Elder Rage - A Distressing Symptom Occurring in Some Alzheimer's Patients

Summarized by Robert W. Griffith, MD
May 31, 2007

Jacqueline Marcell is a former television executive, who after caring for her elderly parents (both with early Alzheimer's), became an author, publisher, radio host, national speaker and advocate for eldercare awareness and reform. She is the best-selling author of "Elder Rage", a Book-of-the-Month Club selection receiving 50 prestigious endorsements including from Hugh Downs, Regis Philbin, Johns Hopkins Memory Clinic, and AARP. Endorsements and Reviews: www.elderrage.com/Review.asp. Robert Griffith, Editor.

ELDER RAGE: If I Only Knew Then - What I Know Now!

For eleven years I begged my obstinate elderly father to allow a caregiver to help him with my ailing mother, but after 55 years of loving her, he adamantly insisted on taking care of her himself. Every caregiver I hired to help him sighed in exasperation, "Jacqueline, I just can't work with your father - his temper is impossible to handle. I don't think you'll be able to get him to accept help until he's on his knees himself."

My father had always been 90% wonderful, but his raging temper was scary! He'd never turned his temper on me before, but then again, I'd never gone against his wishes either. When my mother nearly died from his inability to care for her, I had to step in and risk his wrath to save her life - having no idea that in the process it would nearly cost me my own.

Early Signs of Dementia?

I spent three months nursing my mother back to relative "health", while my father said and showed he loved me one minute, but got furious over some trivial thing, call me horrible names, and throw me out of the house the next. I was stunned to see him get so upset over the most ridiculous things; even running the washing machine could cause an outburst, and there was no way to reason with him. It was heart wrenching to have my once-adoring father turn completely against me.

I immediately took him to his doctor, but was flabbergasted when he acted totally normal when he felt he needed to! I couldn't believe it when the doctor looked at me as if I was the crazy one. She didn't even take me seriously when I reported that my father had nearly electrocuted my mother and that he'd left a gas burner on for hours without it lighting, filling their home with fumes and nearly burning the house down. Much later I found out my father had instructed the doctor (and every healthcare professional) not to listen to anything I said because, "I was a (bleep bleep) liar, and all I wanted was his money!"

Then things got serious. My father had never laid a hand on me my whole life, not even a swat, but one day he nearly choked me to death for adding a pay-channel to his TV cable package, even though he had eagerly agreed to the idea a few days before. Terrified, I called 911 and the police came and took him to a psychiatric hospital for evaluation. After a couple of days of tests and observation, they released him, saying they couldn't find anything wrong with him. I could not believe it. And, even more alarming, similar horrifying incidents occurred four more times.

Caregiving Catch 22

I couldn't go home and leave my mother alone with my father, because I was sure she'd die from his inability to care for her. I couldn't get the doctors to believe me, because he was always so sweet and sane in front of them. I couldn't get medication to calm him - even when I could, he refused to take it, threw it in my face or flushed it down the toilet. I couldn't get him to accept a caregiver in their home - even when I got one, they wouldn't put up with him being so mean for very long. I couldn't put my mother in a nursing home - he'd just take her out. And I couldn't put him in a home - he didn't qualify. Both of my parents refused any mention of assisted living and legally I couldn't force them. I became trapped in my parents' home for nearly a year trying to solve endless crises, crying profusely every day, and becoming infuriated with an unsympathetic medical system that wasn't helping me appropriately.

Geriatric Dementia Specialist Makes the Right Diagnosis

You don't need to have a doctorate degree to know something is wrong, but you do need the right doctor who can diagnose and treat it properly. Finally, I stumbled upon a compassionate geriatric neurologist/dementia specialist who ordered a battery of blood, neurological and memory tests, along with PET scans, on both of my parents. First, he ruled out all the reversible dementias and reviewed all their medications, and then diagnosed Stage One Alzheimer's in both of them - something that all their other doctors had missed entirely.

Trapped In Old Habits

What I'd been coping with was the beginning of dementia, which is intermittent and appears to come and go. I didn't understand that my father was addicted to, and trapped in, his own lifetime bad behavior, and that his habit of yelling and pounding the table to get his own way was now emerging over things that were illogical and irrational. I also didn't realize that 'demented' does not mean 'stupid' - a concept that is not widely appreciated; he was still socially adjusted so as never to show his "Hyde" side outside the family. Even with the onset of dementia, I was amazed that he could be so manipulative and crafty. Meanwhile, my mother was as sweet and lovely as she'd always been.

Balancing Brain Chemistry

Alzheimer's is just one type of dementia; there's no stopping its progression, nor is there yet a cure. However, if identified early there are medications that can slow its progress, keeping the patient in the early (independent) stage longer, and thus delaying full-time care.

After treating my father's dementia and the (often) accompanying depression, the doctor prescribed a small dose of anti-aggression medication, which helped smooth out his volatile temper without making him sleep all day. Once my parents' brain chemistries were properly balanced, I was able to optimize nutrition, fluid intake, and medications with much less resistance.

Creative Behavioral Techniques

I was also able to implement creative behavioral techniques. Instead of logic and reasoning, I used distraction, redirection and reminiscence. Instead of arguing facts, I validated their feelings and lived in their reality of the moment, striving to "go with the flow." And if none of that worked, the offer of vanilla ice cream usually worked in getting my father into the shower, even though he swore and yelled at me, saying he'd just taken one yesterday!

Then, finally, I was able to get my father to accept a caregiver, though he'd alienated about 40 in the previous 12 months - most only stayed for ten minutes. With the help of Adult Day Health Care five days a week for my parents and a weekly support group for me, everything started to fall into place. It was so wonderful to hear my father say again, "We love you so much, sweetheart."

Then, after several more years of loving each other, my parents both died from heart attacks, just a few months apart. And even though being responsible for every aspect of their last years was the hardest thing I have ever done, I'm proud to say I gave them the best end-of-life that I possibly could.

Alzheimer's/Dementia Often Overlooked

What I found shocking is that none of the many healthcare professionals who treated my parents that first year ever discussed the possibility of Alzheimer's with me. I was told that their "senior moments" and intermittent odd behaviors were just old age, senility, and a "normal part of aging". Since one out of every eight persons by the age of 65, and nearly one out of every two by age 85, develops Alzheimer's disease, I should have been alerted to the possibility.

Had I been shown the "Ten Warning Signs of Alzheimer's", I would have realized a whole year earlier what was happening, and gotten my parents the help they so desperately needed. If this rings true for someone you love, I urge you to get help from a dementia specialist sooner rather than later.

Ten Warning Signs of Alzheimer's

Memory loss

Difficulty performing familiar tasks

Problems with language

Disorientation of time and place

Poor or decreased judgment

Problems with abstract thinking

Misplacing things

Changes in mood or behavior

Changes in personality

Loss of initiative

(Reprinted with permission of the Alzheimer's Association)

"Elder Rage" on Amazon: http://www.amazon.com/Elder-Rage-Take-Father-Please/dp/0967970318/ref=pd_bbs_sr_1/002-8511096-0041667?ie=UTF8&s=books&qid=1179175441&sr=1-1

© Copyright 2007: For permission to reprint all/part of this article, or to interview Jacqueline Marcell, contact her at http://www.ElderRage.com

Source

• Elder Rage, or Take My Father... Please! How to Survive Caring for Aging Parents J Marcell, Impressive Press; 2nd edition, April, 2007

Related Links
Elder Rage
Coping With Caregiving radio show
Alzheimer's Federation of America: Coping with Anger and Aggression
PBS: Recognizing Symptoms of Alzheimer's
Responding Positively to Alzheimer's Victims

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