My dad with Alzheimer's is becoming increasingly aggressive and agitated, what can I do to protect my mom?

A fellow caregiver asked...

My father is 73 years old and was diagnosed with Alzheimer's about 3 years ago but we started noticing symptoms about 4-5 years ago. He is in the mid/moderate stage at this point. Although my father does not admit that he has Alzheimer's, I believe that he may have realized that something wasn't right about 6-7 years ago and that is why he chose to retire and moved from D.C. to New York to be closer to me and my children. My mother is a young 68 and continues to work three days a week. He is very resentful that she works but she needs to in order to keep her sanity. We have a wonderful young girl that comes and keeps my father busy and active while my mother is at work. We have been trying to take my father's car away for the past month but keep hitting road blocks. We have tried to be honest, hide the keys, dismantle the car, but to no avail. Although he currently can't drive the car because he thinks the keys are lost or that the car is broken (I actually don't know what he thinks at this point), he is EXTREMELY angry! He blames my mother or me for doing something to the car or losing the keys. He tells me that I am always on my mother's side and I don't do anything to help him with car. When I offer to help he tells me that I don't understand the true problem with the car and that it's all my mothers fault and she needs to fix it. I understand his frustration, anxiety and stress about with not being able to drive but he is becoming very aggressive towards my mother. My mother has already told me of instances of him grabbing and twisting her arm, throwing things in her direction, and blocking her path aggressively when she tries to move about the house. My parents never had the greatest relationship to begin with and my father could be aggressive towards her at times, although very, very infrequently, but my mother and I are afraid for her safety. Before the dementia, when he got angry, he was able to control himself and stop his agression before he hurt someone. I'm afraid now that he won't be able to stop himself and cause serious injury to my mother. We have looked at facilities and daycare programs but none of them are appropriate for my dad at this point. He is too "with it" for something llike that now. What do we do??

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

Your father is at a particularly difficult stage of the disease. He's aware of his mental shortcomings but also knows that he's unable to do anything about it. His frustration and subsequent aggression are totally understandable. He's striking out at your mother probably because she's the easiest target. This kind of rage is usually a cry for help. The best way to help both him and your mother is to shift the "bad-guy" roles to others so you and your mother can be his best allies. Let others be the bearers of bad news. If your mom can get accustomed to empathizing with him rather than correcting or criticizing, his violent outburst will likely lessen. Your mom is probably right in her criticism, however, it becomes counterproductive with a person with dementia.

The car situation seems to be the over-riding issue for your father. As you say you've tried everything that we normally suggest: hiding the keys, hiding the car, pretending the car doesn't run, all to no avail. The consequence is that he blames your mother for the car problems and unfortunately he's correct, so you want to shift the responsibility to an authority figure and let your mother play the role of sympathetic spouse.

Request a "formal" order from his doctor that he has to stop driving and sell the car. Many state motor vehicle department will test a person whose judgment is in question. Talk to them. You may also talk to your local police department for advice. This is a search for a figure of authority for whom your father has respect. It may help you get him to understand that the car is no longer an option and he may even accept the car being sold. Go to search on "Driving" this will give you more tips and a list of state laws relating to these issues.

In order to help your father with his resentment over your mother's work, collaborate with his companion on something purposeful to do during the day. It doesn't matter what it is or if he's able to actually achieve anything as long as he feels accomplished and enriched. (Suggestions: lectures, musical performances, library visits, picnics, movies, or café lunches "“ or home bound projects: gardening, cooking, art projects, simple wood work, like bird feeders, or housework)

A couple of suggestions to maintaining harmony with a person with dementia:

This is not the same person you knew before. He looks the same and sounds the same, but his reality is constantly shifting and he can no longer relate to your reality. He easily succumbs to depression from feeling lonely, lost, and confused. Those of us in his life need to become his strongest supporters even if it means ignoring hurtful outbursts and rantings.

You'll never win an argument with a demented person. All you'll manage to do is aggravate the situation. No matter how outrageous his behavior, try to ignore it and if you feel you can't, step outside for a deep breath and remind yourself that it's the disease, not him.