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I've talked with you folks before. We placed my mother in a nursing home. However, she is VERY belligerent. She is constantly threatening my wife and I with lawsuits etc. She has had some very serious health issues along with the dementia. I have seen a definite decline since she has been at the nursing home with regard to her dementia; not her physical care. I've been reluctant to visit her since she is so hostile. I haven't seen her in six weeks. This upsets me, but I am not sure what to do as each time we interact she threatens to call lawyers to get "control back". She keeps demanding services from the nursing home's lawyer, but luckily, the nursing home's social worker seems to have gotten through to her. While she was in the hospital at Christmas, she was delirious and called 911 from her hospital bed because she thought "she was in a dumpster and Chinese people were holding her down; and that the nurses (who were pushing cardiac telemetry units) had cash registers". Any thoughts on how to deal with the belligerency?

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has a doctor declared her incompetent yet? this me and the wrote a letter that states the disease and that they can no longer make medical, financial or life decisions . if not start there. everything you have described is the disease and it will only get worse no matter where she resides. she is in the best place for care. don't feel guilty for not visiting its very hard to see the decline and even though she is your mom it doesn't mean you have to endure the abusive behavior. most with this disease too have lost track of time and it really doesn't matter if you visit every day or once every other month. my fil thought years went by between vistas when it was only a week or less. some times he thought on the same visit if he fell asleep and woke up in a 30min time span he thought a month went by. we can't feel guilty because their disease makes them do things that could make us feel bad.
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once you get the dr letter if a poa has been done then it will activate it if no poa then you need to go to court and get listed as guarding for her. then any threats of law suits are just nonsense as she has been declared incompetent
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I have durable power of attorney and HCP. Massachusetts provides a "temporary guardianship" which we have attained through the court. It lasts 90 days. Then we have to go back and plead for a permanent guardianship. Already paid the attorney for this "permanent plea" component. The attorney, and the nursing home have to provide my mother with "notice" in written form that this was applied for. At the time she was given the document (even though we told her multiple times this was going to happen), she became very belligerent. Since then, she constantly threatens lawsuits regarding her "money" and such. The doctor invoked her Health Care Proxy some months ago. I am her health care proxy. I really don't want to go to the nursing home and have nonsense conversations, then be the target of third party comments "I should have left him on the sidewalk to die when he was born, he's not going to be in charge of me" etc. I really, truly don't want to be exposed to this. The fear is, since I stopped visiting, that I will have some sort of legal finger pointed at me going forward.
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As temporary Guardian, you can talk to the MD and request medication to calm her down. You do have a responsibility to supervise her care, which at least means talking to the nurses and MD's on a regular basis, attending case reviews and submitting financial reports to the court. If you can be there when the doctor is there, good, but insist that he at least call you with an update.
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In Mass, as a guardian of an elder, not a conservator, I am under no obligation to submit reports to the court. I am in constant contact with her social workers and they have been sending reports to me on her status. Although, the last week or so, I have needed a break from the insanity. I will be calling the social workers this week to see how she is doing. They usually give me a "deer in the headlights" response, and I have to yank anything out of them.
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So anyway, I really haven't received any insight here on what to do with regard to the belligerency. I don't know of a way to approach my mother and have a more "reasonable" visit. (Remember, I've also posted that she's $55,000 in debt) as well. This is what I am asking.
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You call the MD, not the social worker. CALL THE MD AND GET AN RX. Because when you go back to court, the judge will ask you what you are doing to oversee her care. The Judge will expect you to say "Yes I have reviewed her medication with the doctor and I have followed up by seeing mom once a week to track any improvement."
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In years gone by when my mother was in hospital for surgeries she'd go bonkers as well, screaming for someone to call the police and so on and I understand that reaction to anesthetic is quite common in elderly people. She's been mean, manipulative and spiteful narcissist life long and, since being in the NH, her behaviour has been awful, pushed along by the decline due to Parkinsons, stroke and dementia.

