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Dad as a dementia patient is vastly different than dad when he was in his right mind. Before dementia, dad was a reserved, quiet man. After dementia (and he’s moved from the initial to later stages since contracting and surviving COVID), he has had increasing incidents of resistance (and anger) to help from the caregivers at the AL home where he lives. He has never physically lashed out, but he will refuse to do as they ask, argue about things, and generally be negative about his situation - especially when his mood is sour. These moods change as the day progresses, with resistant behavior most prominent in the afternoon to late evening or when he’s tired. Lack of independence and isolation seem to be key issues that trigger this behavior. For example, last night the caregiver on with dad had him call me because dad was angry that we’d had them unplug the lift chair he has in his room. He likes to play with the lift remote to raise and lower his chair, and has slid off the chair and fallen to the floor several times because he falls asleep while it’s in the raised position. Dad is unable to walk or pick himself up off of the floor since COVID. He was angry with me for allowing them to do this, because he felt he wanted his independence. We compromised by allowing the chair to be plugged in while he was wearing a motion sensor. The team there is working with me to keep him feeling more secure, but he alienates himself from the staff with his anger and resistance. I’m just looking for approaches that have proved useful with dementia patients who exhibit this type of behavior. There is a memory care side to the home, but dad can’t move there yet because it’s full.

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If the AL staff can’t handle his conduct, he may improve when the move to MC is accomplished.

I don’t think you should get into discussions about “allowing him” - if something is unsafe, that’s just the way it is, and if the solution is pulling the plug, there’s no discussion - “That’s the rule”. He can either live by the rules or lose the use of the chair.

If there is a psychologist/psychiatrist within the present setting, a consult with that person may be helpful.
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bundleofjoy Mar 2021
dear anne,

hug!!
i do understand, the importance of trying to keep things safe.
at the same time, i understand the father too -- if his only pleasure is to go up/down with the lift chair, kind of like an amusement park ride...why not.

it's awful to "live", bored, alone, doing nothing, no pleasures.

i do of course understand there's safety to think about.
i wish us all courage, strength, in helping our loved ones!!

bundle
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Teepa Snow has some in-depth videos about dementia/ALZ on YouTube which you may find very helpful when trying to figure out how to interact with an affected LO. I wish you wisdom and peace in your heart as your work to help your dad!
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Louise315 Apr 2021
Thank you for bringing up Teepa Snow. I actually arranged a zoom with one of her consultants today! I’m hoping that we will learn a lot from the session.
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You're right, Louise, his loss of independence and the feeling of isolation is a major contributor to his behavior. Also the loss of control in not being able to enjoy his chair. It's great the staff is working with you, and that you've got him on the list for MC. As already mentioned, go to YouTube and search for Teepa Snow, dementia careblazers, or just search for dementia. All of these and many more videos will show up.
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My mother is 94, lives in Memory Care, and has fallen 68x so far. Whatever must be done to prevent these falls MUST be done. We even went so far as to remove travel knit pants from her wardrobe because they're 'slippery' and she claims they've caused her to fall off of her recliner 3x already. You reach a point where everything is dangerous, everything is slippery, and every single precaution is taken and STILL the falls happen. It's mind boggling, really, not to mention extremely frustrating.

Afternoon & late afternoon agitation and argumentativeness is known as Sundowning & is very common as dementia progresses along it's miserable way. There are things you can do to try to eliminate or reduce Sundowning, but you're not there in the ALF with him.............so, I don't know. Here's a link:

https://medilodgeofludington.com/announcement/10-tips-to-recognize-reduce-sundowning-delirium-in-dementia-patients/

Anger & resistance/arguing in general go along with dementia. If I say black, mom says white. If I agree it's white, she's back to saying it's black. Nature of the beast, and dementia is a beast. You can and should speak to your dad's doctor about his behavior so perhaps a mild sedative can be prescribed to calm him down some, which may or may not work, who knows? CBD oil has been known to work wonders for some dementia sufferers, as well as one son bought his mom a BioMat mini and says it changed her from a lion into a lamb. It's all trial & error really. For my mother, it's all been a bunch of errors as NO medications seem to work, and they all exacerbate her moderately advanced dementia. We're now trying to wean her off the last miserable failure of a medication that was tried.

The trouble with motion sensors is this: by the time the alarm goes off, they're already on the floor. The CG will come in and find my mother on the floor after her bed or chair alarm goes off, b/c there's no such thing as a sensor that will alert someone to a POTENTIAL fall.

Memory Care is the best bet for your dad, once there's an opening. Will it change his behaviors? Nope. But the staff is more accustomed to the residents and their combative/quirky behaviors so they have lots of tricks up their sleeves to deal with it. They also don't like having the residents sequestered in their rooms all day, so they'll urge them to come out & join the happenings in the activity room where everyone hangs out.

So, if dad gets angry with you for authorizing the unplugging of his chair, so be it. You can always tell him the motor is broken or some such thing, I lie to my mother like a rug whenever necessary. Anything to keep her calm & happy, that's the goal with dementia. It's called 'therapeutic fibbing' but I call it doing whatever you have to do to keep the peace.

Wishing you the best of luck dealing with a dreadful condition. I hate dementia with every ounce of my being.
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Louise315 Apr 2021
Thank you for your thoughts and responses to our situation. It has been a long haul! It’s nice when you can chat with other people who are suffering with the same stuff. I hope you and mom are doing well.
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Thanks for your kind reply. I do realize that it’s not safe for him, and the chairs probably should be moved from his room, but you’re right he has very little to look forward to. Dementia is a nasty illness! His 90th birthday is about two weeks away, and I have no idea what gifts to get him. Probably what he would want the most he can’t have, which is to be able to spend the day with his loved ones. I am the only one who will be able to be in the room with him because I’ve been given a doctors permission to act as a caregiver. It’s a terrible time for people who suffer from this disease. Covid has made it even More difficult.
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