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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by crazy teresa on August 15, 2006, at 12:56:33
My husband's aunt is elderly and no longer able to care for herself. Her mental facilities are sharp. She has always been VERY demanding, however she is seemingly engaging in a psychological warfare. Any suggestions about coping with her would be GREATLY appreciated. Our entire family is at wit's end...
What we found out she's doing at the assisted living facility:
Refusing all pysical therapy. Refusing all meds. Refusing to get out of bed to go to the bathroom, soiling the bed. Refusing to let anyone come near her to clean her once she's soiled, claiming they're making her lay in it. Screaming at the aides. Calling 911 when her call light is not answered as soon as she thinks it should be. Calling the dr's office repeatedly, demanding to speak with the dr, screaming at his nurses. Faking helplessness to get others to push her wheelchair. And yesterday she pushed a table into an aide's stomach.
We confronted her yesterday while we were there, but I don't think it did any good. She claims she's a model patient.
Posted by Tamar on August 15, 2006, at 14:52:42
In reply to Suggestions on coping with Aunt G?, posted by crazy teresa on August 15, 2006, at 12:56:33
I don't know a lot about this, and of course I don't know the lady in question, but it sounds very much like dementia to me. However, you say her mental faculties are sharp. I have heard, though, that the onset of dementia can be a bit like this: sharpness much of the time but uncharacteristic behvaiour (often rather aggressive and hostile behaviour) at other times.
Have you talked to the doctors?
It must be very difficult to deal with. I'm sorry you're going through this. If it is dementia, I think the best course of action is to read up as much as possible. Relatives with dementia can be very challenging, but need a lot of love and support.
Tamar
Posted by ElaineM on August 15, 2006, at 16:07:37
In reply to Suggestions on coping with Aunt G?, posted by crazy teresa on August 15, 2006, at 12:56:33
I was thinking that it could sound a little like depression. I've had an older relative who decided after their spouse died that they were done with life. Didn't want to eat, see a dentist or doctor anymore, no more medication, wouldn't change outfits, sometimes wouldn't even move from a chair (and would sleep sitting up in their clothes). The way it was justified was, "Why bother with any of it. You don't know what it's like to lose someone you've spent your entire life with. There's no point." But depression could still occur without a prior loss.
My family's in the process of getting her in an assisted living facility, and eventually geriatric psychiatry sessions will be brought in.
Have you considered having mandatory sessions? (though I'd advise you to not actually say the word "psychiatrist") Also, sometimes older relatives who live away from family "act out" to force more contact, force more visits and whatnot. Before it got bad, my relative used to call saying she was unwell because she knew that if she said that that someone would be out the next day to take her to the doctors. Does your aunt get regular visits from family members?
Is your aunt on ADs? It is so important to make sure that food and medication gets in. Does she eat on her own (like her own little goodies) and just not tray / dining hall meals, or is it like a hunger strike? If she is violent with staff they may look to sedate her to deliver medicines.
It's so horrible to go through. THough mostly sad -- especially when they seem to still have high level of mental functioning. I wonder about what Tamar said about Dementia. We were able to rule that out by setting up a geriatric neurological assessment. Perhaps you could mention that idea to the facility's staff.
Sorry you're going through this. It's not easy. We always used to just keep in mind that if it's hard for us to deal with, it's got to be infinately more frustrating or confusing for them to be living through.
Good luck, I hope both your family, and your Aunt G get some relief.
EL
Posted by crazy teresa on August 15, 2006, at 23:39:17
In reply to Re: Suggestions on coping with Aunt G? » crazy teresa, posted by Tamar on August 15, 2006, at 14:52:42
This kind of behavior from her is not new; she has always been very demanding and completely manipulative, especially in any kind of a medical setting. She was an army nurse, so you can imagine the hell she puts medical personel through.
These behaviors seem to be more concentrated now that she's had to move into assisted living. Her dr. is on vacation, so for now we're at a stand still unless she gets worse and they bring someone else in to see her. When he gets back, I will bring this up with him.
Thank you for your response!
Posted by crazy teresa on August 15, 2006, at 23:53:22
In reply to Re: Suggestions on coping with Aunt G? » crazy teresa, posted by ElaineM on August 15, 2006, at 16:07:37
> I was thinking that it could sound a little like depression. I've had an older relative who decided after their spouse died that they were done with life. Didn't want to eat, see a dentist or doctor anymore, no more medication, wouldn't change outfits, sometimes wouldn't even move from a chair (and would sleep sitting up in their clothes). The way it was justified was, "Why bother with any of it. You don't know what it's like to lose someone you've spent your entire life with. There's no point." But depression could still occur without a prior loss.