I certainly don't blame you for staying away. My mother brought the authorities down on my head because she suggested I was stealing her money, which is ludicrous so I had to sort that out - which I did, case closed - meanwhile being treated like a common criminal.. Eventually, for the sake of my health and sanity, I went into hiding, changed my phone number and she doesn't know my address. I visited briefly this afternoon. She was out of it mostly and could barely speak but she was calm. She's had a number of strokes over the years. The last one a few months ago put her in hospital, then returned to the NH deemed palliative. Since then she's had two more mild strokes to my knowledge.

We've never been close, in fact I've spent a lifetime avoiding her, so I have no feeling for her. All I feel now is pity and I hope she passes away soon for her sake if nothing else. We wouldn't let a beloved pet suffer. We're kinder to them than we are to people.

I can't offer any advice as I'm in Canada, but I wanted to post so you know you're not alone. God Bless you. Please keep us updated. We care!
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Hugedoof I see you posted while I was typing. When you put dementia on top of other serious health issues it's like putting gasoline on a fire. Know that your mother will never change her behaviour and, as she declines, it will only get worse.
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Well thank you everyone. So, it looks like she will decline, and that there is very little I can do to improve the personal interaction.
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Hugedoof no, there's nothing you can do. Just know in your heart of hearts that you did the best for her and she's now safe, cleaned and fed with round the clock care. There comes a time when we ensure that they are well cared for and have all they need and leave the professionals to care for them. They are trained to deal with these things, us mere mortals are not.

