How to handle outbursts in public?

There comes a time where outings do more harm than good. Have you had your mom evaluated for dementia? If not, I would do that ASAP. Taking brain images can tell the doctor exactly what kind of dementia she might have, as they are not all Alzheimers and do not all have the same treatment path. What you describe is not normal aging.

I feel this is a critical step to understand what you're dealing with, if or what kind of anxiety meds might help, and to inform your planning for her ongoing care. If it is a dementia, the road will not get easier and you will need a lot of help.

My mom has Alzheimers - moderately severe impairment - and as much as I love the IDEA of taking her on outings to see the world and have nice experiences, wild horses could not make me do it. She is much less agitated on her predictable daily schedule, where the health care aids get her up, dressed, her meds, and to meals at the same time every day. She has social interaction with staff and the other residents on her unit. There are activities. Everybody there knows what to expect and what to do when it happens.

She is in a constant rage about her hair. It's cute on her at this length (at ear lobes), but she absolutely will not consider visiting the onsite beauty salon or barber. One lady, one time in the dining room, supposedly told mom that she had a bad haircut there. That one sentence out of that lady's mouth forever ruined any chance I had of getting mom to the beauty shop.

If I took those words at face value, I would perceive a problem. However, I don't believe that actually happened. And so what if it did? Maybe the lady who had the "bad" haircut didn't specify what she wanted. Maybe the haircut looked great and made it easier to self-care for her hair, but it wasn't the same haircut she had when she was 20 when she needed 50 curlers to sleep on every night. Who knows. Every salon in business has had complaints. It's no reason to avoid it without a good try. I'm not going to go through the upset of getting mom out of the building and to an appointment or to a walk-in place.

I have seen the same thing with my 94 year old dad. He loves to get out of the assisted living facility and go for a ride in the car. However, any encounters where he has to participate in any form or fashion, particularly with strangers, are just way to stressful for him.

Find a beautician who will visit your mom and do her hair at home. Still, you can play a "salon" game and let your mother write the check and tip her (if she is still able to do it without agitation...) At least you will not feel bad if your mom feels moody or does not behave. But yes, woman still feel better when groomed: manicure/pedicure/hair styling can be great activity for any woman....

U are not alone... I know this is hard. My Mother lives in a REALLY nice independent senior living home. She chooses to sleep most of the time. I took her out recently to the Dollar Store (Walmart) just is TOO big... She started yelling at me in the store, so I walked away but stayed not to far away and she calmed down! I have had her yell at me for giving a tip to the hairdresser SO you can't win! Do what you are comfortable doing. Yesterday she called and wanted to VOTE, we had a primary in Iowa, so we took her with us. She was in her slippers however she went! take care, Are you in a support group???

What a wise and perceptive hairdresser that was to treat your mother like she did! She deserved her tip and then some.
When I first read your question I wondered if you mom had agoraphobia (afraid of leaving the house). This is still a possibility, but considering that the hair salon seemed to be where she had the outburst, there seems to be more to it.

I agree with Sandwich42. If your mom hasn't been seen by a neurologist to see if she has dementia, this needs to be done. Sometimes dementia symptoms can be the result of infections or medication interactions so everything needs to be examined just in case.

I do agree that taking people with dementia out can be either good or not so good depending on their personality and their stage of dementia, if that's the problem. For many, a trip out can be invigorating as long as they aren't over stimulated. However, routine and familiar surroundings are very important to many, so going out of the house can cause extreme agitation.

It's very hard when people fight having their hair done. Your mom may not like the touching that is involved or if she gets a shampoo she may be afraid of the water. She may not understand what the scissors are for. Most outbursts are based on fear or confusion.

Getting to the bottom of what is wrong is just a first step. If she has dementia, then try to become as educated as you can about how to cope with it.

Please keep coming back to this community. There are many wise caregivers and professionals who can offer not only advice and tips but community and comfort.
Take care,
Carol

Taking your mom to the salon was a very thoughtful thing to do and I'm sure she enjoyed having her hair done. But all the stimulation and noise may have been too much for her. Bless the hairdresser for treating your mom with kindness and sensitivity. I think hairdressers see that kind of thing on a pretty regular basis as most women your mom's age still like to get their hair washed and set and styled.

