more on her game during doctor appointments so she can usually look very oriented but at home I see more of the forgetfulness, depression and frustration. I think it's because going to the doctor or somewhere outside of the home is out of the ordinary so she's just more alert during those times.
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In general a spouse or significant other is a “safe” person to vent to. It must be exhausting to try to cover up problems in company of others.
If the anger is verbal if you can calmly say don’t talk to me that way, I understand you are frightened, frustrated, angry. Then try to remain calm and don’t get angry in turn. If you can’t, leave the room if it is safe to do so.
If the anger becomes violent that is a completely different thing and you HAVE to protect yourself. If you have to call 911, explain the situation and ask for transport to the hospital.
Do talk to your spouses doctor. Medication for anxiety can help. Also talk to YOUR doctor, dealing with this is stressful and it can and will effect your health.
good luck, hang in there
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This happens all the time with or without there being dementia. The person will generally be aggressive and abusive to one person close to them. Sometimes it's a spouse, one of their adult children who is their main caregiver, and many times it is their hired main caregiver. It can quickly turn into a dangerous situation for the person on the receiving end of their anger and aggression. The best suggestion I can offer is for the person who is on the receiving end of the anger and aggression to completely ignore the person when it starts up if it is safe for them to do so. I do not mean safe for the person displaying the anger and aggression, but for the person they turn it on. If it is not safe for them to be ignored and left unsupervised, then it is time for the person with dementia to be put into a care facility for safety reasons. A hired caregiver will quit a job when a situation gets like this. Certainly I've walked away from jobs with aggressive clients because I will not risk my own safety regardless of how great their need for care is. A spouse or family caregiver can't. That's when it's time for a long-term care facility because when the aggressive behavior starts it's not safe. It's not safe for the person with the dementia to not be living in a controlled environment either.
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jacobsonbob Dec 2020
We have a family member like this (and as far as we can tell, there is no dementia involved and she is not very old). Without provocation she is nasty to me and to her husband, but whenever she is on the phone or visiting others, she is "oh, so sweet". It's probably a personality or emotional problem, and people of any age can get this way.
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We all tend to take out our frustrations on those we love most, dementia or not. It's just the way it is. I guess it's because we feel safer with someone we love, as we should.
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MargaretMcKen Dec 2020
It sounds like you might think this applies to Domestic Violence too. Yes, men who are violent to their wives very rarely beat up on their boss. It's the 'loved person' who needs to feel safer, not the aggressor.
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It is for ALL OF US easiest to emote in the presence of someone loved and trusted. We are on our best behavior with strangers, those we want to impress. Sadly, that's the human condition.
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You are talking about 'Showtiming' which is when a dementia/ALZ sufferer acts all sweet & nice & normal to a stranger, then reverts back to confusion & all the same old/same old with their loved one/caregiver.

Now, if your husband is being aggressive and angry, and HITTING you or raising his hand to you, that's something entirely different and it's NOT OKAY. Dementia or no dementia, aggressive violence is NEVER alright.

If your husband is hurting you and hitting you while you are alone, call 911 and have him taken to the ER for a psych evaluation. He may need to be placed in a Memory Care Assisted Living if he's acting that way. Or, at the very least, you would need to contact his PCP for medication to calm him down, and see if that works.

Don't live in fear, ok?

Best of luck!
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BurntCaregiver Dec 2020
That's when it's time for a nursing home. When the aggression and violence start , it's no longer safe for the person to be living outside of a facility and in a controlled environment. Not safe for the person themselves or the one on the receiving end of their aggression and violence.
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If this is new behavior ask for a UTI test for your husband. If he has always been this way, then just more of same.

It can also be that your husband is feeling your tension or anxiety about his behavior and feeling a bit picked on. It’s a fine balance to look out for a loved one with dementia and yet not cross the line into bossiness or criticism.
None of us like our actions to be restricted. Think toddler.

When I first started helping care for my DH aunt, she referred to me as her “guardian angel”. 10 or so years later, not so much.

Now when the PT or bathing aide comes in, “Who called you? Did 97 call you?”