I suspect, as your mother declines and her mind continues to blow out of the window, as my mother's has,she'll have episodes of creating havoc and episodes of being not there, and those episodes can change within hours so you take a chance when visiting as you never know how it's going to be. When I visited this afternoon my mother was calm and pretty much out of it, yet the RN said she'd been ok this morning ... whatever they view as ok.
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Hugedoof your not visiting very often is a sound choice. It is very difficult to disregard what a mother says even if it is the disease talking. If you feel visiting is too emotional, you can always call. I wouldn't worry about any legal ramifications. Your mothers accusations have less creditability being in a NH than if she lived with you. Your mothers threats are more bark than bite due to her condition.
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When you visit and she goes off on you, walk out. Wait a while, try talking to her again, if she goes off on you again, go home. This is how you behave after you talk to the doctor about meds for her.
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If you believe that people have souls, know that souls are untouched by the experiences of the body. You could pray for peace and love in her soul, or pray your love envelopes her. Maybe on some level she may feel it: or not, but at least you could feel better by knowing you are sending your mother, in need, love and prayers for the best departure. I feel for you and I would not be surprised if my own mother follows the same route. It already sounded very familiar except Mom is healthier. Keep praying for her highest good and it will do good thing for you too.
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It is worth having a thorough medical evaluation to consider any acute infections, any cause of pain, any side effects of current meds or possibly trying new meds to help her settle down a little. But, her incapacity is very obvious and is documented so even if she did manage to look up a lawyer and make enough sense to have someone investigate, you need not worry. And, it looks like you have done all that needs done legally already, the other posters are right, look into the medical angle. Actually, sometimes as the person becomes less energetic and less capable, things may calm down in some ways. Sorry it has to be this way for you and Mom. Dementia sucks.
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It's very interesting to try to understand the thoughts of the elderly. Fear of death, obsessions about one's safety, attachment to the ego and losing touch with all else...
Do ALL people go this way if they have lived a lifetime of attachment to their ego or have a fear of death? Has anyone met others who live and die differently, although they may have had dementia?
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Perhaps all the anger, rage, and seething accusations are like an energy trying to find release. The mind is a nest of habits: habitual thoughts. Habits are "knee jerk reactions". When intellect declines the brain must go on that automatic kind of impulse: needing to fix what feels wrong,needing to blame someone for what's wrong, needing so much and not knowing how to soothe oneself anymore. Feeling that nothing will help and despair in not trusting what's next. I can only imagine...
But it is so hard to not think: that's a person I love who is attacking me! So hard. I am sending you my heart felt hope that you find ways to detach and carry on with peace in your heart. We all need some kind of umbrella of peace when our "loved ones" are beating down on us like pelting ice rain.
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Is she being seen by a geriatric psychiatrist? Is she on meds for anxiety, depression, agitation? My understanding is that this combativeness can be a stage of dementia that passes. If visiting her upsets you and her, don't visit. Can you call her once a week via phone? If she gets belligerant, hang up. I'm so sorry that you're going through this.
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Have her evaluated by a geriatric psychiatrist who can prescribe medication to calm her down and, hopefully, control her behavior. A geriatric psychiatrist is much better than a primary MD for this.
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Your pain is very real and understandable. Many caregivers go through this and it is ugly. You have placed your mother in a safe place where she will be looked after for the rest of her life. You mentioned her high intellegence. this may have made it possible to hide her decline for longer than most but the threats are very common. It is usually that the loved one will call the police or adult protective services and sometimes they do to the inconvenience of the caregiver and family because it is the duty of the authorities to investigater the claims the elder has made. I don't think you have any need to worry about law suites she would have done it by now. As long as you did not cosign on any of her debt there is also probably no need to worry but in case there is trouble try and establish a paper trail. The creditors usually just have to write it off.
At this time the only way to calm your mother is with medications, better treatments may emerge in the future as the number of people with dementia rises but for now this is it. Finding the right combination of drugs to calm her but not make her a zombie is often a matter of trial and error and does not question the competency of the MD. The disease also has an unpredictable course so no one can guide you on a time line. You mentioned you had to yank information from the healthcare providers and this may be because there is non to give like us they can only guess. No body here has a crystal ball they can only express their experiences although some have medical training and greater knowlege of the healthcare sytem than others. I am sorry if you came here looking for answers and have been dissappointed but the reason is that there really are not any. We offer support, prayers, love and fellowship and occassionaly humor but crystal balls no they are lacking.I appologise that i did not go back and read your older posts but if i do the web site erases everything I have written in this post and that looses the spirit of the reply if I have to re type. Blessings to you and your mother. Visit or not that is up to you but find your own peace mother is already in a different reality.
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@Ashlynne, Not exactly right! As she declines, she might get better!
@Hugedoof, Dementia patients go through different stages of the disease progression. They express different "behavior" patterns and, sometimes, it might change over night.... though, for other residents "bad behavior" might stick there longer. Indeed, that behavior indicates that there is something wrong with them and, because they can't express what exactly, they are acting out in that destructive way. You might watch Teepa Snow (u-Tube) who is teaching caregivers to deal with any behavior issues.
I can hear your pain.... Yes, it might discourage you from visiting your mother seeing her in such disaster. But you should not take her hurtful words so personally. The disease is speaking louder than her. There is still loving mother somewhere deep inside, who raised you and gave you all she could. She loved you unconditionally and now it's your time to remember it, because she can't....
Unfortunately modern medicine is not armed yet with remedy for dealing with such straggle. I am very sorry you experience it. But, considering that she is in the NH and most her need are met, it might be right for you to stay away for a while to keep yourself sane.
It takes a lot of courage to acknowledge your pain and ask for help.
She can't remember, she is confused, she is in pain (probably!), she needs help and she can't say what is wrong with her. You need to find a facility experienced with recognizing that. She probably needs one-on-one care. Yes, I know it's very costly. Do you have any siblings? Any other family members who can contribute? Can you look around for different facility specializing in such problem?
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Unfortunately the behavior is part of the nature of the disease. You can't really change the advancement of the disease but talk to the doctor there are lots of meds out there that can help with the symptoms. My MIL has Dementia, High Anxiety, Depression, and Psychosis. Before she saw the Neurologist and Psychiatrist she was getting out of control. Now they work together to help with the memory loss and the crazy thoughts she was having with episodes of acting out. I can't believe the difference in her behavior with the meds. The "acting out" has just about stopped.

