How should I handle my mom with dementia going into an irrational, aggressive and abusive rage for hours?

What kind of doctor is treating her dementia? (psychiatrist, GP, geriatrician, neurologist, etc) Is she on any meds for it? Have you discussed this with her doctor? If her doctor is not a specialist and hasn't any idea of how to treat this, it might be time to switch to a specialist. There may be medications that can greatly reduce this behavior.

One way to get help would be to call 911 the next time she is in a rage. In the ER ask that she be evaluated for her mental health problems. They will look at all the drugs she is taking and perhaps try others, under their close supervision.

But calling 911 is a last resort, I think (since she really isn't hurting herself or you). First, discuss this with a doctor very experienced with dementia.

Thanks Jeanne Gibbs. She is under the care of a geriatric doctor. I will discuss this with him.

Yes, this type of behavior can be very common with dementia. It is very scary and hard to deal with. I agree you should speak with her doctor. Usually this happens in late stage dementia. You may have to consider a care facility, as sometimes we are just not equipped to deal with this type of behavior in the home environment. Please take care of yourself too.

Thank you texastalking. It is hard to deal with. Take care of yourself also.

MYPETUNIA615, another idea is that your Mom might also be suffering from an urinary tract infection [UTI] which can cause many different strange and abusive symptoms. This is somewhat common in elders. The test is fairly easy if Mom cooperates, peeing in a cup. It was can controlled with antibiotics.

Thanks fregflyer. The last time she acted like this, she was tested for UTI. It came back negative. I think it has to do with constant mood swings.

my mom threatens the throw me out i bet it happens after noon maybe round 2 pm !! that is sundown effect if ya wanna call it that ...well for me she did that & 2 times i take a hour long walk with my dog & come back she has claim down try that & also if it happens at he same time what you can do is play something on t.v that she really loves & get that on & then if she still acts up then leave for that hour ...try to do that let me know if it helps ..google the sundown syndrome & see --good luck ,.later M

It sounds like you need to get the cops involved because she's getting physical. They will remove her and get her to a facility where she can get the help she needs and if she needs it, she will be involuntarily committed to a facility. 

Someone here mentioned a UTI. That just don't make no sense to me. People get UTIs all the time and don't get violent like that. It sounds to me like a later stage dementia or Alzheimer's and she needs to be involuntarily committed to a proper facility surrounded by staff who are specifically trained to deal with this kind of thing. She needs to be around trained professionals 24 seven

My Mom has been doing this also for about 3 weeks. Yes UTIs can cause irrational behavior my Moms were chronic she now takes d-mannose cranactine a natural substance and hasn't had another one so far. Hopefully she will go to psych appt in a couple days to get meds checked. She's taking low dose of seroquel maybe it needs to be increased for a while. Hope this is helpful .

Dontask4handout...UTIs in elders - at least those with alz/dementia - can cause extreme behavioral issues...It can almost mimic a psychotic break. But if the UA has ruled this out - once the sample's been cultured. For anyone who's female loved one has chronic UTIs, you can ask the clinic's lab for specimen cups & those collection "hats" that are perfect for collecting a sample without a ton of hassle. I always have a couple on hand. So much easier to do this all at home & run it to the clinic after. I've heard about the d-mannose & am going to start adding that to her daily routine.

As for OP, it definitely seems like a medication tune-up is in order. If her doc seems to shrug it off, then might try a psychiatrist who specializes in Alz/dementia.

my mom has dementia & every month she gets a UTI she has a upper stupid catheter
& she talks crazy when it effects her & she does other things ..it can cause problems it is worth to check for uti

... my mom was doing that, like you it would start for small reasons, a look, or I would leave, a thought she created, a television show, didn't seem to matter.  The anger she had from not only the dementia but also from the fact that "she knows she has it" .. those fears translated to anger for her.  She simply expressed the anger more easy than trying to explain or verbalize her fears or irrational thoughts her dementia was causing. 