Sadly it goes with the territory.
I do try to be aware that I traded my friendship for being the fun police and take my time so as not to be abrupt of pushy when encouraging her to participate. I’m not always successful.
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I'd have to agree with lealonnie on the call 911 for them to be taken to the hospital for a psych eval. My Mom was put on the geriatric psych ward twice before being placed in AL. There were a lot of med changes to get her to calm down with the psychosis and emotional outbursts. That mention of UTI is also something to always watch for. They are so mind altering it's frightening. Sending you heartfelt wishes for answers and some type of peace.
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disgustedtoo Jan 2021
Yes on the scary results of UTIs, but in discussion with someone else, it seems ANY infection can induce some of this, not just UTIs! We're going to have to suggest blood work along with the UTI test, as infections would raise the WBC counts. Then it would take some time to figure out where the infection is (the one discussed was in the mouth, but it could be anywhere!)
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Sure. I see that all the time. Not just the spouse but at the person who is doing the most for them. My grandmother did that to my mom. And I have friends who had loved ones they were caring for do the same thing. Have no idea why that happens but it happens a lot.
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Yes, I have this all the time with my husband. He constantly says mean things no matter what I try. It is exhausting! I am at a loss as to what to do! I so feel your pain!
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I dealt with this when taking care of my dad. The doctor told me that it is normal for people with dementia to become aggressive or agitated and take it out on the closest person, this is 90% of the time the main caregiver.
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Oh my gosh, yes! I go through this with my dad all the time. I am his legal guardian. Treats me like crap much of the time while my siblings don't even see that side of him.
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Yes.
I was kicked out of the house because of a perceived wild party in the basement (I was asleep.)
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My mom and dad had a beautiful marriage and truly were best friends. I was very close to both of them and spent a lot of time with them. I never saw them fight and they talked all the time. When my mom started showing signs of dementia, he would call me and say that she was yelling at him and "not the same person". I explained to him that it is the dementia and not him. I don't know if anyone really knows why this happens because the person with dementia cannot explain and if you ask they usually don't realize the behavior and become angry at the accusation (maybe they don't remember acting that way?). It really is a patience and tolerance situation in these cases. I always tell myself that my mom does not need to adjust her behavior because she has a disease that she cannot control. Her brain is literally slowly dying. I have to adjust my behavior and in my dad's case, I just became his shoulder and support to help him cope with my moms change in personality. It is difficult for everyone caring for someone with dementia. Blessings to all the caregivers.
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Well, it could be two things.

One, the people they are around for a short time needs to stick around all day and see if the actions change.

Or # 2.
The couple already argued a lot before dementia and is just going back to it.

#3. Maybe the Spouse treats them differently then the other people treat the loved one.

Set up a Camera and then watch your interactions and see what you do prior to the Spouse becoming agitated.
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my2cents Jan 2021
Good idea on camera to observe your own interactions with dementia patient. More often than not, the immediate family will try to correct their loved one to get them to understand reality. So, the argument is always just below the surface.
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I think it’s pretty common in dementia. The person is on some level aware that they losing it, but in grieving, they first get angry. They may still be inhibited about showing anger to strangers, but feel safe to show it to close friends or family.

so expressing anger may be a sign they trust you. Hope that’s some comfort.
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Very common from what I saw with a couple of folks. Could be that the others don't have the same history with dementia patient as the spouse. Some family members insist on trying to get the dementia loved one to see reality and so there is frustration on both sides most of the time when they are together. Kind of an 'air' of frustration lives in the house with spouses. And the visitors are new and kind of break things up.

Don't really know why this is, but yes - what you see is common.
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As others have stated, this is normal. The real concern I have is what to do about this behavior. Physical violence should never be tolerated. Verbal and emotional abuse must also be dealt with. Asking the person with dementia to change will most likely never happen. A doctor prescribe anti-anxiety medications to help the person relax instead of taking frustration out on others. Other strategies include having a routine schedule for the person with dementia, dealing with Sundowner's Syndrome, and check-ups with the doctor when person is unusually agitated. If the spouse of the person with dementia is afraid to be with him/her, it may be time to move to a memory care unit.
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For whatever reason - they always seem to turn on the person they love most. But that does not mean it is OK or that the person being abused has to ignore it. The person with dementia does not know they are doing it. Walk away if possible - time out like child -let someone else in family do caregiving OR if physical or constant verbal may have to relocate.
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My adult son at 41 has early onset Alzheimer's and the most severe anger issues and threats are directed toward me or about me with other caregivers in our home. I know it is his disease. But I can handle it, the other caregivers are horrified for me. But then, he knows I'm MOM and I make all the hard decisions and it is difficult for him that I am always the one to make sure the routines are appropriate. I have to be sure all the caregivers follow similar routines and ways of dealing with him. The consistency and routines are critical to his care and wellbeing. We are working to continue as much independence, dignity and enjoyable activities as possible as this goes along. But boy, is he angry at me a lot of the time!
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disgustedtoo Jan 2021
Wow! Only 41... How sad. It's bad enough when older people get it and it robs them of their final years, but to have to lose so much of one's future...

