How should I handle my mom with dementia going into an irrational, aggressive and abusive rage for hours?

A few months ago a neighbor down the street dealing with husband's dementia called 911 when her husband's abuse got out of hand after about a month of escalation. After talking with police she had him admitted to a lockdown Alzheimer's care facility, where, IN HER WORDS, he went even ''loonier'' and ''meaner'', they treated him with heavy medications to control most of his outbursts, and often he had to wear restraints in bed - 3 months later they treated him for a UTI they had detected, and a week later, it was like he began to awake from a fog, and wondered where he was at and why. She got them to reduce the other medications they had put him on.
While he still had Alzheimer's, he had returned to his 'normal self', the mean screaming, fighting lunatic was gone. It took another month for her to get him back home, and his decline is worse for his time in the facility, but he is not the raging bull ready to charge that he was when she sent him there. She says now she wishes she had talked to his doctor when his mean/fighting episodes started but she was reluctant to tell the doctor about them. When the police were called, they made the best suggestion that they knew for her personal safety (to admit him to a lock down care facility).
She knows she lost precious time with him, and it caused his decline to hasten.
She now knows if the symptoms last a few days, to get him to his doctor.
She met a man at the lock down care facility who's wife was in there for violence and anger, then she got started on an anti-psychotic medication, and he has now taken his wife back home where she is doing better and happier.
Not everyone is fortunate enough to have family ready and willing to take care of them at home, but whenever possible, it is most often the best situation for the patient.
Most patients never leave a lock-down care facility.

Thanks for all your responses. It is very hard to deal with rages. I know that it is not her talking. I try very hard to walk away and for the most part I do. It is the hurtful things that she says towards me and my husband. I am a mother too. I would never say these things to my children. ( I know that I am in my right mind). Then while I am still hurting, she calms down and is as sweet as sugar. She does sense that something is wrong with me. But I lie and say everything is alright. I find it very hard to hide my emotions (I'm Italian). It's the emotional roller coaster I find hard to deal with.

First get a good medical/mental checkup. Then tell her in no uncertain terms that she cannot act that way and it simply will not be tolerated. Make sure she understands. Stand your ground. If it continues, and it is dementia, please make plans to remove her from your sight as it will eventually destroy you. Please do not let that happen.

we have plenty of the real thing cats about 7 & 1 dog there is 3 that are playful & young .

RUN don't walk to her doctors office!
First work with her doctors (especially geriatric psychiatrist or neurologist) on MEDICATIONS - also meet with a doctor or nurse for a visit on reviewing all of her RX's best time of day to take them, with or without food, any interactions etc. Even medications that she may have been on for a long time need to be reviewed.
Then discuss any antidepressant or similar medications that may help her on a daily basis.
Next - pay attention to possible UTIs or constipation - they can REALLY affect mood and behavior. We got to the point we knew grandma had a uti based on her behavior
alone, usually the emotional outbursts would stop within 24-36 hours of starting
appropriate antibiotics.
3 ask the doctor for a medication specifically for such events. There are many options including liquid and dissolvable medications like alprazolam or similar medications.
This can't be a happy situation for either of you, but you and her doctors are the ones that can find potential treatments and solutions.
Sometimes food, or music can help provide a distraction, but hopefully with the help of her doctors you can reduce the occurrence of these episodes.
Best wishes!

Blessings - I can back you up somewhat on that robotic cat.
My older brother bought one of the "Joy" cats for our mother, a few months before we finally moved her. When he told me what he did, I predicted, and was right, what her initial reaction would be: What did he waste his money on this for? Followed by, as predicted, he should have bought this for YOU.
The reason for this is before dementia 1) she would consider this a waste of money, and 2) she was never really an animal lover. She tolerated the few pets, mostly dogs, that we had when growing up. She always tells me not to get any more when one of my cats passes on. Sorry mom, I like them and the company they provide!

Anyway... she would sometimes, long before dementia, fawn over little dogs, and maybe seeing a kitten (god forbid a cat climbed into her lap!), but that was the extent of it. That said, she has marveled over this "cat" - probably more so because she is fascinated with what it can do, not so much that it is a pet to be snuggled and cuddled. She apparently showed it off to the neighbors before we moved her, and still about 6 months later will still marvel over it and what it does.