My mother was started on very small doses of saraquil and her moods leveled out.  The dosage is small enough to calm yet not enough to create any type of larthargic or 'doped up' type response. She remains alert, simply calmer. Then, months later she started what could be explained as mini panic attacks, but only after specific triggers, such as being in a crowd or after strenuous exercise (perhaps using the restroom then taking a shower all within an hour, etc) so her physician prescribed a small dose of larazapam, that has worked very very well. She is on small dose saraquil every day and larazapam "only if she enters a panic (perhaps once per week.)
 I do want to mention  "urinary tract infections' are used far to quick as reasons and excuses for elderly behavioral abnormalities and are used from everyone from care facilities to family members etc ... but when the actual infection itself is 'not that common' when you place percentages of elderly comparatively  ... So No, UTIs are not the 'go to fix all'... they are not.  As long as your parent is hydrated, and their nutrition is basically balanced and as long as they are bathed/showered and performs decent peri- care and changes incontenance pads/briefs often enough in-between a shower, an elderly person does not contract UTI's as often as expressed by many. 

As I've had to learn with my mother, dementia in any stage, is unpredictable, although you can almost get used to the unpredictability, the brain of a dementia sufferer is not ever functioning properly it's simply that the more disturbing or 'noticeably imbalanced times" comes in definite waves and are highlighted. 

**If you are caring for your parent at home I would not call the police nor take them to a hospital for psych evaluations (those two paths can turn out to be very detrimental to an elderly person and are impossible to reverse the steps once those two avenues are taken) ... Simply set an appointment and take her to her physician and tell them what her behaviors are and perhaps they can test her blood to rule out any issues and perhaps they can provide assistance to calm and ease her via initiating small doses of carefully monitored medications. With our elders, it's always best to take smaller measures to find solutions rather than jumping to conclusions or making harsh and perhaps detrimenial decisions. 

Lastly,  I would like to suggest, that when/if  you are speaking with either a doctor, nurse, or to any facility in a hospital setting, make sure you strongly emphasize that she is "not" physically hurting you (unless she truly is) .. because, if she's ever to be placed in a care facility, an abuse report/statement that you make to a hospital or to her physician, even during a passing conversation with them, all you say to them will go on her medical records and physically abusive reports will keep her from ever being able to be in a standard facility and will only be allowed to be in a phych type facility. (And there are major differences between the two I can assure you.)

Most memory impairments, such as dementia or Alzheimer's may cause aggressive & assertive behaviors. We tend to forget that our behavior is an old memory, so, if we were a mean person when well we probably will be with dementia. You may hear profanity and cruel words due to the areas of the brain being damaged as well. Was she diagnosed by a neurologist with tests given? MRI, pect scan, sometimes a spinal tap? At her age ? to go that route now, but she should be checked out by her doctor to make sure there are no infections going on. There are anti psychotic meds that do help, but, you will have to watch for side effects & at her age a low dose may be the best call, just enough to calm her. You don't want to over do with these meds, there's more sleeping that will go on due to drowsiness & you don't want a risk of falling. Sometimes at this age, less may be better. Hard I know, it's your mom, but don't respond to the behavior or cruel words. It's a battle you won't win. Give her & you a time out & walk away for awhile. It is like taking care of a "terrible 2 toddler." Keep yourself safe with the swinging, using the arms length space rule & don't think she won't hit you, she's not always knowing you these days, not her fault. Don't have things around that could be thrown either, you don't want to get hurt. You have to keep everyone safe as well. When my brother with ALZ is angry, he's fast, on a mission almost. As the dementia progresses it seems the assertiveness lessens, with more compliancy behavior but timing is different for everyone. Dealing with this is not for sissies, pleading & tears useless, I had to learn this early on. This behavior may be a deal breaker, home or a facility, don't feel guilty or blame yourself for choices made. True words were spoken, "It's a roller coaster ride." Blessings🌸

No one seems to have asked - does this only occur at certain times of the day, specifically later afternoon and/or early evening? If so, this could be "sun-downing".

Each dementia sufferer can exhibit different behavior during this period of day. Some will become combative, some, like our mother, showed benign OCD behavior, checking the same things over and over (she was still living alone, so who knows what she might have done if living with one of us???). At the memory care facility she still goes through this, checking drawers and what not, so they report.
If it is random, then yes, do consult with a doctor, primary care IF that doctor is well-versed in dementia, otherwise seek a specialist. As some say, medication might help (personally I prefer non-meds, but sometimes this is unavoidable).

