After several strokes, my uncle's behavior is inappropriate -- what can we do?

2 answers | Last updated: Sep 20, 2016
A fellow caregiver asked...

My uncle has suffered several strokes in the last six years. Physically, he has recovered and is fairly independent. However, he has gone from a charming intelligent man who was always very respectful of women to constantly leering and making sexually inappropriate conversation. It's bad enough at home, but a family outing with him to a restaurant, bank or grocery store is mortifying for all, especially my poor aunt. He will openly turn to stare at women as they walk by and flirts constantly expressing specifics (without profanity). We are not prudes, but his behavior and commentary is extremely offensive. Young female relatives are starting to avoid him,and no one brings a future in-law around. He would be mortified to know he's behaving this way, but it's getting worse, not better. It's like there are no controls in place, and he seems bewildered when we try to discuss it. Is anyone else dealing with this, and how are you handling it? I am also starting to worry about legal consequences.

Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Sorry to hear about this.

It sounds like he might be suffering from "Frontal Lobe" dysfunction, most likely from all the strokes. This causes people to be disinhibited and inappropriate in social settings.

I would first start by having him evaluated by a Neurologist and getting an MRI of the brain. A Neuropsychologist may also be helpful in sorting out if there is a dementia co-existing that can be treated with medications.

For symptoms such as this, I commonly prescribe extended release valproic acid once a day. It is used as a "mood stabilizer" and often deals with the problem in a healthier way then would be accomplished with the use of "anti-psychotic" medications. Please ask your doctor/Neurologist about the use of this medicine, or others like it, to help regain some control of his behavior.

Good luck!

Community Answers

A fellow caregiver answered...

I am so sorry for the tardy response to this excellent answer. Dr. Castle's suggestions were on-target. I passed the info on to my aunt, who was desperate enough to become insistent about trying something other than the anti-psychotics, which tend to have very adverse reactions in our family. My uncle has toned it down now, and the family also went to some family counseling. The younger generation is much more accepting of the remarks now that they understand he can't help it, even though we're still having our "aw jeez" moments in public :-) My aunt is now getting more help from the youngsters, and for that, I thank you from the bottom of my heart.