My Mother has dementia and we were just recently told she has Alzheimer's. There are 7 children that care for her at home for the last year and a half. She has to have 24 hour care and each of us spend at least one night with her. She is incontinent so we all have to change her and either wash her or give her a shower which both are a chore no matter who is doing it. The problem is with the younger two (a female and a male) just recently she started hitting them when they were trying to clean her up. My sister bent over to clean her legs and such and she started smacking her on the back of her head. My brother started cleaning her up and bending over to do the same and she started hitting him on his back with her fist. She has never been a violent person. Was told by Occupational Therapist they shouldn't be cleaning her. That would be great if we had someone to come over every time she made a mess in her pants or she needed to be cleaned up. Recommendations?
Fact is this is not a site to tell people what to do but share your experiences. They can decide what works from there.. Choose your words carefully.
If no signs of infection, she may need some kind of medication to calm her down. During a serious sun-downing episode due to UTI, mom was also given the lowest dose of anti-anxiety meds. It was just enough to take the edge off, and worked first time, every time, within 15-20 minutes. No need to wean off the medication when it wasn't needed anymore.
Why does she need an OT therapist. They help with ADLs. You Mom probably doesn't remember from day to day what the therapist has told her. You dress her? You bathe her? You cook for her? Laundry? So where does she need someone to show her how to do her ADLs? You probably do it all. I let Moms go. The Physical Therapist showed her how to use her walker. I did everything else for her. It wasn't like she had a stroke and had to be taught how do do things all over again. PT I can see but even then with Dementia they forget the exercises or are hard to teach.
I do agree your loved one will not retain the skills to be independent but handling the hitting and preparing your Mom with calming strategies may be helpful and prevent the hitting. Every situation is different but very helpful for us
No matter how much you offer to pay, it would be VERY DIFFICULT to find someone who would do toileting and monitoring while having to deal with being assaulted physically.
Are her present targets afraid of her outbursts?
Keep in mind that her personality prior to her illness has NOTHING to do with what she is doing now. At this point, she is operating with a brain that is becoming progressively more and more dysfunctional.
As painful as it is, you cannot expect her to control herself or her reactions.
You have clearly tried everything possible to honor your mother, but perhaps it’s time to consider whether she’d prefer you to continue your present care plan or to consider another level of care.
Does she hit anyone else? Just the 2 younger ones? Seems odd. But then again so is the mind of someone with dementia. Go figure.
Is she taking any medication for anxiety? If so can the dose be given prior to the 2 youngest starting their shift of caregiving?
And would it be possible that mom be changed in bed where it would be m ore difficult for her to hit someone? You could give her a soft cloth to hold while you change her. Once you get the hang of it changing someone in bed is pretty easy and somewhat safer as there is less of a chance for her to fall.
Or using a commode where she can sit and she can be cleaned while she is sitting.
With 7 it might seem easy(ier) but this may only get worse as far as her violence and you might want to have a discussion about placing her in Memory Care if it is not going to be safe to care for her at home.
BUT don't stop taking care of her and don't push the care off on one person -- endure.
I think the missing word is adult in the title:
"Mother with Alzheimer's/Dementia just started hitting her younger <<adult>> children."
Since OP says:
"There are 7 children that care for her at home for the last year and a half. She has to have 24 hour care and each of us spend at least one night with her." I would doubt these are really "children" in the sense of young age. If they are, they shouldn't be overnight care-givers either!
It's probably just a reference to the youngest of the offspring. My "younger" brother is 10 years younger, however he isn't a child (age-wise anyway...) Same for referring to my other brother as older - he's only a year older, not 20 years older! We are, by some definitions, still our parents' children...
It seems that your only choices are to have her MD prescribe some type of low-dose anti-anxiety medication for her, such as Ativan or Xanax, or have her placed in a facility that specializes in this disease.
You might also create a care schedule. Get together with your siblings and ask who can help on which days.
Talk to social services in your town about best care. Also, speak to her doctor about best care and best meds. If there is a senior center in your town, call them for advice.
Im not sure about the hitting issue. Alzheimer’s is very difficult. I like the idea of trying to distract her. But, definitely talk with her doctor about it. Maybe it’s caused by anxiety, but maybe not.
Good luck 💕
But, kudos to the Band of Seven!! May you always be together and get along so well!