Maybe it was a one time thing with your mom. I would test the waters again because if it was a one time thing getting your mom to the salon on a regular basis would be a wonderful way for her to get out of the house. Write out the check before you leave the house next time and make sure your mom has the exact change for the tip. If she has another outburst you'll know for sure that you probably can't take her out anymore.

I just re-read your post and realized that you had tried the salon twice already so forget what I said! ;-)

a lady friend of mine said she made up little index cards indicating her mother had dementia and to please forgive any words or upsetting behaviors that might inconvenience the other people. She said this would help if they went out to eat and she made crude/rude remarks out loud. My friend said she would quietly slip a card to the table closest to them and it explained the situation. Most people understand if an elderly person does this but it can be embarassing, I am sure, to the daughter/son who is out with them. But you can't help it and neither can they. We need more understanding people in our world.

I come down in the middle here. I appreciate the understanding that often an elder is more comfortable in their own routines and environment. And, it's also true that it can feel encouraging and refreshing to go outside our environment for visits.

The challenge I see it, is figuring out how to work with another person, whose fears are different from our own. Some of those may be heightened by the vagueness that medications can add to one's abilities to respond to challenges as they arise. It matters for the person leading someone to a not-regular activity, to pay attention, respond, and explain, not ignore those fears.

So many people "chat" over the process of mobility - comings and goings - and we do not consider the fears of those with impaired ability to balance, see, hear, remember. Many people are conditioned to try to chat, be cheerful, assume that an elder can follow along, doing essentially two things at once.

I learned in guiding my younger brother's (brain injury) adult care, that he needs both down time - alone, and social exposure, but he needs them in a balance, and pace of transition that he can follow along with. Our culture often suggests activities or outings as if they were intrinsically wonderful in themselves, without considering the wish and need, for parties to follow along - which means a slower pace when senses decline, and being with someone alert to this need for slowness - as one gets into the car, as one tries to remember, did I bring my checkbook. Did I use the restroom? Will we come back home safely and promptly? If I need to use the bathroom but am too embarrassed to disrupt or say so, will someone respond promptly and guide me gently to find it?

Is some caretaker person, relative or paid - paying attention with cheerful, positive help, keeping in mind the primary focus of helping me with this outing, rather than fitting in with the hairdresser or others in the social setting. Building that trust and awareness starts when I arrive to pick up an elder, who is reassured by my responsiveness to every hesitation, agreeing with their fear and helping them resolve each concern as we go out the door.

Many elders, who remember the role of being parents to their children, hide their immediate physical difficulties from them. But when you lose considerable vision, hearing, mobility - even going across the room takes focus and being with someone who respects how disorienting this is, and wait for your slowness, not chat over your efforts to collect yourself and take on a new setting, which is not remembered in detail and is thus a challenge for you, so many unknowns,

All outings are risky, when you fear your ability to adapt in new expectations - which include conversations with people who are not familiar with the slower world of elders.

We don't live life from the outside, but the inside. Our culture has focused on the goals and values of the young, judging people as happy based on activities, social status, external trappings. As elders, and as someone with a different life path which included considerable separation from mainstream, I know we crave to see someone willing to let go of that external perspective, who wants to tune in to listen dependably and quickly, even if just briefly, and be ready to help if we have any fears. If someone shows that close one-to-one transition awareness, we can go out, and feel safer, and once settled in and sitting down, we can then enjoy the new, refreshing experience, or even the lovely one of a haircut.

What a good idea to carry prewritten notes. I also believe if you can pay in advance under cover if possible might help.

Wonderful insights and suggestions for this amazing group! Keep them coming. Every one of you has added something valuable.
Carol

We no longer take mother out to shop or any other outing. She gets far to over stimulated and has the type of outburst you described. For us it was in the middle of the store. She has not had her own credit/debit cards or checkbook for sometime due to spending issues. Her dementia causes her to believe she is very wealthy and this is far from the case. She accused me of stealing her check book and credit cards and proceeded to tell everyone in the store I was stealing her nail polish as well. It was pretty awful - fortunately we live in a small town and the clerks knew what was happening. The Assisted Living facility does have a salon on site and she is able to get her nails and hair done there without interruption and she provides us with a list of items she thinks she needs from the store. She does request to go occassionally - however we change the subject and move on. I will not take her out any longer. Even on days where there is to much activity in the living facility they keep her in her room to prevent over stimulation and the resultant outbursts.

