The violence of Alzheimer's caregiving.
TBI+Alzheimer's

The violence of Alzheimer's caregiving.


This year has been very eventful, and it's just getting started. On January 3, my mom, with Alzheimer's, fell on her head, and it was terrifying. She was fighting with me about going to the bathroom in the kitchen, which I was resisting naturally; she got upset, lost her footing, and face planted. Immediately, she had a giant Snicker bar-sized knot on her head. Since then, it's been difficult to determine what is Alzheimer's and what is traumatic brain injury in terms of her behavior. Before the fall, she had anxiety and could be prone to outbursts, but after the fall, she more frequently chooses violence. People rarely mention this side of caregiving, but I feel I must share this. If you are a caregiver for an Alzheimer's patient, you have to watch out for scratching, biting, screaming, punching, and kicking.

When Alzheimer's patients exhibit violent behavior, it's important to understand that it's typically not a deliberate choice on their part. Alzheimer's disease affects the brain, leading to cognitive decline, changes in behavior, and, sometimes, loss of impulse control. In some cases, individuals with Alzheimer's may become aggressive due to factors such as confusion, fear, frustration, or discomfort. Most of my mother's violence is around the bathroom. She's very much like a demonic toddler. She doesn't want to wear a Depends, or she only wants to wear pants without a Depends, or she wants to wear neither and is screaming for help as you try to put one or the other on her flailing legs. I know it's horrifying for her when she doesn't recognize me, but I also can't let her lie in a bed that is soaked in urine or worse. And that's when she snaps and yells for help while punching, scratching, etc., and I have to choose patience. But it's hard. It feels a lot like being in an abusive relationship. And it very much is.

Caregivers and healthcare providers must approach these situations with compassion and understanding. Managing aggression in Alzheimer's patients often involves identifying triggers, creating a calm and supportive environment, and using techniques such as redirection, validation, and reassurance.

In some instances, medication may be prescribed to help manage behavioral symptoms associated with Alzheimer's disease. Be careful because the hospital sent her home with another medication that made her worse. At some point, I hope traditional medicine opens up to CBD and its benefits. Still, it's important to explore non-pharmacological interventions first and consult with healthcare professionals to determine the most appropriate course of action.

Ultimately, it's essential to prioritize the safety and well-being of both the individual with Alzheimer's and those around them while providing compassionate care and support. Many people are dealing with this in silence, but to help people prepare for this, I wanted to share our story. I love my mom, and since she got out of the hospital, I have followed her for every bathroom trip in the middle of the night. We sometimes have tense negotiations about underwear and sometimes I win.

If your loved one has Alzheimer's disease and has experienced a fall, several potential outcomes and considerations may arise:

  1. Physical Injuries: After a fall, your mom may sustain physical injuries such as bruises, cuts, fractures, or head injuries. It's essential to seek medical attention promptly to assess and treat any injuries, especially if there's a possibility of a head injury or concussion. The internal brain bleed stopped on its own, but remember, anesthesia makes dementia worse, so that has to be considered if surgery is on the table.
  2. Increased Risk of Future Falls: Individuals with Alzheimer's disease may be at a higher risk of experiencing falls due to factors such as impaired balance, gait disturbances, and confusion. It's crucial to address any environmental hazards and implement fall prevention strategies to reduce the risk of future falls. And remember the patient's unwillingness to be helped at times. That's our main issue.
  3. Changes in Cognitive Function: A fall, especially if it results in a head injury, may lead to changes in cognitive function or exacerbate existing cognitive symptoms in individuals with Alzheimer's disease. Monitoring your loved one's cognitive status closely and communicating any changes or concerns to her healthcare provider is essential. We put my mom in hospice, so she gets a nurse's visit twice a week, which has been tremendously helpful.
  4. Emotional Impact: Experiencing a fall can be distressing and disorienting for individuals with Alzheimer's disease. They may feel anxious, confused, or scared following the incident. Emotional support and reassurance can help alleviate some of these feelings and promote safety and security. I don't remember her being as violent before the fall, although there had been a couple of times when she scratched me. She now often punches, kicks, bites, or screams, and that's fairly new. And yes, I do get injured sometimes. But if it means she stays upright, I can absorb some punches.
  5. Caregiver Considerations: As a caregiver, assessing your well-being and seeking support as needed is essential. Caring for a loved one with Alzheimer's disease, especially after a fall, can be physically and emotionally challenging. Don't hesitate to contact family members, friends, or support groups for assistance and guidance. I have added hours for my home health care worker and made a concerted effort to meet more of my self-care needs. But let's be clear: TBI, on top of Alzheimer's, is a considerable upgrade in care and strain on the caregiver. Mobility is an issue as well, as there are few clues about what mood she will be in. Instead of a day-by-day situation, it is very much a minute-by-minute scenario now.

Overall, addressing the physical and emotional aspects of a fall in someone with Alzheimer's disease requires a comprehensive approach that considers their individual needs and circumstances. Collaborating with healthcare professionals and implementing appropriate interventions can help promote your mom's safety, well-being, and quality of life. I have nothing but amazing things to say about Mercy Hospital and its hospice program in St. Louis.

Sending warmth and strength your way ??. As the admirable Helen Keller said - Alone we can do so little; together we can do so much. Your resilience is an inspiring beacon of hope to others on similar journeys ??. #Unity #StrengthInNumbers #Hope

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I'm deeply moved by your courage in sharing your story. In these challenging times, Maya Angelou's words resonate deeply, "You may not control all the events that happen to you, but you can decide not to be reduced by them." Your resilience is inspiring. ???? If you're interested in joining a cause that's also about nurturing and growth, we're supporting a global effort in tree planting, aiming for a Guinness World Record. It might be a meaningful way to connect with nature's healing power: https://bit.ly/TreeGuinnessWorldRecord

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Sandy Hall

Former Program Manager Washington University Olin School of Business Center for Experiential Learning

9 个月

Praying for your mom. ????

Md Sabbir Molla

Japanese language Teacher.

9 个月

Love you mom.

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