Acting Out

Allow me to help with you

What do you do when the person in your care is becoming unmanageable and maybe hostile? This subject has come up several times lately after I’ve given a speech on Caregiving. It’s a common problem and we need to be prepared for it. I’m talking about the elderly here and not the cases of young people who are under care. Although, the resolution of the situation may be similar.

Several years ago, when I was managing the care of my friend who had Alzheimer’s Disease, I was still in business as a financial advisor. The administrator of the assisted living facility where my friend lived had become my financial planning client. I had the advantage of spending time with this knowledgeable woman who, for many years, had dealt with hundreds of personalities in various stages of aging and dementia. I asked her one day if our personalities changed much as we aged. We do not all have dementia in old age, I want to make that clear. But, it’s common and effects people in a number of ways. What she told me was not surprising. I’ve taken notice over the years since and her observations seem to bear out as true.

She said that if we were sweet and easy to get along with when we were younger, we would, most likely, be the same in old age. If we were feisty or a contrarian when young, we would probably be difficult as an elderly person, especially if we suffered from dementia. I’ve often asked a person who tells me that their mom has been acting out and maybe even tried to hit someone, if she was always a bit feisty. The answer is inevitably yes, she wasn’t the easiest to get along with when she was young. It’s interesting, I see this more often in women than men. They just don’t want someone telling them what to do and they’re often not polite about it. There is no reasoning with someone who can’t any longer control their emotions. Those who will listen to what someone says they can’t do anymore often feel very badly and might even apologize. But, don’t expect anything to change for long. They can’t help themselves, their brain is not functioning as it used to. We must accept this as part of the malady and have compassion.

This is how it’s going to be for a time. It’s often not a long time, depending on the health of the person involved. As I’ve observed it, these stages progress over months. Before you know it, you’re past this volatile stage and onto the next, which is usually a higher level of physical care being required because health is diminishing. It’s not the same for everyone and I’m speaking in generalities. I’ve personally cared for three different people over a period of sixteen years, as I’ve mentioned previously. And if there’s one thing I know for sure, it’s that nothing stays the same for long. As Caregivers, we are constantly moving through and past the stages of decline.

So what do you do? This is just my opinion, everyone should have a plan for this kind of event, but I’m often asked this question so I want to address it. Please have a plan of your own in place.

First, make sure the Caregiver is safe as well as the patient. If the patient is at home with a hired caregiver that has been lashed out at, the agency (if there is one) needs to be notified immediately. They’re prepared for events like this and should have prepared their employees. They will speak with the people who contracted with them and resolve the situation. But, be safe first. If it’s a really bad situation, call 911. If not through an agency the people/family who hired the help or is the Caregiver themselves need to speak to the doctor in charge of primary care. Maybe a change in medication is all that’s needed.

Did I mention: SAFETY FIRST?

It’s time to reevaluate the level of care your loved one needs. We don’t like to hear this. It means change. It, also, often means more cost. It’s absolutely necessary that all involved recognize the progress in the condition of the patient. I had to change the residence of my friend who had Alzheimer’s a few times, eventually to a dementia care unit. If the patient lives in an assisted living facility, the administrators there will be helpful in making recommendations. If they live at home and/or with family, I would talk to the doctor about the level of care to expect next and be ready for with a plan for the next stage. That way you won’t be caught off guard if things change suddenly, as is often the case. Know what your insurance companies will pay for and how you will be reimbursed. I would ask an administrator of an assisted living facility for advice on the local options if you need to move your loved one to professional care, even if the patient doesn’t live at their property. They are most often happy to help the community and make referrals.

I wish you love and compassion.

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