For one, I think people understand that something cognitive is going on with your mom....don't worry about being embarrased. I took my 90-year-old grandma (with dementia) to the salon 2 weeks ago for a perm and color. She REFUSED to move out of the waiting room chair for 30 minutes! The hair dresser and this sweet woman getting her hair done came over and tried to get her to sit in the beauticians chair, but she refused. She eventually decided she would participate, (30 minutes later) but by that time her hair color was the only doable service we could do, since the hair dressers next client was coming in soon.

Just the other day we went out to eat and she yelled at the bus boy for making too much noise with the dishes, even though the noise level was perfectly acceptable in the restaurant. You are not alone! Just do what you can to calm her down, and go about your day. People understand.

My grandmother also enjoys sitting, sleeping and staring at the wall. It is becoming more and more difficult to engage her in activities or conversation, but none-the-less, do what you think is right. Even though you are experiencing some outbursts in public, I still think it's good for them to get a change of pace sometimes. Good luck!

My mothers assisted living building has a beauty shop on the first level that is open to anyone that wants to use it. I am not a hair stylist by any means and I really don't know what I'm doing but I already gave my mother 2 haircuts that she loves. My mother is paranoid leaving the home and does not trust anyone to cut her hair. I did my best and I think she looks so cute in her shorter hair.

I found that my mom was happiest at home where she felt safe. I had her friends visit and have lunch when she was able. Her grandchildren would visit and that made her happy. We would be watching TV and I realized she wasn't watching the televsion but watching me. At night she walked into my room numerous times calling my name. It took awhile to realize she just needed reassurance that I was close by. She did much better in her own home around things she was famlliar with. Taking her out might make you feel better, and I mean this in the nicest way, what's important is what makes her feel better. If she wants to sleep let her.As long as her personal hygiene is taken care of and she's eating I wouldn't force anything it causes too much anxiety for both of you.

I have slipped a small card disclosing my husband's Alzheimer's diagnosis to the nurse at several doctor appointments. It makes the whole visit much easier and the doctor knows to direct any questions to me rather than to my husband.

My husband has brain damage and alcoholic dementia, as well, and tends toward inappropriate lashing out on occasion. Once, in a restaurant setting, when his ire was directed toward me, I turned to him and quietly exhorted him to calm down, assured him repeatedly that I loved him, and informed him that yelling me in public was waaaayyyy inappropriate. He responded, after a moment of thought, with a very abject apology, and said, "That wasn't me." And it wasn't. On another more recent outing -- for a haircut, coincidentally -- he lashed out at the conclusion of the cut, stating that it was "the worst haircut he'd ever had," after which he stormed out of the shop. I was left to make apologies to the poor woman -- who had actually done a very nice job -- and I simply explained to her that he suffers from a form of dementia and offered my regrets for what he had put her through. I also gave her a nice tip and thanked her for her service. Needless to say, though, we won't be going back there!

My Mother gets very agitated when she has to pay any money or write a check. The way we handled it was to pay the hairdresser up front for the month. She still tries to write her checks but the hairdresser knows what's up and tells her that "the family has paid for her." That seems to settle her a bit. The check thing was getting real frustrating for her - we now pay all of her bills online. She groused for a few months about us "taking her money" ect... but now she has forgotten and just thinks that magically everything gets paid for.

The hubs is here 24/7. I would love to go out , anywhere at all. Ask if he wants to go out he will say yes. The minute the car starts moving he wants to go home... So whats the point

One time I picked up my Mom at the hairdresser - heaven only knows what she says when I am not around- and the beautician was looking at me strangely. The hairdresser tells me that my Mother wants to go to the casino and I am refusing. What??? For one thing she hates casinos but I digress. Two months earlier I had taken the hour drive to take her to the casino and when we got there she was overwhelmed and immediately wanted to go home. I made a face which my Mother saw in the mirror and then she says to the hairdresser "She what she does." OMG - I felt like a 12 year old girl again being scolded by my Mother in public. However that was a couple of years ago and I have a much thicker skin now - but I still avoid that hairdresser - haha.

