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She is 93 with moderate dementia. She has always been this way coming back from childhood, her way of control, this I am aware of and not wanting to give into that control. It is quite difficult that now I am the sole caregiver for her, my brother, the other sibling, died twelve years ago with cancer and his family is very distant with us. So it is hard to be doing this alone after thirty years, caring for my father who died of cancer in 1987, my elderly grandmother who died in 1997, my brother who died in 2002 and now my mother. I would appreciate any advice or input you might have.

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Walk out of the room when she is in mid sentence. Don't give her an audience. If she follows you, tell her you will be glad to listen to her when she calms down and lowers her voice. Go to the bathroom or bedroom and close the door. Let her rant. She will get tired eventually. She sounds like a toddler throwing a temper tantrum. Treat her that way.
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Yup, I agree with Rocknrobin. How do you handle your mom's raging outbursts? You don't. If she's acting like a 2 year old, treat her like a 2 year old. If she's screaming at you tell her that you will not tolerate being spoken to like that and then walk away and stay away until she's done. Then go on like nothing happened. Walk away the next time too.
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"I was so bored, I read the New Yorker," says 93 yr old mother. "I couldn't find anything in it I liked. It was all about young people's problems."
After she was done ranting about it I said, "I guess someone has to start a new magazine, The OLD New Yorker."
She didn't seem to get the joke. Good thing I laugh at my own remarks, if I can get them in sideways.
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It is very hard, Artlaurie; and not only because of your mother's personality but also because, as you say, you are now alone. And you must feel very much alone. I'm so sorry, you sound rather desolate, and I can understand why you might.

Has your late brother's family been in your thoughts more than usual, recently? I ask because twelve years is quite a lengthy adjustment period, so it seems unlikely that you would suddenly be feeling his loss more deeply unless, perhaps, some particular milestone or memory had come to mind.

Handling your mother's outbursts: there are numerous guides to dealing with challenging behaviour. From your description of your mother I would recommend Christine Lawson's book on the Borderline Mother (but then I would! - I've recently discovered it) - there are plenty to choose from for further reading, and meanwhile forum members will have excellent advice based on practical experience.

But aside from that, what respite do you get from your mother? I'm finding out for myself that regular breaks are sanity-savers. I personally get four hours a week, when the lovely Liz comes to sit with my mother; and I'm trying to establish a pattern of a week's residential respite care for her every three months or so. Getting time away, even if it's only so that you can lie down and drum your heels in peace, does seem to be vital.

So, returning to the subject of family, have you perhaps been thinking of building bridges? Does your mother have grandchildren she doesn't know (and would like to, and who would benefit from her attention - goodness it gets complicated!) on your brother's side?

In any case, however, while a rapprochement could DV prove rewarding, I shouldn't count on it for actual, practical support even in the best of circumstances. So I would also be looking for some outside caregiving resources. Start by asking your mother's medical team about what would be both suitable (they'll need to know what they're doing) and available. And affordable, if that's an issue.

The thing is, it's an awful lot easier to handle challenging behaviour in a calm and constructive way when you're not already exhausted and driven to distraction yourself: hence the need for time off. Best of luck, let us know how you're getting on.
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After reading this thread and hearing of this type of situation over and over I have a question. Understand, I am not caring for a person with dementia so I might just be ignorant but I don't understand why combative dementia patients are not medicated for that.

My uncle became very combative a few years into his dementia and the doctor prescribed some sort of sedative. The effects were dramatic which saved my aunt from a life of caregiving h*ll. It's five years later and my uncle is still being cared for by her at home and he seems quite content. He does sleep a lot (12-14 hours a day).

Medication is not just about making things easier for the caregiver it's also about making life better for the patient. In my opinion sleeping half the day is far preferable than being fearful, angry and hostile, he is none of those things now.
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I understand wanting to treat the person with dementia like a 2-year old when they are acting like one. The big difference is that the 2-year old can eventually learn from the experience. The person with dementia can't. In this case, walking away isn't "teaching" anything, it is removing yourself from an abusive situation. In order to be an effective caretaker you have to take care of yourself too.
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artlaurie im day 4 of not talking to mum? shes in a terrible mood and yes follows me to argue and yes i have to walk away now i am so lucky i have a friend down the road whose mum died of alz so she knows only too well the anger and "tantrums" the other posts are so right dont give her an audience. I go for a walk or my room or a friends ive had to throw out 3 meals that i cooked for her before i went out as she wont eat "anything ive cooked" yep temper tantrum like a 2yr old only we cannot punish a 77yr old? Like "go to your room and come down until you behvave" oh i wish!!! you have to rise above it and yes ignore her mums in the front room now sulking banging doors? BUT she has time to reflect then it will be all over me and buying me things blackmail? i was in a state last year before i joined this site as i didnt know what to do with these outbursts but have learnt alot here. Shes getting old shes afraid of dying and her anger can only be taken out on the one closest and thats you and me! Treat them like a kid and DEMAND she behave or else as i say to mum "theres a lovely home up the road with spare rooms if youre not happy here". Harsh but true i can put up with alot from mum but this abuse type behaviour is not on in any situation so let her know that you are not taking it and i assure you she will calm down and appreciate you even more although she wont admit it!
Hugs its very hard and so stressful but you get tougher and stronger if not youll crack!
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One time Mom and I were in the car and we just arrived in front of her apartment building. She couldn't understand why I couldn't be in 2 places at once and started yelling at me a the top of her voice and calling me "B*tch! You B*tch!" I was shocked.
Then she saw someone outside and shouted, "My daughter is a b*tch!"
Makes me laugh at it now, but then I was devastated. Now I see it is a mental problem, as it has always been but everyone covered it up.
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Go, so, ask yourself why you continue to subject yourself to these car rides? "No mom, we're not going shopping this week. I'll call and have your groceries delivered. My doctor says that being yelled at is very bad for my heart condition". "No mom, we can't go visit the kids in my car. You make me so angry when you yell and cry, I'm afraid I'm going to drive off the road. Here's the number of a taxi service; they're lovely". Detach with love, but detach. Lest you die first. Stress kills.
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LadyForbes, why were you helping to pay your mother's bills? Sounds like a bit of a tactical error.
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