How do you cope with the angry side of dementia?

[Frazzledinmyforties]

My (relatively young) mum was diagnosed with Alzheimer’s around a year ago. We lost my dad 4 years ago and she’s not been the same since.
In the last 6 months or so she’s become increasingly angry. Shes really vicious and nasty with her words and she spits at me and throws things at me.
I am her only carer, though I don’t live with her and the nastiness is always directed at me. We’ve had police and social services involved but no one will do anything because “she still has autonomy over her care and can’t be forced to have any”.
I genuinely don’t know how to cope with it. I’m pretty thick skinned and work in Learning Disability which has massive cross overs with Dementia.
I know all of the factual side; I don’t know how to cope when she’s hysterical at the sight of me and I’m the only one who can help her.

Any advice will be gratefully received.

@Laughingravy “Seems to me these police and social workers are talking nonsense“ They absolutely are and even when I tell them my background (part of my role is training people on the Human Rights Act and Mental Capacity Act) I’m just met with resistance. I suspect some don’t understand the use of LPA and some just want to do the minimum to get rid of us. And yes, I bet it would be a different story if bills weren’t getting paid.

In terms of her finances, it’s all very black and white. LPA has kicked in and I deal with it all legally. But the medical side is relentless. We rarely see the same person twice and I get told very often that “she does a great job of acting sane”.
We (mum, police and a social worker) agreed a set amount I’d give her in cash every Friday as well as doing her food shop online. Most weeks she’ll call me by Monday hysterical demanding that I give her money because she has none. I usually ignore it until she gets a neighbour to call the police (4 times so far this year), calls emergency services herself and tells them I’m starving her and withholding her funds. They then turn up, can’t see any money so tell me I must give her some. We’ve tried putting the money in a safe which she lost, we tried my husband given her the money instead of me, taking pictures.

Thank you all for your kindness, I appreciate you each taking the time to reply.

When my DM was saying really horrible things about my dh and dds (and quite untrue, she’d never have even thought them pre dementia - they were deeply hurtful to hear. I eventually told her that if she didn’t stop saying such awful things NOW, I was leaving (I used to do sleepovers with her) - and I meant it. And she must have known I did, because she did stop. For that evening, anyway,

FiL OTOH was apt to fly into truly terrifying rages if thwarted in the tiniest thing - I had to tiptoe around him on eggshells. The first time it happened was because he’d washed some underpants and wanted to hang them on the washing line - only we have a very small garden with no line! I offered to tumble dry them for him, but no, and the frustration triggered the rage. He was still physically fit at the time - it was so frightening I had to leave the house and take the terrified dog with me.

I know dh didn’t really believe me when I told him and to be fair, I probably wouldn’t have believed it either - it was quite out of character for pre dementia FiL. However, it wasn’t long before dh saw such a rage for himself. Dh was then a big hefty bloke and even he said he wouldn’t have dared to approach him.
It wasn’t long after that that we found him a nice care home. I just couldn’t cope any more, especially when Dh was often away for work.

Did your mother live on £100/day prior to dementia?
If she did then give her the money.
If she didn’t then her request, no matter how calmly made, is not being made in a ‘lucid’ moment.
It is another dementia symptom & the LPA still holds.

Can you mother use a debit card or are you giving her cash?

Can you set up a prepaid debit card, put £100 on it initially and then reload it as needed? I have one of these for a relative where I have to monitor their spending. The app tells me what they are buying in real time and I can cancel or freeze everything via the app if the card gets lost.

Is she fixated with money? Has she had money worries earlier in life which are now manifesting with rage? My relative fixates on very specific money things and gets highly agitated if the fixation isn't dealt with e.g. she wanted to write a cheque but couldn't find her cheque book and turned the house upside down looking for it. Then she became fixated on going to the bank to check her balance and kept asking to be driven to the branch. We got printed copies of her statements and this calmed her down.

With regards to capacity, is it helpful to know that capacity is not universal and is actually decision specific. It’s nuanced, a patient might have capacity to refuse a wash, but not have capacity to make a decision about spending £200 on bitcoin.

Yes capacity can fluctuate, but the baseline state is always important to note and how this impacts on long term wellbeing.

So in relation to money, does she have the capacity to retain, recall and forward plan/weigh the consequences of her request? If not, then I would err on the side of caution. She might be able to for £100, but does she realise that continually spending this amount of money will mean that long term she will have less resources. Is she able to weigh that she might not be able to pay the gas bill the week after if she’s spent all her money?

The police and SW can give blanket statements, but let’s face it the reality is less than blanket isn’t it.

That's not the best advice in my opinion.

Not much to add other than to say I hear you.

Very similar situation with M. But this time, she was the one who worked in LD but way back in the day when it was all institution based. But she knew how to work the system and presented very plausible for many many years (also complicated by her own MH issues and a diagnosed PD as well). The behaviours haven't improved as such, but the dementia progressed to a point where she was hospitalised and into a nursing home that could handle her. Has been the best outcome all round.

Just because you work professionally in care it doesn't equip you for when it is your own parent. All you can do is plug away at it and be ready for when the inevitable happens.

Good luck

@MenopauseSucks no she definitely didn’t have £100 a day to spend before. We agreed £100 a week because that’s enough for the food shop (that she never ends up doing) and any extra bits she might need. So no, based on that I can’t give her more.
@Marquee2go we’ve tried that too. She won’t use a debit card because it doesn’t look like the one she used to have so she doesn’t believe it will work. (I tried Monzo and Revolut because I can control them online).
@BluesandClues So in relation to money, does she have the capacity to retain, recall and forward plan/weigh the consequences of her request?
No she doesn’t. She has no idea how much money she has or how it is kept (accounts, shares etc). I have to tell her and write in messages, so she can refer back to that “No I can’t bring more money because your council tax etc has come out”.
@Lastknownaddress you’re right in how different it is when it’s a family member.

Why?
This is what I had to do to keep my DM safe and salvage my own life.

I’ve been through it myself but you can’t walk away without making sure she’s safe.

Of course, that’s why I told social services I was withdrawing my care instead of carrying on and patching to the situation with band aids.

You were lucky if they listened