It's good that you understand and can "cope" with it, but it has to be heart-wrenching - bad enough knowing his life will spiral ever downward and be cut off too soon, but to have to be the punching bag as well... You're a strong person to be able to carry this burden with such aplomb!

(just to be clear, the burden isn't referring to your son, but rather his condition. sometimes written words can get misconstrued.)
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Yes. My mom acts "normal" around other people, but has hallucinations and anger spells around me.

It sucks.
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I am sorry you are going through this. Mom (with dementia and before dementia) was always hostile toward my dad, blaming him for everything and putting him down, when Dad was as fine a husband and human being as ever lived. She was sweet and charming to everyone outside the family, nasty or neutral to family, and a hellion toward Dad. She took credit for everything, said Dad did nothing (when he was in poorer physical shape than she was) when in fact, Dad was doing most of the housework and taking care of her. (Dad should be declared a saint). When Dad passed away 4 years ago, I became Mom's primary caregiver, still am, and immediately took on the role of scapegoat for Mom's hostilities. At first I was deeply hurt, but now, thanks to this group, I began to understand how common this scenario is with dementia. The one who does the most takes the most heat. Besides, I believe mom had some form of mental illness before dementia began its slow destruction of her brain. That's just how it was and is. I wish I knew then what I know now, and would have spared myself loads of grief.

The best course of action for us both was to turn Mom's day-to-day care to AL memory care, who have done a spankin' good job, I might add! Before Covid, I could visit and leave at will, and just be a daughter to Mom. Now I visit by appt according to memory care rules (mask and distancing). And it's okay.

You will find loads of help here. It's so hard to make the needed changes in our lives and to do the emotional "work." But the payoff is liberating. Wishing a better 2021 to you and everyone!
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disgustedtoo Jan 2021
I'd almost think you might be my long lost sister, except for the part about her taking credit for everything, dad was nothing. ALWAYS harping on him, but as you say, sweet as pie to others, okay most of the time with us, but could turn on you in an instant!

I'm fairly certain she would have been hell to deal with if I could have taken her in. I couldn't, so I found the best place near to where I live, so I could watch over everything and visit. She was never nasty to me, and while she once in a great while would get her dander up with staff, most of the time she was quiet and well-behaved (UTI time excluded!) Like your mom's place, this one was awesome, always took good care of mom, clean, good food, well-fed (a few too many ice cream bars!) and enjoying the activities.

I can't tell you how many times staff would say how much they loved my mother, she was "cute" and "funny" and they enjoyed having her there!!! She did have her feisty moments, but most of the time she was mild-mannered Clark Kent. I wondered who did the body snatching, replacing my mother with someone else! Whoever the body snatcher is, they probably wouldn't show up at our houses, so we get the one and only original model!
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My wife. Daily!
I have always been told that they take it out on the one they love the most.
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BTW: No violence<
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My husband gets very angry when I am on the computer. He wants me by his side 24/7. I believe he is jealous of my time away from him. I pray he doesn't get physical. We have no money to be able to afford a nursing home. He is on a list for Hospice but they will not enter him into Hospice until he is incontinent. This is extremely hard as I cannot get away. I think I have a young man who is a neighbor who is willing to come sit with my husband for 2-3 hours twice a month just so I can spend time with my family and/or go shopping, Dr.appt., etc. We caregivers need help. Its very hard when we are living on Social Security and do not have the funds to pay for Memory Care or ???
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BeckyT Jan 2021
Jacilyn, look for a free half hour consult with a Certfied Elder Care Attorney. They can do remarkable things to qualify your husband for Medicaid and protect you and your home at the same time (there are trusts that a be made).

There is no reason why you should be afraid in your own home. Please check into this.
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Imho, my sister in law, who has Alzheimer's is like this, but in a reverse way, e.g, she was always short tempered and mean spirited with her spouse BEFORE the diagnosis. After the diagnosis, she was suddenly pleasant to him.
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The title of your question is almost the title to the story of my life, except my significant other is my mother, not my spouse. She openly ignores me when I speak to her at times, the point where I say Are listening to me? And she replies Yes, So I say are you ignoring me, to which she actually says Yes.

