Hello everyone,
I am seeking advice on what to do about my once gentle, loving, brilliant elderly (97) dad.
His personality has completely changed - but he exhibits little or NO memory loss - most likely he has frontotemporal dementia (FTD). He can remember dates, times, even reminds me that he needs his 3P pill. However, for the past 3 years he exhibits almost daily raging and abusive rants - all centered around a fixation on a former aid who left our employ 1 1/2 years ago because of his behavior, which included berating her for working for other clients, treating other clients better than him, things like things like that.
This former aid has become ALL he thinks and talks about, and he believes I "secretly" fired her due to my jealousy of their close relationship. This "relationship," he insists, is nothing romantic, she is like a daughter to him, but he looks at her picture all day on his phone, and demands to see her every, single day from morning to night, no exaggeration, getting angrier and angrier when we say we can't do that (or we try to re-direct or ignore).
He has a neurologist and a psychiatrist. We have tried talk therapy and it really backfired. We tried all the different types of anti-depressants and anti-anxiety meds - they made the behavior worse. Now we're onto anti-psychotics (Abilify). It worked beautifully for one week(!), and then his raging came back worse than ever before. We've upped the dose (it's still very low, don't worry) but ... I've lost hope.
I realized how his behavior was affecting me when I actually got more than 4 hours of sleep last week for the first time in months, during the Abilify honeymoon. I simply do not know how to communicate with him in a way that doesn't trigger a rant that goes on for literally HOURS. I've tried re-directing, ignoring, being totally neutral, screaming, crying - all of it. If anyone has had a similar experience and can offer any advice or resources (like some brilliant geriatric psychiatrist to consult?), I would very much appreciate it. Thank you, sorry for such a long message.
PS "Abilify Honeymoon" title of my autobiography
This doesn't fix the underlying issue and it is very likely he will then redirect his scary emotions (rage) at something else. I think you know the bigger issue is that his dementia is beyond the point where it can be handled at home. If professional caregivers can't handle him, it is time to move him to a facility.
Also, you say you can't do this right now, I want you to consider that your you and your mom could actually be in danger. He has lost all sense of reason. Who is to say that he won't put his hands around your mom's neck the next time he is raging? Or knock her down? Or grab a knife?
We don't know your personal circumstances, but at some point this becomes an emergency and you just have to do something to get the ball rolling. I think the potential danger makes it time.
In an amazing coincidence, she called me today (well, not so amazing. She called because my dad somehow found her number - which I deleted - somwhere and called her 20 times in a row). She asked if everything was okay. I told her what was going on and she offered to call him. They spoke for 15 minutes and she explained that she no longer works in the building, she is not around anymore. His response? She's lying to cover for me. She's actually in the building, but hiding from him because she afraid of what I'll do to her. No amount of reality can stop his declining brain from thinking what he wants to think.
I have gotten the ball rolling, I just didnt have the energy to go into details about that - what I really need to get help getting his behavior to a place where others can deal with him and work with him in the memory care facility I will be moving them to within a few months. Hence, my post.
My mother is safe. My father is not violent, just angry - at me.
Your mother will also have to understand that they may not be able to live together anymore. That might be a possibility now and she will have to accept it.
In the meantime, no one should give his rants about the former aide any attention whatsoever. Completely ignore him when he's carrying on about her and remove her picture from his phone if you are able to. I was a homecare CNA for 25 years before going into the business end of it and I've had many clients like your father. The rants must be ignored completely. You cannot reason with a person that has dementia even if they seem totally fine. When they are fixated or in a dementia loop about something, reasoning and explaining over and over again will do nothing but make you exhausted. It's like trying to reason and explain to a toddler having a tantrum. The effort will be futile.
Take the very good advice you find here. The next time he starts raging call 911 and have him taken to the ER and insist he be admitted for psychiatric evaluation or for a 'Social Admit' which means the person cannot receive the care they need at home so must be admitted to the hospital until an appropriate facility can be found for them to go to.
I will actually keep the "social Admit" in mind - as I said in a reply above, I was so tired when writing I really couldn't get into the details of future plans. My sister found a place near her and they have rooms that can take two people. It is a memory care facility (CERTUS) and it took us months to find - we were looking closer to where I live. It will take about a month or two.
Thank you for the advice about ignoring it when he rants. It is SO hard to not respond sometimes - he really knows how to push buttons, and his energy is ENDLESS. Any response fuels the obsession further, and yet, I'm only human, and I often do the wrong thing and start arguing or try tricking him, etc., etc.
When I deleted her photo from his phone two weeks ago, he accused the aids of doing it because they want her job and don't want him to look for her. He was being horrible with them, so I put it back in. I told him "verizon sometimes updates and things get moved." When I tried to throw away a photo he keeps of her, his ranting went on for DAYS (i kid you not) and I finally gave in.
Today, he somehow found her number somewhere and called her 20 times in a row (!). He believes she is secretly working in the building and hiding from him because of me, and he wanted to ask her if this was true.
After receiving the 20 phone calls, this lovely woman finally called me and told me (I was horrified) and asked if it would help if she called him and told him she no longer works in that building. I said, if you want to - big mistake. She did, they spoke for 15 minutes. His response? She's lying and saying she is no longer there to cover up my lies and because she's afraid of me and what I'll do to her if she communicates with him.
There's no way around it. i have to accept reality.
But, there it is - you are right. it would have been best for me to ignore everything and tell her to block his number. But I hoped that speaking with her would calm him down long enough for the higher dose of Abilify to kick in - no such luck, I'm afraid.
Your life and your health matter too. It sounds as if your father was a loving dad before this horrible, tragic disease overtook him. Would he want you struggling along with four hours of sleep a day, coping with rages, screaming and crying because of them? Would he want you to suffer as much as or possibly even more than him? Of course not!
I hope you find a solution that considers your health too. You shouldn't have to crucify yourself on his mental illness. What would that prove? (Answer: Nothing.)