What can it do? When you pet and/or scratch it and hit the "sweet" spots, it purrs, it meows, it moves it's head, blinks, wiggles the ears. Sometime it raises one paw and proceeds to "lick" it, slurping noise included! If done long enough and hit the right spots, it will roll the upper body back, purring away, to allow the tummy to be rubbed/petted. Eventually it will roll the upper body back up (it is in a lying pose, with head and shoulders raised.

Given a choice between dog and cat, for someone with dementia I would likely recommend the cat (I DO like dogs) - they have done studies and that gentle purring has a calming effect on many people, not just cat people. I have not seen the robotic dog in person or watched anything online, but real dogs tend to be more "exuberant", barking, jumping, etc, so I would guess these robots would try to mimic that behavior like they mimic the cat behavior. It would all depend on the person it is intended for, but again, I think the calm, quiet, purring and quiet meowing would be more beneficial for someone with dementia.

So, if your friend/loved one IS or WAS a pet lover, one of these could help bring some comfort, especially during those anxious moments that happen too often. If nothing else, it is a distraction from whatever they might be fixated on, and distraction/redirection is one of the caregiver's tools (and family members). It is certainly worth a try!

(If it doesn't work out, there is probably a young family member somewhere who would love to "inherit it! ... or you could mail it to me!! :-D)

Caregivers, might be worth a try for those trying moments or just to aid in relaxing our loved ones during a quiet time. They are robotic cats, there is a dog as well. They are called Joy for all Companion Pets, they are manufactured by Hasbro, priced at $99. I've witnessed the cat & dog in action at a day program for the memory impaired, they work, really giving off a calming effect. If you google them there are videos of them in action. I found it touching to watch. Seeing the real time interaction with them, the smiles, the joy & calmness they seemed to bring I thought the pets were worth the $99. If one was more of a cat lover the kitties work, there are 3, which seems more relaxing than the puppy I thought. What can I say they are cute & it's a "feel good moment" to see. Blessings 🌸

MYPETUNIA you are welcome! Want all caregivers to be safe & well. We matter too. Blessings 🌸

Thank you, Blessings4Ever.

So many good points or not? If you call 911, a police officer will arrive, a report will be made, they will possibly call for an EMT, the next move is your hospital's psych ward. Anti psych drugs will be used, much stronger than home meds. Your loved one will sleep for days, may be worse when they wake up, home may not be home anymore. Don't know if "man hugs" are a good idea either, in a hospital setting they are called "restraints." That's got to be frightening. If someone is scared, they may become more agitated or "give up," because they've forgotten what's going on to begin with. It's called being submissive. Compliancy happens with disease progression. Not investigating why at all what's going on? You don't do that with your own concerns, you seek out reasons & help, your loved one can't tell you what's wrong anymore. Let's not forget these are memory impairments; battles won't be won, any of your fighting words in response to their verbal abuse not understood, your direction & guidance way over their heads as soon as you give them. It's all way too much to understand for the afflicted, so you, the loving caregiver will be the recepient of it all. Less is better. Keep direction & guidance short & simple. Walk away when you sense any agitation coming on. Ignore the verbal abuse, even though it's hard, think pleasant thoughts. Just go with the "time out," if your 5 minutes is 15, let it be, it's a good rest for you. Try & take care of you both, if you choose, until you change course. Remember you are doing the best you can. Don't forget you! Blessings 🌸

Last year, I discovered just how oddly a UTI can affect the elderly. My 87-year-old Momma was totally irrational!!! UTIs should definitely be considered with any behavior change, although apparently testing isn't always as reliable as we'd like... see this article that I came across last week: https://www.sciencedaily.com/releases/2017/04/170428084433.htm

While I know it is extremely difficult to do you must remain calm as one cannot reason with a broken mind - if UTI has been ruled out and she is taking an anti-psych drug then it may need to be changed or adjusted - I understand some of the memory drugs like aricept can cause agitation even

Seroquel did nothing to calm my mom and increasing it only made things worst so we switched to risperdal - she's still a handful but night and day compared to a year ago