My mom who is turning 82 this month is summarily doing the same thing sans the public outbursts. She doesn't want to leave the house. She only wants to sleep all day. She gives my sister, who is her 24/7 caregiver, an argument when she tries to get mom up. Mom says we are tying to kill her by making her get up. She feels she had to do it all her life and shouldn't have to do anything now she doesn't want to, (like dealing with a stubborn child). Most days she will sleep the entire day and only wake long enough to take her meds and maybe have a minimal bite to eat.
Dad passed away last September at 83 and I know she is having a hard time dealing with it. Some days are better than others. I live in Massachusetts and they live in Florida. I recently spent a week there trying to get mom moving and eating and more active than she has been for my sister. Bringing my daughters to see her helped. My sister has no income because she is mom's 24/7 caregiver and has her own health issues. My sister and I were able to get rid of a lot of junk that mom hasn't been able to part with. She first agreed to let me donate dad's clothes, but then refused saying she is not ready. We didn't touch them.
Mom finally let me "trim" her hair as she won't let anyone especially hairdressers touch it. It was too long and unruly. I cut several inches off of it and she said she felt better. My sister has been trying to get mom to let her color her hair telling her she would feel better if she looked in the mirror and felt a little more groomed.
I think our being there helped at least a little. She put a little lipstick and make up on and is trying to get up earlier in the mornings. We told her if she needed to she could take a nap for no more than an hour to help her sleep through the night.
At her most recent doctor appointment he decided to take her off all other medicines except her anxiety medicine hoping that the need to sleep all day will stop. She doesn't want to go out, even to the grocery store. She goes, but begrudgingly and not often without an argument with my sister.
We, my sister, my daughters and myself, have tried to talk to mom about sleeping all day and the affect it is having on her muscles explaining they will atrophy. Some days mom has indicated that she is done, meaning she wants to die, because she is sick and tired of feeling sick and tired. The doctor has indicated all of her labs are excellent. She just doesn't want to move about and gets testy when we try to motivate her movement. She will change the subject.
She has not had public outbursts...yet. Mostly because she wont go out. When on those rare instances we manage to get her out she enjoys herself but tires easily. Again, from lack of movement in general.
While visiting her in Fla. we took her to St. Augustine and walked St. George street most of the day. We took her to Sea World and spent that day walking about. She refused a wheel chair, although we made frequent rest stops for her. We got her out to dinner, out for lunch at an aunts house and into the swimming pool. She even asked my sister to go for a walk with her and the dog.
None of this, I am sure, will be permanent. But she has seen the result for the better for getting her muscles moving, at first she was sore and it was explained it was because of lack of using her legs.
All we can do is accept the fact that she won't come home to Massachusetts where there is more family. Since my sister will not return, mom will not either.
There are days when I hate answering the phone fearing bad news. For now all we can do is what we are doing, continuing to encourage her and calling her every day trying to narrow the distance.

No, get her out. Since the hairdresser seems to understand her condition, just pay the bill plus tip before and your mother won't have to. Just keep trying and see how her behaviors are in outings. Try to keep the outings to quieter places like a museum or get her enrolled in an adult daycare program for dementia patients. Don't let her sleep all day. Her kidneys will suffer greatly, not to mention her other body parts.

Ferris has an excellent suggestion for inactive seniors ... an adult day health program. It could be one day a week or five. Even if they mostly rest in the recliners, getting up, getting dressed, getting in the van, having lunch with a group, and going home again are more activity than staying in bed! Plus they are very likely to enjoy SOME of the many activities so they won't sit in the recliner all day.

Public outings have to be decided on a case-by-case basis. What is just the right amount of stimulation for one person is overwhelming to someone else. More casual outings are generally safer than more formal occasions. An outburst at a park watching a bandstand act is not as disruptive to others as at a classical concert at Symphony Hall. Most people are very understanding, but it is also good to minimize chances of interfering with the activities of others.

Encouraging someone to look their best is often very helpful. Just be sure it doesn't backfire and sound like you don't like them the way they are! If someone offered me a manicure I'd be delighted. If someone suggested hair color I'd be insulted. My mother, on the other hand, is scheduled for a perm and hair color next week, in her NH -- in spite of dementia, pain, and a broken hip keeping her hair up is very important to her. One size doesn't fit all, but if you know your loved ones' attitudes grooming offers can be a real mood elevator.