She's not depressed. It's more like she's doing it just to get attention, which is pretty much how she's always operated. She's very satisfied with herself as she sits back and watches the chaos she creates.
>
> My family's in the process of getting her in an assisted living facility, and eventually geriatric psychiatry sessions will be brought in.
>
> Have you considered having mandatory sessions? (though I'd advise you to not actually say the word "psychiatrist") Also, sometimes older relatives who live away from family "act out" to force more contact, force more visits and whatnot. Before it got bad, my relative used to call saying she was unwell because she knew that if she said that that someone would be out the next day to take her to the doctors. Does your aunt get regular visits from family members?
>
I asked the coordinator when psych services will be brought in. She said when they feel like they need to be. I think her dr. should address this as soon as he gets back. She absolutely forces contact with my husband and I through acting out and I am at my limit (we are the ones who live closest to her, other than the relatives who gave up years ago trying to deal with her and refuse contact with her--I'm telling you she's a handful!)
> Is your aunt on ADs? It is so important to make sure that food and medication gets in. Does she eat on her own (like her own little goodies) and just not tray / dining hall meals, or is it like a hunger strike? If she is violent with staff they may look to sedate her to deliver medicines.
She's supposed to be on them for anxiety, but is refusing them. Claims to be allergic... Has recently started refusing all meds.> It's so horrible to go through. THough mostly sad -- especially when they seem to still have high level of mental functioning. I wonder about what Tamar said about Dementia. We were able to rule that out by setting up a geriatric neurological assessment. Perhaps you could mention that idea to the facility's staff.
I will absolutely ask about this too.
>
> Sorry you're going through this. It's not easy. We always used to just keep in mind that if it's hard for us to deal with, it's got to be infinately more frustrating or confusing for them to be living through.
>
> Good luck, I hope both your family, and your Aunt G get some relief.
>
> EL
Thanks for your kind words. We just have no idea what to do. It's horrible.
Posted by Dinah on August 16, 2006, at 10:00:36
In reply to Re: Suggestions on coping with Aunt G? » Tamar, posted by crazy teresa on August 15, 2006, at 23:39:17
Maybe she's angry. Most of the people I know who had to go to assisted living were angry on many many levels. Not least the loss of power over her own life. Maybe the only way she has to approximate that power is to exert power over others.
It doesn't make it any easier to live with, of course. And regardless of what she requests, I think it's fair to say that your visits will be cut short if certain conditions aren't met. When my father was sick, I knew he was angry. But he still knew that if he insulted my son, or threatened to kill a family member (idle threat), or said things to me that exceeded a certain level of unkindness, I'd kiss him and tell him I was sorry I wasn't able to stay.
Posted by crazy teresa on August 16, 2006, at 12:00:23
In reply to Re: Suggestions on coping with Aunt G? » crazy teresa, posted by Dinah on August 16, 2006, at 10:00:36
I've been racking my brain trying how to set some limits with her. I have been very stern with her to try and convey that her behavior is not acceptable. She just twists everything around and changes the subject.
Maybe we can find some kind of a reward system for good behavior, as bizzare as that sounds?
Posted by Dinah on August 18, 2006, at 9:07:34
In reply to Thanks Dinah!, posted by crazy teresa on August 16, 2006, at 12:00:23
I must confess I never tried to change his behavior per se. I just clarified my boundaries by stating what I would and would not listen to when I visited him, and by sticking to it. And I tried to leave, when I had to, with as much regret and love as I could muster.
I would also try to forestall a tantrum. If I saw he was getting close to threatening to kill the family, and I was feeling up to it, I'd talk to him about how frustrating it was to be dependent on others to do what he was always able to do himself. And how they invariably didn't do it when or how he would do it himself. It still let loose a salvo of anger. But at least it was about the thing he was really angry about.
Posted by pegasus on August 18, 2006, at 9:11:15
In reply to Well..., posted by Dinah on August 18, 2006, at 9:07:34
Posted by Dinah on August 18, 2006, at 16:47:11
In reply to Dinah, you should be a T (nm), posted by pegasus on August 18, 2006, at 9:11:15
My therapist talked me through every step of it.
And I wasn't up to it all the time. Sometimes I just left crying, or yelled back at him. But I tried.
This is the end of the thread.
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