At her age, I wouldn't call 911 - I've seen folks at her memory care escalate to that point - it isn't pretty and the results were worst

If she is safe and won't fall or otherwise hurt herself - play music or turn on a DVD of Singin in the rain or my fair lady
Get her a cookie or ice cream
Give her space

Distraction and patience and the right meds if necessary

If it's still too much then look for the appropriate care facility

PS - Gund makes a talking teddy bear that says I love you - I got one for my mom's roomie and she was calmed by it 

meridianav, that's exactly what happens. When the rage is over and she calms down whether it be a nap or a major distraction, she totally forgets any of it. It takes me a little longer to calm down. Some things that she says to me are very hurtful. It's an emotional roller coaster.

I FIGURED OUT WHY TO GO AWAY FOR A HOUR OR SO !!!! THEY WILL FORGET WHAT OR WHY THEY WAS DOING WHAT THEY ARE DOING ..THAT IS HOW OF COURSE IT DEPENDS HOW LONG THEY REMEMBER FOR 1 THING & THE BEST TIME IS SLEEP EVEN A HOUR OR EVEN MAYBE 5 MINUTES ..MY MOM DOSED OFF ONE TIME & FORGOT WHAT SHE WAS DOING ..SO THAT IS A TOOL FOR ALL OF YOU !!!!!

... Riley.. not sure if you've cared for anyone with dementia, but it most certainly does matter "why. It most certainly does. Our elders are human beings of whom are entering their last years on this earth and we who have found ourselves having the responsibility for them understand that these elder persons who most have contributed to society are now living in the very same society that refuses to respect their value as living beings. Ones who suffer Mental and physical degrading due to age related disabilities and illnesses are not to be treated as if they are to be locked up, should not be treated as sub human beings. So, if a caregiver sees an issue then to advise that caregiver to seek better ways to resolve or deal or to assist the behavior is the "correct path, rather than the path of yours of zero tolerance... zero tolerance removes reasoning, removes patience and understanding, it removes seeking the cause and seeking a reason... therefore removes any investigative help for that individual who very much has a right to receive. Zero tolerance is a cold and power play approach to every single aspect in life and has absolutely no place when dealing with humans, let alone as they age. I hope I've made myself clear.

I don't care why she does this - it is unacceptable and cannot be tolerated under any circumstances. Check with your doctor, office on aging - you may be forced to remove her from the premises. This simply cannot go on.

My mom (in her 90s) just flips on a dime into an angry rage. It is very difficult to handle at times, and if I can change the subject, divert her attention, or give a compliment, sometimes that works. I do not live with her, and often dread going to her home. If I can, when she starts the verbal abuse, I calmly walk out and leave. I have no sibling support, and she will not allow a caregiver into her home, but at some point she is going to need assistance - more than the 2-3 days per week I give to her now - I have to work, too. She has always had an anger problem, it only gets worse as they age - and it is always directed at the person who keeps them going, and who is kind. Conservatorship is out of the question.

I also have this problem with my wife. She has Lewy's Body dementia and this kind of behavior is more prominent with Lewy's Body. She also is subject to the Sundowners Syndrome. I have been told she gets frustrated and then angry and then takes her anger out on her caregiver (me). The strange thing is that she does not exhibit this behavior when other people are around, It is usually during this time she falls. I did call 911 once and will never do it again. But, that is another story. My solution now is to simply wrap my arms around her and hold her on the couch or bed until she calms down. I am told this is illegal because I am restraining her but, what else can I do?

Hi, when your mother does become violent, look after yourself first. Walk away from what is happening. Yes, she is your mother, but she is also violent. Protect yourself physically and emotionally, as best as possible. Talk to her geriatrician about these outbursts also. All the best, Arlene Hutcheon

I had this happen with my Dad. He was diagnosed with psychosis, and because he was a threat to all of us including himself. He was hospitalized in a Psych Unit. When I eventually got him into the Cleveland Clinic, they told me it was mid-stage Alzheimer's. With the right drugs the psychosis lessened considerably.

My wife has done that. She kicks the security screen doors and scream that I'm keeping her prisoner. I called 911 and a trip to the ER got her primary doctor on the ball. I had to replace both screen doors as they were bent out of shape.