Lindipan, having just gone through it myself, I'm going to suggest that your mother is still in deep mourning for her life partner. She has only been a widow 8 months, and for many of us that is not enough time to adjust. I'm so glad that you and your sister are able to get her moving a bit and into some activities. Grief is different from clinical depression and different from dementia, even if some of the behaviors seem the same. When she says she is sick and tired of being sick and tired she may mean she feels hopeless to feel so lonely and bereft. The good news is that most of us heal from grief and get back to a new "normal" life. Be patient with her and continue to gently encourage activity. You fear her recent improvements won't be permanent, but I offer hope that they very well could be!

Thanks . We know it will take time for her to go through the grief process. Dad had been sick for a while so her feeling of loss is deep. She trying to make an effort, but like I said there days and then there are days. We thank God for every day we have with her and only want to find a way to give her a good quality of life. She does have early stages of dementia and we know that doesn't help the situation. Good luck to you and sorry for your loss too.

I also agree with the idea of taking your mom to a beauty parlor located inside an independent living or assisted living facility. They've seen it all and understand dementia and outbursts.

My mom never carries a purse anymore, I pay for everything. I tease her that she's like Queen Elizabeth - she has a minion (me) to handle all of her business and carry all of her necessities. That always gets a smile out of her.

You could also take your mom out (in a companion or transport chair) to parks or outdoor areas, to see the flowers and birds. Or take her (if she likes children) to sit near a park playground where kids are playing. My mom enjoys watching children and often when we're sitting there, parents will have their kids wave at mom, which she loves. There are a lot of places you could take your mom that are quieter in nature where if she starts to have an outburst, you can immediately leave (if you've got her in a transport chair). Good luck!

My mum is the opposite in that she is always on the go, she loves to get up and get dressed and going. She is constantly asking me where we are going next .she loves to be in the car but visits to cafes, shops etc must be short because before too long she is saying come on let's get going...however, when we drive home she gets this annoyed look on her face and says " oh we're home, so were not going out now? "
There is no relax time with her, she finds it very hard to sit still in one place.
In relation to your hairdressing issue, I too have had this happen on our last visit which up until then hadnt being a problem.
she didnt want to have her hair washed and when the hairdresser started to do the blow dry she got very anxious and announced she had to get going, she started calling out for me and saying " pleeeease let's go" like a child.
The poor hairdresser quickly dried her off.
I then realised that normally she would go to the hairdresser in the morning and this appointment was very late afternoon (witching hour I call it) so if your mother suffers from sundowning maybe make sure appointments and outings are done in the morning rather than after lunch?
Also, what about morning walks to a cafe for something she enjoys like an ice coffee or similar, so that there is a reason for her to get out of bed?
Or perhaps an outing where she is helping other people , like being with children or walking a small dog. Sometimes people who are losing their independence and/or mind, get a great deal of satisfaction and self worth by helping others!

What do you do when your Dad, who has Alzheimer's starts to talk in a sexually suggestive manner to women in his assisted living facility?

My husband is always wanting to go out and after we get home within minutes he wants to know when are we going out….totally forgets that we just had a great 4 or 5 hours out, very frustrating for me. When we are in a store, if he wants something and it is either not necessary or definitely something he does not need, probably because he has several, that is when he gets childish and causes a scene, then I either let him have it or explain his illness and try to hustle him out of the store….in restaurants he is becoming quite sloppy and tries to wipe up making more mess and is always needing the bathroom and I have to go with him and wait out side as he would not find his way back and often has an accident. I know he needs stimulation and to get out but it is getting so frustrating, especially when he asks when are we going out just after we get back….oh well….that's the way it is…..groan

It took a while for my mother to surrender to the fact that she has to go with me, and she cannot stay home alone so only once in a while does she act out.
She was isolated in the facility where she lived. Now that she is with me she enjoys the interaction in stores and restaurants and gathers a lot of attention being the old lady that everyone makes over.
She always says she doesn't want her hair cut, she's is not going to get her hair cut, and I say that she doesn't have a choice because I can't take care of her hair if it gets too long.
She fights more at home with me and admits she has little concern for others' feelings so my neighbors all deserve to be sainted. I think it is important my mother understands that there are still some normal things in life she still needs to do and cannot control. It comes under the safety umbrella and she knows I will do my best to keep her safe.

Icohen6825 - that's a great question and deserves its own topic: What do you do when your Dad, who has Alzheimer's starts to talk in a sexually suggestive manner to women in his assisted living facility?