Are Alzheimer patients aware of their aggressive behavior?

6 answers | Last updated: Sep 12, 2016
Hincke asked...

My 90 year old father "flew into a fit of rage" over my son's trying to fix the lock bar on the sliding door. He yells, "this is my house! I paid for it. You ask ME if you want to do anything." (my son is 28). I told him that Mother asked him to see if he could fix it. That didn't matter! He paid for the house. He then yelled at my sister because she initiated the whole "fix the door" situation. She cried and had to leave. I then asked Dad about yelling at the two. He knew nothing about what I was talking about. Do Alzheimer patients just black out when the "rage" happens? I can't get a definitive answer!


Expert Answers

Merrily Orsini, MSSW, was a pioneer in the business of providing geriatric care managed in-home care. She currently serves on the board of the National Association for Home Care and Hospice and is Chair of the Private Duty Homecare Association. She holds a master's degree in social work and is a nationally known writer and speaker on aging, elder issues, and in-home care.

In order to understand the behavior of someone with a dementia, your question 'Are Alzheimer patients aware of their aggressive behavior?' can best be answered with a deeper understanding of the disease. The part of the brain that understands, and reacts appropriately is diminished. Expecting someone with Alzheimer's to be rational and to remember is an unrealistic expectation.

The entire family needs to read and learn about the disease, how to work with someone with Alzheimer's and what to expect and not expect. There are many wonderful resources that cover these topics, and your life, as well as that of your father, will benefit from some deeper understanding of a) the disease process itself, b) how to live with and care for someone with Alzheimer's disease and c) a support group or some avenue for sharing experiences and learning from each other.

So very sorry that you are having these issues, as it must be painful for all. But, it is more than a "black out" when rage occurs, it is really an inability to have control over actions and reactions, and a process of the disease itself.


Community Answers

Monica heltemes answered...

I am sure this situation and your dad's reaction was upsetting with all involved. Like Merilly said, understanding aggressive behavior in Alzheimer's patients can make a world of difference and perhaps even avoid it from happening in the first place. Your father's brain does not work like a healthy brain.

In the situation described in the question, these functions are failing:

  • Memory -- Your father does not remember why the door needs to be fixed.
  • Reasoning -- Your father does not understand that your son was fixing it because he was asked to. Even explaining this to your father will not help and may make him even more angry. To your father, he sees someone else doing a house repair that is being done without him and to his house, of which he obviously very protective and proud.
  • Controlling emotions -- Your father cannot temper his dissatisfaction with this "˜sudden' house repair being done by someone else. He just feels that somehow this is not right in his world and he reacts the only way he knows how "“ by yelling.

Learning more about how Alzheimer's affects the person's brain and how caregivers can work with the person effectively is a difficult process and will never be perfect. But it can make day to day life more enjoyable for all involved. In this case, the simple solution would have been to repair the door when your father was not around and then not tell him that your son fixed the door. Wishing patience and understanding for you and your family!


Brmeagher@tampabay.r answered...

we live in florida and I would like to go to a family reunion in mass. my husband does not want to go. He has the start of demecha and i feel quilty. We have no family here. is there a place that he can stay for four days and what do i need to pay for the help. i would feel guilty if i left him alone as he is a diabetic. His wife Help b


Rosar answered...

Hello,

Going to your family reunion is a great way to get respite. There are several options for your husband's care: In-Home Providers for care at home or an Assisted Living Community that offers short term stays. Caring.com's Senior Care Directory can help you locate resources in your area: www.caring.com/local. Family Advisors can also help you find short term or long term community stays. Family Advisors can be reached at (866) 824 8124. Rosa at Caring.com


Ca-claire answered...

Most of the time I think of Alzheimers as being a fully grown pumpkin, just picked from the vine, but left on the ground, as the pumpkin had split open before picking. Ants and other little bugs find their way in, and start munching in various places in the pumpkin. Think of the solid portions of the pumpkin as being memories from the past. The soft portions are what controls actions and behaviors.

The ants might nibble here and there, but mostly in the soft portion, as it's easier to eat, then they nibble their way outwards, going at the memories backward from the way they were made (newest memories going first, then out towards the rind. Slowly, but surely taking away learned behaviors, manners, judgement, reasoning and appropriate ways to care for bodily functions. It's insidious. No way to stop it, or replace the missing portions.

It might help to watch the movie 50 first dates. There is a character in there called 10 second Tim. Shows what damaged pathways, whether from a traumatic brain injury, a stroke, or from dementia can do. The young woman in the movie can only remember today, tomorrow, today's memories are not there. Very interesting way to watch how you can work with this and adapt it to your dealing with dementia patients, although in the movie, the man is trying to 'date' the young lady with the memory problem, while the Father and Brother of the woman, try to keep the woman's world the same each day.


A fellow caregiver answered...

My father goes into rages just like the ones you described. Recently, I had to replace the washing machine, and he had a major tantrum because I didn't ask him first. Even though I paid for it with my own money. He still insists on tryng to fix things, even though he always makes a big mess of it. And gets really angry if you get someone else in to do it.