I know she has dementia.
I know she has severe hearing loss.
I know she's still in the grieving process over my father's death, which was over a year ago.

However, at the end of the day, when my pain levels are higher (I suffer from 3 incurable pain conditions), being purposely ignored is the last straw. There is nobody in her life she would treat with such disrespect and insolence.
So, I can empathize with the author of this question. I wish I had an answer. I feel for you. It's a tough situation to be in.
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For those in need of help but can't afford it, BeckyT suggests finding EC attorneys who offer a free limited initial consult. Use your time wisely by drafting all you questions, knowing what your assets are (income as well as any savings and property.)

While plans may take time and not benefit you now, WE need to make our voices heard! Back on Nov 29, 2020 I posted a link to an article I read:

https://www.nytimes.com/2020/11/27/health/biden-senior-citizens.html

The thread is:

https://www.agingcare.com/discussions/suggestion-to-become-active-in-promoting-caregiver-help-not-a-question-463299.htm?orderby=recent

To date only 2 people have read this post and commented. We are such a large group, we need to have our voices heard!

Read the article in the link to see details on what is planned. The plan is to help caregivers, family ones as well as others, among the ideas being considered. WE need to make sure our Representatives and Senators are made aware of the NEED. It might be too late for the ones we are caring for now, but this problem isn't going away, it NEEDS to be addressed!

PLEASE, contact your Reps and Sens and send them this article link. Include a brief overview, if you want, of all the struggles you go through to provide care. Express how much we ALL need this help, sooner rather than later!

To find your state reps:

https://www.house.gov/representatives/find-your-representative

^ this finds your Sen by zip code.

https://www.senate.gov/senators/How_to_correspond_senators.htm
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Yup, all too often this happens. Depends a lot on who is doing the care-giving. Sometimes it is the spouse, sometimes it is an adult child, sometimes it is hired help. The nastiness is usually directed at whoever happens to be the primary care-giver.

My mother was like that somewhat BEFORE dementia (sweet and nice to everyone else, not so much with us!), but thankfully it didn't seem to carry through, at least with the staff, at MC.

We tried bringing aides in to her condo, but she thwarted that in short order. I couldn't take her in (brothers both considered it and half-heartedly suggested it to her, but it would have been a HUGE mistake, or worse!) So MC was it. For the most part, she was well-behaved and didn't really cause much grief. Once in a while something would get her dander up and she could be feisty, but most of the time she didn't and was well liked by all the staff.

But, what you've described IS very common. IF it gets too bad for the spouse/care-giver, doctor might be able to Rx something to take the edge off. Mom only needed those during the initial move and during the first UTI at MC. IF it drifts into physical abuse or seems like it might, definitely get in touch with docs and get this taken care of! Even though others say if they get physical it's time to move them, the issue WILL need to be addressed BEFORE they move to a facility. The last thing you need is a call in the middle of the night saying come pick him up, he can't stay here! It might be possible with the right medication(s) to defer the move, if it's enough to calm him down. He'll likely still have moments, but if something can reduce the frequency and help make daily life a little more pleasant, it would override my usual concerns about medications! Hearing that verbal abuse all day would drive me batty!
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Josie2365 Jan 2021
I appreciate your response. She has never gotten physical; on the contrary, it's like a monumental effort to get he to do anything. She reliably does one thing, which is make dinner. I think this is a very good thing for her, because she does assume responsibility for something. Other than that, all she wants to do is watch movies or tv. Her personal areas, like her vanity/bathroom in her master bedroom, are sometimes so badly neglected I just can't believe it. I do a lot of cleaning on the sly, which I don't think she notices (which I don't take personally, because I really think she doesn't know the difference anymore), but she did Not raise me that way. It's just a sad situation, which will not get better over time. She is a healthy woman for her age, but has a very unhealthy mind.
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I did a course with the Alzheimers association where I live and found it extremely helpful and gave me a lot of insights, and one was that it is very common for people with Alzheimers or dementia to feel and express anger towards their primary relationship/carer. The course helped me so much and it helped me to not take things so personally and to be more compassionate and even if that was being difficult, at least I could find more understanding. It also helped me with very practical insights eg people with dementia can see the change from a light to a dark floor as a hole. Wishing you and your parents all the best.
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