Others have suggested making yourself unavailable when this occurs, certainly doable with a walk or some other outside activity. If she is not apt to hurt herself, remove yourself from these tirades. For sure do NOT take this personally as it really is not.
If, on the other hand, it is occurring regularly later in the day, read up on sun-downing and methods for dealing with it. If you note it only happens later in the day and in the morning she is back to her "old self", then certainly this might be the case. Redirection sometimes works, more lighting during those darkening hours, and if needed some medication to calm her during those times (should be dosed BEFORE the 'pumpkin' time...)

I'd agree with disgustedtoo. Can you make this a little bit of a research project/game, and take some notes on when this happens, what happened before, etc.? A lot of things like this happen out of habit, I'm learning, and if you can pinpoint what triggers it, if anything, you might be able to start controlling (or dodging) those impulses. At the very least, I've found that "studying" the situation helps remove yourself from it mentally and emotionally. And if she can't physically hurt you, at least then it really is like a baby trying to punch you.

Both " disgustedtoo" and "iamdanielhom" have made good suggestions.

I would only add to check for dehydration as this can also cause problems. The person is uncomfortable and doesn't know why - it can make any of us irrational at best.

While my DH isn't physical with me, he is becoming irrational and a lot of it was too much fluid being drained off him, and every hour the need to get up and void.

We really do need to do the 'leg-work' and research to learn as much as we can. Diet and nutrition can also play a part. Right now my DH will only eat Fish Sticks and must have his Hot Chocolate for breakfast. So I add a "greens" supplement to his Hot Cocoa (I'm using Barlean's Chocolate Silk) and I add ice cream for the extra calories. I use Ensure as the base instead of milk. So his "breakfast" is around 500 calories and he does get his nutrition. The rest of the day he only wants his Fish Sticks. So his drinks throughout the day consist of Ensure mixed with V8 Smoothies. Nutrition and calories. Sometimes I can get away with adding some "Berry-Greens" but sometimes he doesn't like the taste and won't drink it. Definitely a learning experience.

I wouldn't call the police either. And before you call 911 for an ambulance, be aware that this isn't covered by a lot of insurances. I would talk to her primary physician first. You can call and a nurse will get back to you with answers if taking Mom in is a problem.

My mom had rages too - once she was in hospital they put her on decaf coffee & that helped a lot -

If she drinks regular coffee start by doing 1/4 decaf 3/4 regular for a week or so then 1/2 & 1/2 for another week then 3/4 decaf 1/4 regular then all decaf - the caffeine is a drug that can cause this so cold turkey is not the way to go - be gentle as possible

One sign is if she wakes up running for the pot of coffee then that shows she might need her fix of caffeine - mom did this & we used to joke that we should just put caffeine in her morning insulin little realizing that this was contributing to her behavior problem - not all went away but there was a drop over about 80% compared to prior to being on decaf - hope this helps

I agree "Tired 1of4" with your comment of not calling 911. Nothing good would come out of that only extreme frustration and more confusion for your mother. Her behavior needs to be discussed with a good physician; either primary or neurologist. Good luck. I'm sure it's the dementia acting up. Her love for you under normal circumstances is still there. Just get her the help she needs.

Thank you all for the sound advice. I am going to keep tabs on what time of day and what is going on at the time. She also has a doctor's appointment soon.

My wife has done that. She kicks the security screen doors and scream that I'm keeping her prisoner. I called 911 and a trip to the ER got her primary doctor on the ball. I had to replace both screen doors as they were bent out of shape.

I had this happen with my Dad. He was diagnosed with psychosis, and because he was a threat to all of us including himself. He was hospitalized in a Psych Unit. When I eventually got him into the Cleveland Clinic, they told me it was mid-stage Alzheimer's. With the right drugs the psychosis lessened considerably.