The effects of the meds won't last forever as her disease progresses but for now it makes it so she can still be with us at home instead of a nursing home, and allows her to function in the day without me having to worry.

Just know that you are making the decisions that are in her best interest and that her "threats" are idle threats because I'm sure any court that has her evaluated will see she isn't in her right mind. I know for my MIL once she was declared incompetent by a doctor (in my case her psychiatrist) the only one that needed to be notified of anything was me.
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I've always been extremely close to my mother.....so when she acts hateful to me (I moved in with her 6 months ago as her memory became non-existent), it's so hurtful. I know if she was 'ok', she wouldn't behave this way....but....that doesn't change the heartache when she does. I see from all the many posts in this site that things will probably only get worse as time goes by. I thought about counseling, but in the end, I have to find a way to get a 'thick skin' and not let it get to me. I think that's the best any of us can do when it comes to this issue.
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From my limited experience I can recommend she be checked regularly for UTI, and start hospice services ASAP for both her and the family.
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My mother is in a great facility. They are very aware of her dementia. They have a full dementia unit, but they do not believe my mother is ready to go there just yet. She has been checked for a UTI multiple times. The threats are very real and directed at me. Anyway, thank you for the input.
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What is it about a UTI that has a bearing on mental issues??
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I'm not sure when you say that the threats are "real". Certainly they are real to her, but are they to anyone else but to her, and hurtful to you? In other words, her disease talks and you feel as though it's your mom talking? I totally understand that, my husband was in EXACTLY the same situation a year or so ago, and no amount of what anyone told him eased the hurt of his mom yelling at him, calling APS at him and telling him that she was going to write him out of her will. But you know what? She died (starved herself to death, because she didn't want to live the way she was living) and he has a much better relationship with her in his head, because he distanced himself from her when she became abusive. I've posted elsewhere on this site that when it became clear that she was very close to death, I insisted that he go to see her one more time, by which time the psychiatric drugs had kicked in and she was calm and non-beligerent; or maybe she'd just moved on to the next phase. Dear man, please don't beat yourself up; don't go see her if she's yelling at you; I think that's as bad for her as it is for you. Be well, Barbara in Brooklyn.
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Hi,
I recommend you start by becoming familiar with the services and benefits available to your mother. Assisted Living facilities are costly and generally only accept private payments. It sounds like your mother could benefit from having Medicaid as that will open the door for her to receive services like home care, if that is an option your family wishes to consider. To find out if your mother is eligible for Medicaid.I know one of the Home Care Agencies in Ottawa.The agency is called the ByTown Home Care Services. They provide free care consultation.When you call, you basically want to inquire about available services for your mother's situation as well as family caregiver resources. There website is : bytownehomecare I hope this information was helpful. Good Luck.

I hope this information was helpful. Good Luck.
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Shryl, In the elderly, especially in elderly women, often only symptom of a uti is altered mental status, i.e., new behavioral symptoms. I'm not sure anyone knows what the causal link is, but if new symptoms appear, it's the first thing that should be checked. NH staff generally know this, most general practise doctors do not.
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ElanaElderCare, you mentioned that "There is still loving mother somewhere deep inside, who raised you and gave you all she could. She loved you unconditionally and now it's your time to remember it, because she can't.... " I do definitely respect your opinion and experience, but unfortunately, it doesn't apply in my case. I believe Ashley is in a similar situation. Sometimes, the relationship with the mother isn't ideal, doesn't include loving unconditionally, and includes a lot of dysfunction going back to our childhoods. Dementia can make all those things much worse. For someone who hasn't experienced it, it is really hard to fathom: "What do you mean your mother didn't love you unconditionally?? Isn't that what mothers do??" But for some of us, that is our reality. As our narcissistic elders lose control over their faculties, they panic, because CONTROL is what it has always been all about. I fully expect that belligerence, lies, and threats could all be part of my experience going forward. So just a gentle correction that for some of us unlucky ones, she really didn't "do the best she could", and for some of us, dementia only exacerbates an already nasty personality.
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