Thank you all for the sound advice. I am going to keep tabs on what time of day and what is going on at the time. She also has a doctor's appointment soon.

I agree "Tired 1of4" with your comment of not calling 911. Nothing good would come out of that only extreme frustration and more confusion for your mother. Her behavior needs to be discussed with a good physician; either primary or neurologist. Good luck. I'm sure it's the dementia acting up. Her love for you under normal circumstances is still there. Just get her the help she needs.

My mom had rages too - once she was in hospital they put her on decaf coffee & that helped a lot -

If she drinks regular coffee start by doing 1/4 decaf 3/4 regular for a week or so then 1/2 & 1/2 for another week then 3/4 decaf 1/4 regular then all decaf - the caffeine is a drug that can cause this so cold turkey is not the way to go - be gentle as possible

One sign is if she wakes up running for the pot of coffee then that shows she might need her fix of caffeine - mom did this & we used to joke that we should just put caffeine in her morning insulin little realizing that this was contributing to her behavior problem - not all went away but there was a drop over about 80% compared to prior to being on decaf - hope this helps

Both " disgustedtoo" and "iamdanielhom" have made good suggestions.

I would only add to check for dehydration as this can also cause problems. The person is uncomfortable and doesn't know why - it can make any of us irrational at best.

While my DH isn't physical with me, he is becoming irrational and a lot of it was too much fluid being drained off him, and every hour the need to get up and void.

We really do need to do the 'leg-work' and research to learn as much as we can. Diet and nutrition can also play a part. Right now my DH will only eat Fish Sticks and must have his Hot Chocolate for breakfast. So I add a "greens" supplement to his Hot Cocoa (I'm using Barlean's Chocolate Silk) and I add ice cream for the extra calories. I use Ensure as the base instead of milk. So his "breakfast" is around 500 calories and he does get his nutrition. The rest of the day he only wants his Fish Sticks. So his drinks throughout the day consist of Ensure mixed with V8 Smoothies. Nutrition and calories. Sometimes I can get away with adding some "Berry-Greens" but sometimes he doesn't like the taste and won't drink it. Definitely a learning experience.

I wouldn't call the police either. And before you call 911 for an ambulance, be aware that this isn't covered by a lot of insurances. I would talk to her primary physician first. You can call and a nurse will get back to you with answers if taking Mom in is a problem.

I'd agree with disgustedtoo. Can you make this a little bit of a research project/game, and take some notes on when this happens, what happened before, etc.? A lot of things like this happen out of habit, I'm learning, and if you can pinpoint what triggers it, if anything, you might be able to start controlling (or dodging) those impulses. At the very least, I've found that "studying" the situation helps remove yourself from it mentally and emotionally. And if she can't physically hurt you, at least then it really is like a baby trying to punch you.

No one seems to have asked - does this only occur at certain times of the day, specifically later afternoon and/or early evening? If so, this could be "sun-downing".

Each dementia sufferer can exhibit different behavior during this period of day. Some will become combative, some, like our mother, showed benign OCD behavior, checking the same things over and over (she was still living alone, so who knows what she might have done if living with one of us???). At the memory care facility she still goes through this, checking drawers and what not, so they report.
If it is random, then yes, do consult with a doctor, primary care IF that doctor is well-versed in dementia, otherwise seek a specialist. As some say, medication might help (personally I prefer non-meds, but sometimes this is unavoidable).

Others have suggested making yourself unavailable when this occurs, certainly doable with a walk or some other outside activity. If she is not apt to hurt herself, remove yourself from these tirades. For sure do NOT take this personally as it really is not.
If, on the other hand, it is occurring regularly later in the day, read up on sun-downing and methods for dealing with it. If you note it only happens later in the day and in the morning she is back to her "old self", then certainly this might be the case. Redirection sometimes works, more lighting during those darkening hours, and if needed some medication to calm her during those times (should be dosed BEFORE the 'pumpkin' time...)