Like JuliaRose, I don't have suggestions for the hitting issue - there are many good ideas posted, so try those or a variation of them and see if any might work.
Thankyou so much for your brilliant insight - I am going to print it out and give a copy to our local Alzheimers Society office!
Emmdee from Bristol, UK
This assumes that you've already explored what might be upsetting her? Plus, it is important to give her a running commentary on what's happening so that she isn't startled or frightened by any part of the washing routine. "I'm going to take this pad away, is that all right?" "Let's get this soiling off your skin, okay?" "I just need to make sure your skin is dry and comfy." etc etc etc.
I also have to assume that what the OT meant is to come back to the task if she's upset, and meanwhile just do what can be done. So, for example, take any wet/soiled pad away and put a clean one under her, then come back to proper cleaning and drying after a bit of a break; that kind of thing. The principle that if the client says stop, you stop is correct; but of course it doesn't mean that you give up altogether!
Real answers from the OT would be good... or an OT with a bit more experience ?
Are the younger siblings being overzealous? Is there skin breakdown or diarrhea? Or rash, etc?
Or does the mother see them as children? Perhaps an older sibling to oversee and address cause (probably already done)?
It’s not worth the fight to give her a shower when she’s not in the mood for it.
I know elderly people with dementia who have gone years without bathing.
If she has the resources, consider a memory care community. They’ll take care of the ‘maintenance’ stuff and you can go back to having a more pleasant, non-confrontational relationship with your mom.
If she doesn’t have the resources, talk with an elder law attorney about spending her assets down so she can qualify for a Medicaid nursing home when her care becomes too much to handle at home.
Perhaps she does not like having a male caregiver? She might have been abused/injured by a male person at some time in her past (not necessarily her own child)
Have the primary care provider (MD, NP, or PA) check her for a urinary tract infection. Many times changes in behavior are related to a UTI.
The PCP might also recommend medication for the behvior.
If she allows others to do it, perhaps these two could assume other chores that don't involve personal hygiene.
Sometimes we are doing things unknowingly that create confusion or fear and then our loved ones lash out the only way they know how to. So having a professional observe the technique and add their 2 cents can be priceless.
I would also buy a long handle, soft bristle brush to clean her legs with, it is something that keeps heads from being down and not seeing what is happening. Have mom hold it and help her clean, this creates distraction as well.
Best of luck getting through this stage. You all are a testament to what a wonderful mom you have, God bless all of you and give you wisdom for this journey.
Great big warm hug for all of you!
I want to make sure that you are clean, so that you don't get any sores. I want to make sure your comfortable. Talk calmly as you're working.
Change the subject...I remember when I was small we used to go to...that was so much fun.
Best wishes to you.
From what I understand, this is normal behavior for Alzheimers patients.
a little training by way of TEEPA might help ..
Im slowly seeing a change for the better in daddy.
I find that in my years of elder care service that when it comes to diaper changing and personal hygiene it's best if the client (or in your case your mom) can be included in process. Sometimes speaking to them in plain language and very matter-of-factly like, "Come on, let's get cleaned up. It will only take a second" works. Or telling them that 'their doctor' said they have to wash up (X number of times a day) or they won't get better works too. Asking the person to hold on to the towel for example or the soap often worked as a distraction. There have been times when a dementia client refused a diaper change and a wash up because they didn't believe they had a mess. More than once have I had a client need to put their own hand in their diaper and see for themselves. Whatever it takes because the work must get done no matter what.
If she's at the point where she gets violent and aggressive about getting changed and washed then it's time to look for placement in a care facility. No one wants to see their LO have to be placed, but sometimes a person can't be cared for properly at home by family.
1. Have you talked with her doctor about her aggressive behavior? You didn't mention her medication, so maybe a change in her meds might mellow her out. There's no shame in your mother needing to be medicated because she can't control her behavior. No one deserves to be put in a situation where there is the threat of physical violence.
2. You mentioned her toileting and bathing issues. Toileting (changing adult diapers, cleaning someone up after soiling themselves) can be difficult with any person. I feel for you . What you could do with the bathing issues is buy a shower chair and install a bar on the wall of the shower stall or tub. These things can give a patient a sense of security, which might calm her down. But I really think that you need to consult her doctor first and honestly explain her behaviors. There are medications that might help her aggressiveness. Good luck and God Bless.