Hi, when your mother does become violent, look after yourself first. Walk away from what is happening. Yes, she is your mother, but she is also violent. Protect yourself physically and emotionally, as best as possible. Talk to her geriatrician about these outbursts also. All the best, Arlene Hutcheon

I also have this problem with my wife. She has Lewy's Body dementia and this kind of behavior is more prominent with Lewy's Body. She also is subject to the Sundowners Syndrome. I have been told she gets frustrated and then angry and then takes her anger out on her caregiver (me). The strange thing is that she does not exhibit this behavior when other people are around, It is usually during this time she falls. I did call 911 once and will never do it again. But, that is another story. My solution now is to simply wrap my arms around her and hold her on the couch or bed until she calms down. I am told this is illegal because I am restraining her but, what else can I do?

My mom (in her 90s) just flips on a dime into an angry rage. It is very difficult to handle at times, and if I can change the subject, divert her attention, or give a compliment, sometimes that works. I do not live with her, and often dread going to her home. If I can, when she starts the verbal abuse, I calmly walk out and leave. I have no sibling support, and she will not allow a caregiver into her home, but at some point she is going to need assistance - more than the 2-3 days per week I give to her now - I have to work, too. She has always had an anger problem, it only gets worse as they age - and it is always directed at the person who keeps them going, and who is kind. Conservatorship is out of the question.

I don't care why she does this - it is unacceptable and cannot be tolerated under any circumstances. Check with your doctor, office on aging - you may be forced to remove her from the premises. This simply cannot go on.

... Riley.. not sure if you've cared for anyone with dementia, but it most certainly does matter "why. It most certainly does. Our elders are human beings of whom are entering their last years on this earth and we who have found ourselves having the responsibility for them understand that these elder persons who most have contributed to society are now living in the very same society that refuses to respect their value as living beings. Ones who suffer Mental and physical degrading due to age related disabilities and illnesses are not to be treated as if they are to be locked up, should not be treated as sub human beings. So, if a caregiver sees an issue then to advise that caregiver to seek better ways to resolve or deal or to assist the behavior is the "correct path, rather than the path of yours of zero tolerance... zero tolerance removes reasoning, removes patience and understanding, it removes seeking the cause and seeking a reason... therefore removes any investigative help for that individual who very much has a right to receive. Zero tolerance is a cold and power play approach to every single aspect in life and has absolutely no place when dealing with humans, let alone as they age. I hope I've made myself clear.

I FIGURED OUT WHY TO GO AWAY FOR A HOUR OR SO !!!! THEY WILL FORGET WHAT OR WHY THEY WAS DOING WHAT THEY ARE DOING ..THAT IS HOW OF COURSE IT DEPENDS HOW LONG THEY REMEMBER FOR 1 THING & THE BEST TIME IS SLEEP EVEN A HOUR OR EVEN MAYBE 5 MINUTES ..MY MOM DOSED OFF ONE TIME & FORGOT WHAT SHE WAS DOING ..SO THAT IS A TOOL FOR ALL OF YOU !!!!!

meridianav, that's exactly what happens. When the rage is over and she calms down whether it be a nap or a major distraction, she totally forgets any of it. It takes me a little longer to calm down. Some things that she says to me are very hurtful. It's an emotional roller coaster.

While I know it is extremely difficult to do you must remain calm as one cannot reason with a broken mind - if UTI has been ruled out and she is taking an anti-psych drug then it may need to be changed or adjusted - I understand some of the memory drugs like aricept can cause agitation even

Seroquel did nothing to calm my mom and increasing it only made things worst so we switched to risperdal - she's still a handful but night and day compared to a year ago

At her age, I wouldn't call 911 - I've seen folks at her memory care escalate to that point - it isn't pretty and the results were worst

If she is safe and won't fall or otherwise hurt herself - play music or turn on a DVD of Singin in the rain or my fair lady
Get her a cookie or ice cream
Give her space

Distraction and patience and the right meds if necessary

If it's still too much then look for the appropriate care facility

PS - Gund makes a talking teddy bear that says I love you - I got one for my mom's roomie and she was calmed by it 

Last year, I discovered just how oddly a UTI can affect the elderly. My 87-year-old Momma was totally irrational!!! UTIs should definitely be considered with any behavior change, although apparently testing isn't always as reliable as we'd like... see this article that I came across last week: https://www.sciencedaily.com/releases/2017/04/170428084433.htm