Most memory impairments, such as dementia or Alzheimer's may cause aggressive & assertive behaviors. We tend to forget that our behavior is an old memory, so, if we were a mean person when well we probably will be with dementia. You may hear profanity and cruel words due to the areas of the brain being damaged as well. Was she diagnosed by a neurologist with tests given? MRI, pect scan, sometimes a spinal tap? At her age ? to go that route now, but she should be checked out by her doctor to make sure there are no infections going on. There are anti psychotic meds that do help, but, you will have to watch for side effects & at her age a low dose may be the best call, just enough to calm her. You don't want to over do with these meds, there's more sleeping that will go on due to drowsiness & you don't want a risk of falling. Sometimes at this age, less may be better. Hard I know, it's your mom, but don't respond to the behavior or cruel words. It's a battle you won't win. Give her & you a time out & walk away for awhile. It is like taking care of a "terrible 2 toddler." Keep yourself safe with the swinging, using the arms length space rule & don't think she won't hit you, she's not always knowing you these days, not her fault. Don't have things around that could be thrown either, you don't want to get hurt. You have to keep everyone safe as well. When my brother with ALZ is angry, he's fast, on a mission almost. As the dementia progresses it seems the assertiveness lessens, with more compliancy behavior but timing is different for everyone. Dealing with this is not for sissies, pleading & tears useless, I had to learn this early on. This behavior may be a deal breaker, home or a facility, don't feel guilty or blame yourself for choices made. True words were spoken, "It's a roller coaster ride." Blessings🌸

... my mom was doing that, like you it would start for small reasons, a look, or I would leave, a thought she created, a television show, didn't seem to matter.  The anger she had from not only the dementia but also from the fact that "she knows she has it" .. those fears translated to anger for her.  She simply expressed the anger more easy than trying to explain or verbalize her fears or irrational thoughts her dementia was causing. 

My mother was started on very small doses of saraquil and her moods leveled out.  The dosage is small enough to calm yet not enough to create any type of larthargic or 'doped up' type response. She remains alert, simply calmer. Then, months later she started what could be explained as mini panic attacks, but only after specific triggers, such as being in a crowd or after strenuous exercise (perhaps using the restroom then taking a shower all within an hour, etc) so her physician prescribed a small dose of larazapam, that has worked very very well. She is on small dose saraquil every day and larazapam "only if she enters a panic (perhaps once per week.)
 I do want to mention  "urinary tract infections' are used far to quick as reasons and excuses for elderly behavioral abnormalities and are used from everyone from care facilities to family members etc ... but when the actual infection itself is 'not that common' when you place percentages of elderly comparatively  ... So No, UTIs are not the 'go to fix all'... they are not.  As long as your parent is hydrated, and their nutrition is basically balanced and as long as they are bathed/showered and performs decent peri- care and changes incontenance pads/briefs often enough in-between a shower, an elderly person does not contract UTI's as often as expressed by many. 

As I've had to learn with my mother, dementia in any stage, is unpredictable, although you can almost get used to the unpredictability, the brain of a dementia sufferer is not ever functioning properly it's simply that the more disturbing or 'noticeably imbalanced times" comes in definite waves and are highlighted. 

**If you are caring for your parent at home I would not call the police nor take them to a hospital for psych evaluations (those two paths can turn out to be very detrimental to an elderly person and are impossible to reverse the steps once those two avenues are taken) ... Simply set an appointment and take her to her physician and tell them what her behaviors are and perhaps they can test her blood to rule out any issues and perhaps they can provide assistance to calm and ease her via initiating small doses of carefully monitored medications. With our elders, it's always best to take smaller measures to find solutions rather than jumping to conclusions or making harsh and perhaps detrimenial decisions. 

Lastly,  I would like to suggest, that when/if  you are speaking with either a doctor, nurse, or to any facility in a hospital setting, make sure you strongly emphasize that she is "not" physically hurting you (unless she truly is) .. because, if she's ever to be placed in a care facility, an abuse report/statement that you make to a hospital or to her physician, even during a passing conversation with them, all you say to them will go on her medical records and physically abusive reports will keep her from ever being able to be in a standard facility and will only be allowed to be in a phych type facility. (And there are major differences between the two I can assure you.)

my mom has dementia & every month she gets a UTI she has a upper stupid catheter
& she talks crazy when it effects her & she does other things ..it can cause problems it is worth to check for uti